TREATMENT FOR CHEMOBRAIN

In a new study, UCLA researchers have developed a cognitive rehabilitation program to address post-treatment cognitive changes, sometimes known as “chemobrain,” which can affect up to 35% of post-treatment breast cancer patients. Their findings were reported by Erocli et al in Psycho-Oncology.

An estimated one in eight women will develop invasive breast cancer in their lifetime. Post-treatment, the common mental “fogginess” known as chemobrain can prevent them from staying organized and completing everyday activities, such as sticking to a schedule, planning a family gathering, or remembering where they left the car keys.

This new study, led by UCLA Jonsson Comprehensive Cancer Center member Patricia Ganz, MD, builds upon her earlier research, which found a statistically significant association between neuropsychological test performance and memory complaints in post-treatment, early-stage breast cancer patients.

Study Details

“We invited the women to participate in a research study that assigned them to either early or delayed treatment, with a 5-week, 2-hour group training session. In the session, a psychologist taught them strategies to help them with their memory and maintaining their ability to pay attention to things,” said Dr. Ganz, Director of Prevention and Control Research at Jonsson. “These are activities we call executive function and planning—the things all of us do in order to organize our day.”

Linda Ercoli, PhD, Associate Clinical Professor of Health Sciences at the UCLA Semel Institute, was responsible for the development of the cognitive rehabilitation intervention program, and either delivered or supervised the group training sessions.

“We gave women exercises on how to remember a to-do list, remembering to buy items at the store, or planning a party and deciding what type of food should be served to guests,” said Dr. Ercoli, a coauthor of the study. “Participants were given real-life tasks to complete that would use these types of strategies to improve cognitive function.”

The intervention program also included homework and practice activities that they would discuss at the weekly sessions.

Study Findings 

All of the women who participated in the research study, whether they received the intervention early or at a delayed time point, completed questions about their mood and mental functioning. They also had detailed neurocognitive testing before learning which group they would be in, immediately after the end of the 5 weeks of training and then 2 months later. Most of the women also had resting electroencephalography (EEG) testing, to see if this could measure changes in how the women fared throughout the study.

Dr. Ganz and Dr. Ercoli found that the early intervention group (32 women) reported improvement in memory complaints and test functioning, while the delayed intervention control group (16 women), did not improve in either their cognitive complaints or test performance. The intervention group participants showed continued improvement 2 months after completion of the rehabilitation program.

“The brain wave pattern in the intervention group actually normalized,” said Dr. Ganz. “We hope that this might be an effective biologic way to assess the cognitive effects of cancer treatment in the future.”

The next steps are for other researchers to test out this cognitive rehabilitation program in larger numbers of patients, and to potentially develop strategies to provide intervention much earlier in the course of breast cancer treatment, to either prevent difficulties or hasten recovery.

Dr. Ercoli is the corresponding author for the Psycho-Oncology article.

The study was supported by the Breast Cancer Research Foundation and the Jonsson Comprehensive Cancer Center Foundation.