Department of Psychology, School of Social Sciences, Reykjavik University, Reykjavik, Iceland.
Department of Oncology, Aarhus University Hospital, Aarhus, Denmark.
Support Care Cancer. 2024 Jan 8;32(1):88. doi: 10.1007/s00520-023-08282-5.
Research suggests that cancer-related cognitive impairment (CRCI) can occur before breast cancer (BC) treatment. The limited extant evidence suggests the underlying mechanisms could be stress-related. Potential psychological and biological predictors of CRCI prior to any BC treatment were examined.
112 treatment-naïve women with BC and 67 healthy controls (HC) completed a neuropsychological test battery to assess cognitive impairment and a self-report battery to assess cognitive complaints, cancer-related stress, depressive and anxiety symptoms. Morning and evening cortisol and α-amylase were collected from saliva. Multilinear regressions were conducted.
Treatment-naïve BC patients were more frequently impaired in verbal memory and processing speed and reported more cognitive complaints (all p < .001) than HC. BC patients and HC did not differ in overall cognitive impairment (p = .21). Steeper α-amylase, lower cancer-related stress and younger age was associated with better overall cognitive function in treatment-naïve BC patients. Higher depressive symptoms predicted higher levels of cognitive complaints in BC patients.
Overall, these findings suggest that stress plays a role in CRCI. This study is the first to associate α-amylase with cognitive function in cancer patients, informing future research. The findings on impairment in processing speed and verbal memory among treatment-naïve BC highlight the need to screen for such impairments among BC patients and indicate that future studies on CRCI should include baseline assessments prior to BC treatment. If replicated, these findings could inform the development and testing of appropriate interventions to decrease CRCI among cancer patients.
NCT04418856, date of registration: 06.05.2020.
研究表明，癌症相关认知障碍（CRCI）可能在乳腺癌（BC）治疗之前发生。有限的现有证据表明，潜在的机制可能与压力有关。本研究旨在检查 BC 治疗前潜在的心理和生物学预测因素。
112 名未经治疗的 BC 患者和 67 名健康对照组（HC）完成了神经心理测试，以评估认知障碍，并完成了自我报告的测试，以评估认知抱怨、癌症相关压力、抑郁和焦虑症状。从唾液中采集了清晨和傍晚的皮质醇和 α-淀粉酶。进行了多元线性回归。
未经治疗的 BC 患者在言语记忆和处理速度方面的损伤更为频繁，且报告的认知抱怨更多（均 p<0.001），而 HC 患者则没有（p=0.21）。在未经治疗的 BC 患者中，α-淀粉酶越高、癌症相关压力越低和年龄越小，整体认知功能越好。较高的抑郁症状预测 BC 患者的认知抱怨水平更高。
总体而言，这些发现表明压力在 CRCI 中起作用。本研究首次将 α-淀粉酶与癌症患者的认知功能相关联，为未来的研究提供了信息。在未经治疗的 BC 患者中，处理速度和言语记忆方面的损伤表明需要对 BC 患者进行此类损伤的筛查，并表明未来的 CRCI 研究应包括 BC 治疗前的基线评估。如果得到复制，这些发现可以为癌症患者的 CRCI 提供适当干预措施的开发和测试信息。
NCT04418856，注册日期：2020 年 5 月 6 日。
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