TY - JOUR
T1 - Therapies for Cognitive Deficits Associated with Chemotherapy for Breast Cancer
T2 - A Systematic Review of Objective Outcomes
AU - Morean, Diane F.
AU - O'Dwyer, Linda
AU - Cherney, Leora R.
N1 - Funding Information:
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.
Publisher Copyright:
© 2015 American Congress of Rehabilitation Medicine.
PY - 2015/10
Y1 - 2015/10
N2 - 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.
AB - 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.
KW - Attention
KW - Breast neoplasms
KW - Cognition
KW - Drug therapy
KW - Mental processes
KW - Psychological tests
KW - Rehabilitation
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U2 - 10.1016/j.apmr.2015.05.012
DO - 10.1016/j.apmr.2015.05.012
M3 - Review article
C2 - 26026579
AN - SCOPUS:84943815397
SN - 0003-9993
VL - 96
SP - 1880
EP - 1897
JO - Archives of physical medicine and rehabilitation
JF - Archives of physical medicine and rehabilitation
IS - 10
ER -
