Abstract
Objective To systematically review evidence of treatments for cognitive impairments experienced by at least 20% of all women who undergo chemotherapy for breast cancer. Data Sources Searches of 5 databases (PubMed, Embase, Cochrane CENTRAL, PsycINFO, CINAHL), with no date or language restrictions, identified 1701 unique results. Search terms included breast cancer, chemotherapy, chemobrain, chemofog, and terms on cognition and language deficits. Study Selection Included only peer-reviewed journal articles that described therapies for cognitive dysfunction in women undergoing (or who had undergone) chemotherapy for breast cancer and provided objective measurements of cognition or language. Data Extraction Data were extracted according to Cochrane recommendations, including characteristics of participants, interventions, outcomes, and studies. Quality assessment of all 12 eligible studies was performed using the Physiotherapy Evidence Database scale and treatment fidelity criteria. Screening, data extraction, and quality assessment reliability were performed. Data Synthesis Six articles described interventions for cognition that took place during cancer treatment; 6, afterward. Five interventions were medical (including a strength-training program), 2 were restorative, and 5 were cognitive. Medicinal treatments were ineffective; restorative and exercise treatments had mixed results; cognitive therapy had success in varying cognitive domains. The domains most tested and most successfully treated were verbal memory, attention, and processing speed. Conclusions Cognitive therapy protocols delivered after chemotherapy and aimed at improving verbal memory, attention, and processing speed hold the most promise. Future research is needed to clarify whether computerized cognitive training can be effective in treating this population, and to identify objective assessment tools that are sensitive to this disorder.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1880-1897 |
| Number of pages | 18 |
| Journal | Archives of physical medicine and rehabilitation |
| Volume | 96 |
| Issue number | 10 |
| DOIs | |
| State | Published - Oct 2015 |
Funding
Supported by an Advanced Rehabilitation Research Training Award: Interventions for Neurologic Communication Disorders (award no. H133P120013) from the National Institute on Disability and Rehabilitation Research within the Department of Education; the Northwestern University Clinical and Translational Science Institute; and the National Center for Advancing Translational Sciences, Clinical and Translational Sciences Award (grant no. UL1TR000150). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Clinical and Translational Science Award is a registered trademark of the U.S. Department of Health and Human Services.
Keywords
- Attention
- Breast neoplasms
- Cognition
- Drug therapy
- Mental processes
- Psychological tests
- Rehabilitation
ASJC Scopus subject areas
- Rehabilitation
- Physical Therapy, Sports Therapy and Rehabilitation
