Episodic Memory and Recollection Network Disruptions Following Chemotherapy Treatment in Breast Cancer Survivors: A Review of Neuroimaging Findings

Cognitive remediation in breast cancer survivors: A study protocol

Cancer treatment-related cognitive impairment, also known as "Chemobrain," is frequently reported among cancer survivors. This condition can persist for months after the end of cancer treatment and can affect various aspects of a patients' quality of life. Despite growing evidence, research into effective treatments remains an emerging field. This project aims to assess the effectiveness of a cognitive remediation protocol called Oncogite in reducing cancer treatment-related cognitive impairment. The primary outcomes are self-reported functional and emotional well-being. The secondary outcomes include measures of executive function (working memory, inhibition, shifting), episodic memory, perceived cognitive function and perceived quality of life. One hundred sixty-four breast cancer survivors will be recruited from an existing cohort. Patients will be randomized to either a cognitive remediation group or a no intervention group. Participation in the workshops will be via videoconferencing, led by a neuropsychologist. Patients in the experimental group will also have access to an internet platform with the exercises practiced between the group workshops. The intervention will last four months at a rate of one workshop per week. The following data will be collected: emotional and functional well-being, neurocognitive performance, switching, inhibition, cognitive complaints, episodic memory, fatigue and depression. We will conclude that the intervention is effective if there is 4-month improvement in both emotional and functional well-being to find in the experimental group in their cognitive functioning. This research will contribute to the development of new clinical tools for cancer treatment-related cognitive impairment and facilitate the return to work in cancer survivors.

Intranasal insulin effect on cognitive and/or memory impairment: a systematic review and meta-analysis

Background: Cognitive impairment, characterized by deficits in cognitive functions and loss of delayed and immediate recall, disproportionately affects individuals aged 65 years and older, particularly those with comorbid cardiovascular conditions such as hypertension and diabetes mellitus. Objective: This study aimed to investigate the potential association between intranasal insulin and cognitive and/or memory impairment, with a specific focus on delayed and immediate recall, considering the rising prevalence of cognitive disorders in the aging population. Methodology: Employing a rigorous systematic approach, we conducted a thorough search of MEDLINE, Scopus, the Cochrane database, and Web of Science from inception to November 23, 2022, identifying relevant randomized clinical trials. Our analyses encompassed three key aspects: (i) assessing the impact of intranasal insulin on cognitive impairment, (ii) evaluating its effect on delayed recall, and (iii) examining its influence on immediate recall. Results: Five studies meeting the inclusion criteria were included. The results underscored a statistically significant effect of intranasal insulin on delayed memory (effect size: 1.37; 95% CI: 0.65 to 2.09) and overall cognition (effect size: 0.58; 95% CI: 0.08 to 1.08). However, no statistically significant effect was observed for immediate memory (effect size: 0.48; 95% CI: -0.00 to 0.96). Conclusions: This study provides compelling evidence supporting the significance and efficacy of intranasal insulin in enhancing delayed recall and overall cognition. The observed effects hold promise for potential therapeutic interventions in addressing cognitive deficits associated with aging and comorbid conditions. The findings emphasize the need for further research to elucidate the underlying mechanisms and optimize the application of intranasal insulin in cognitive enhancement strategies.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11571-024-10138-5.

The relationship between psychological distress and cognitive failure among breast cancer survivors: a network analysis

Background

Psychological distress is highly prevalent and has a severe impact on the quality of life among breast cancer survivors. This type of distress is associated with cognitive failure. However, previous studies have focused solely on the total scale scores of these two concepts while ignoring the unique relationship between specific components. In the present study, we utilized network analysis to explore the relationship between psychological distress and cognitive failure in breast cancer survivors.

Methods

The network analysis approach was adopted to estimate the regularized partial correlation network in a cross-sectional sample of 409 breast cancer survivors. All participants were assessed using the Depression Anxiety Stress Scale and the Cognitive Failure Questionnaire. The Gaussian Graphical Model was employed to estimate the network, centrality indices, and edge weights, providing a description of the characteristics of the network.

Results

The results indicated that anxiety-stress and depression-stress were the strongest edges in the community of psychological distress. Distractibility-memory was the strongest edge in the community of cognitive failure. Distractibility and memory were the most central nodes, with the highest expected influence in the network. Depression and motor coordination acted as important bridge nodes with the highest bridge expected influence.

Conclusion

Distractibility and memory in cognitive failure played important roles in activating and maintaining the relationship network. Motor coordination was identified as the crucial pathway for the impact of cognitive failure on psychological distress. Interventions targeting these specific issues might be more effective in improving cognitive failure and reducing psychological distress among breast cancer survivors.

Investigating executive functioning and episodic future thinking in Iranian women with breast cancer

BACKGROUND

This study examined executive functioning and episodic future thinking among Iranian women with breast cancer.

METHOD

We recruited 40 healthy female community volunteers and 80 females with breast cancer (either currently undergoing chemotherapy n = 40 or not undergoing chemotherapy n = 40). Participants were assessed using cognitive tasks that assessed executive functioning and episodic future thinking and a measure of cancer-related fatigue.

RESULTS

Both cancer groups had poorer performance than controls on all measures of executive functioning and episodic future thinking. Those undergoing chemotherapy had poorer performance on all measures of executive functioning than those not undergoing chemotherapy. Cross-sectional mediation analyses revealed cancer-related fatigue had a significant mediator role between cancer group and executive functioning and episodic future thinking.

CONCLUSION

Those with breast cancer, particularly those undergoing chemotherapy, may be experiencing cognitive difficulties. These cognitive concerns should be considered by health teams as addressing these impairments may assist in improving quality of life and treatment adherence.