Cognitive Training for Improving Executive Function in Chemotherapy-Treated Breast Cancer Survivors
Open accessAbstract
Background A majority of breast cancer (BC) survivors, particularly those treated with chemotherapy, experience long-term cognitive deficits that significantly reduce quality of life. Among the cognitive domains most commonly affected include executive functions (EF), such as working memory, cognitive flexibility, multitasking, planning, and attention. Previous studies in other populations have shown that cognitive training, a behavioral method for treating cognitive deficits, can result in significant improvements in a number of cognitive skills, including EF.Materials and methods In this study, we conducted a randomized controlled trial to investigate the feasibility and preliminary effectiveness of a novel, online EF training program in long-term BC survivors. A total of 41 BC survivors (21 active, 20 wait list) completed the 48 session training program over 12 weeks. The participants were, on average, 6 years after therapy.Results Cognitive training led to significant improvements in cognitive flexibility, verbal fluency and processing speed, with marginally significant downstream improvements in verbal memory as assessed via standardized measures. Self-ratings of EF skills, including planning, organizing, and task monitoring, also were improved in the active group compared with the wait list group.Conclusions Our findings suggest that EF skills may be improved even in long-term survivors by using a computerized, home-based intervention program. These improvements may potentially include subjective EF skills, which suggest a transfer of the training program to real-world behaviors.
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Treatment type is known to impact executive functioning, an important mechanism in emotion regulation processes.
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Janelsins, M. C., Kesler, S. R., Ahles, T. A., & Morrow, G. R. (2014) · International Review of Psychiatry · doi:10.3109/09540261.2013.864260 · Cited by 750 · see citing works
Self-citationLange, M., Joly, F., Vardy, J. L., Ahles, T. A., Dubois, M., Tron, L., Winocur, G., de Ruiter, M. B., & Castel, H. (2019) · Annals of Oncology · doi:10.1093/annonc/mdz410 · Cited by 703 · see citing works
“Two smaller cognitive training studies in breast cancer survivors also found improvement in cognitive complaints but reported improvement in some aspects of objective cognitive function [121, 122].”
BackgroundWefel, J. S., Kesler, S. R., Noll, K. R., & Schagen, S. B. (2014) · CA A Cancer Journal for Clinicians · doi:10.3322/caac.21258 · Cited by 546 · see citing works
“Studies of cognitive training for CRCI after breast cancer, although preliminary, suggest that executive function, memory, processing speed, selfrated cognition, anxiety, and depression can improve with as few as 10 hours of distributed training.(164,166,167) In 2012, Von Ah et al randomized 82 breast cancer survivors…”
BackgroundSelf-citationCognitive Effects of Cancer and Cancer Treatments
Ahles, T. A., & Root, J. C. (2018) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050817-084903 · Cited by 373 · see citing works
Diamond, A. D., & Ling, D. S. (2019) · Oxford University Press eBooks · doi:10.1093/oso/9780199974467.003.0008 · Cited by 290 · see citing works
Psychological Aspects to Consider in Breast Cancer Diagnosis and Treatment
Dinapoli, L., Colloca, G., Di Capua, B., & Valentini, V. (2021) · Current Oncology Reports · doi:10.1007/s11912-021-01049-3 · Cited by 223 · see citing works
Jacobson, J., & Matthaeus, L. (2014) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2014.05.005 · Cited by 216 · see citing works
“Researchers have employed various methods in the pursuit of improving EF (e.g., Diamond & Lee, 2011; Kesler et al., 2013).”
MethodDoes cognitive functioning predict chronic pain? Results from a prospective surgical cohort
Attal, N., Masselin-Dubois, A., Martinez, V., Jayr, C., Albi, A., Fermanian, J., Bouhassira, D., & Baudic, S. (2014) · Brain · doi:10.1093/brain/awt354 · Cited by 204 · see citing works
“working memory, attentional processing or cognitive flexibility) (Kesler et al., 2013).”
BackgroundBray, V. J., Dhillon, H. M., Bell, M. L., Kabourakis, M., Fiero, M. H., Yip, D., Boyle, F., Price, M. A., & Vardy, J. L. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2016.67.8201 · Cited by 182 · see citing works
“Sex Female 116 (96) 114 (94) Male 5 (4) 7 (6) Age, years, median (range) 52 (23-74) 54 (31-74) Married/de facto relationship Yes 95 (79) 97 (80) No 17 (14) 16 (13) Unknown 9 (7) 8 (7) Education, years, median (range) 14 (8-19) 12 (3-19) English as first language Yes 117 (97) 117 (97) No 4 (3) 4 (3) Smoking history Nev…”
Joly, F., Giffard, B., Rigal, O., de Ruiter, M. B., Small, B. J., Dubois, M., Fel, J. L., Schagen, S. B., Ahles, T. A., Wefel, J. S., et al. (2015) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2015.06.019 · Cited by 185 · see citing works
Bray, V., Dhillon, H. M., & Vardy, J. L. (2018) · Journal of Cancer Survivorship · doi:10.1007/s11764-018-0692-x · Cited by 184 · see citing works
Hardy, J. L., Nelson, R. A., Thomason, M. E., Sternberg, D. A., Katovich, K., Farzin, F., & Scanlon, M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0134467 · Cited by 183 · see citing works
“Previous studies using this program have demonstrated improvements in cognition in children with Turner’s Syndrome [25]; pediatric cancer survivors [26]; healthy middle-aged adults [27]; healthy older adults [28]; older adults with mild cognitive impairment [29]; and adult survivors of breast cancer [30].”
