Computerized cognitive training in prostate cancer patients on androgen deprivation therapy: a pilot study
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Prostate cancer patients who have undergone androgen deprivation therapy (ADT) may experience cognitive impairment, yet there is an unmet need for nonpharmacological interventions to address cognitive impairment in this population. This study examines the feasibility, acceptability, and preliminary efficacy of a home-based computerized cognitive training (CCT) program to treat cancer-related cognitive impairment.
Sixty men who had received ≥ 3 months of ADT were screened for at least mild cognitive or neurobehavioral impairment and randomized to 8 weeks of CCT or usual care. Follow-up assessments occurred immediately post-intervention or equivalent (T2) and 8 weeks later (T3). The acceptability of CCT was also assessed.
Feasibility:A priori feasibility thresholds were partially met (i.e., randomization rate > 50%, retention rate > 70% excluding CCT drop-outs, but < 70% for intent-to-treat). Acceptability: Participants were mostly satisfied with CCT and found it somewhat enjoyable, though barriers to uptake existed. Preliminary efficacy: Linear mixed models indicated significant time by group effects favorable to CCT in reaction time (p = .01), but unfavorable to CCT in verbal and visual memory (ps < .05). Memory was temporarily suppressed in the CCT group at T2, but normalized by T3. There was no effect of CCT on self-reported cognitive functioning, neurobehavioral functioning, nor quality of life.
This study provides tentative support for the feasibility and acceptability of CCT to treat mild cognitive impairment in ADT patients. CCT had a beneficial effect on reaction time, but temporarily suppressed memory. CCT’s benefits may be limited to a narrow area of functioning. Larger-scale studies are needed.
KeywordsOncology Hormone therapy Cancer-related cognitive impairment Cognition Computers Antiandrogens
We thank Posit Science and CNS Vital Signs for providing their programs to this study at no cost.
This work was supported by the American Cancer Society (L.W., grant no. PF-12-041-01-CPPB) and the National Cancer Institute of the National Institutes of Health (L.W., grant no. 5K07CA184145-03).
Compliance with ethical standards
Informed consent was obtained from all participants.
Conflicts of interest
Wu and Amidi report personal fees from Bayer Pharmaceutical outside the submitted work. The other authors have no conflicts of interest to declare. Wu has full control of all primary data and agrees to allow the journal to review this data if requested.
Content is solely the responsibility of the authors and does not necessarily represent the official view of the National Institutes of Health.
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