MethodCellular mechanisms and treatments for chemobrain: insight from aging and neurodegenerative diseases
Nguyen, L. D., & Ehrlich, B. E. (2020) · EMBO Molecular Medicine · doi:10.15252/emmm.202012075 · Cited by 176 · see citing works
“…current clinical approach is to refer cancer survivors to psychiatrists who can prescribe cognitive rehabilitation, changes to lifestyle, mind-training exercises, cognitive – behavioral therapy, and general coping strategies (Ferguson et al , 2012; Kesler et al , 2013; Henneghan & Harrison, 2015).”
Long-Term Cognitive Dysfunction in Cancer Survivors
Országhová, Z., Mego, M., & Chovanec, M. (2021) · Frontiers in Molecular Biosciences · doi:10.3389/fmolb.2021.770413 · Cited by 185 · see citing works
Faries, M. D. (2016) · American Journal of Lifestyle Medicine · doi:10.1177/1559827616638017 · Cited by 163 · see citing works
“Deficits in EF are presumably common in medical practice, because EF deficits have been found in adults and children classified as obese,(39,40) older adults,(41) and cancer survivors.(42) Subsequently, these”
BackgroundGamification: The Intersection between Behavior Analysis and Game Design Technologies
Morford, Z. H., Witts, B. N., Killingsworth, K., & Alavosius, M. P. (2014) · The Behavior Analyst · doi:10.1007/s40614-014-0006-1 · Cited by 158 · see citing works
“A similar study found significant improvements when participants were exposed to Lumosity ’ s games for cognitive flexibility, verbal fluency, and processing speed (Kesler et al. 2013).”
ResultManagement of side effects during and post-treatment in breast cancer survivors
Palesh, O. G., Scheiber, C., Kesler, S. R., Mustian, K. M., Koopman, C., & Schapira, L. (2017) · The Breast Journal · doi:10.1111/tbj.12862 · Cited by 153 · see citing works
Self-citationWeicker, J., Villringer, A., & Thöne-Otto, A. (2016) · Neuropsychology · doi:10.1037/neu0000227 · Cited by 147 · see citing works
Mayo, S. J., Lustberg, M. B., Dhillon, H. M., Nakamura, Z. M., Allen, D. H., Ah, D. M. V., Janelsins, M. C., Chan, A., Olson, K. L., Tan, C. J., et al. (2020) · Supportive Care in Cancer · doi:10.1007/s00520-020-05860-9 · Cited by 144 · see citing works
“Kesler 2013 [116] USA RCT n = 41 C = 20 I = 21 Breast cancer survivors, aged at least 40 years, ≥ 1.”
BackgroundSelf-citationDamholdt, M. F., Mehlsen, M. Y., O’Toole, M. S., Andreasen, R., Pedersen, A., & Zachariae, R. H. (2016) · Psycho-Oncology · doi:10.1002/pon.4058 · Cited by 138 · see citing works
“Whereas previous research on cognitive training for breast cancer survivors has focused on training specific cognitive functions, for example, executive functioning [10], memory and processing speed [31], memory and attention [32], we targeted several functions simultaneously, reflecting the array of cognitive complai…”
BackgroundInfluentialPark, H.-S., Kim, C., Kwak, H., No, M., Heo, J., & Kim, T.-W. (2018) · Neuropharmacology · doi:10.1016/j.neuropharm.2018.02.013 · Cited by 136 · see citing works
Magnuson, A. M., Sattar, S., Nightingale, G., Saracino, R. M., Skonecki, E., & Trevino, K. M. (2019) · American Society of Clinical Oncology Educational Book · doi:10.1200/edbk_237641 · Cited by 138 · see citing works
Chemotherapy-related cognitive impairment in older patients with cancer
Loh, K. P., Janelsins, M. C., Mohile, S. G., Holmes, H. M., Hsu, T., Inouye, S. K., Karuturi, M. S., Kimmick, G. G., Lichtman, S. M., Magnuson, A. M., et al. (2016) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2016.04.008 · Cited by 127 · see citing works
Self-citationErcoli, L. M., Petersen, L., Hunter, A. M., Castellon, S. A., Kwan, L. C., Kahn-Mills, B. A., Embree, L. M., Cernin, P. A., Leuchter, A. F., & Ganz, P. A. (2015) · Psycho-Oncology · doi:10.1002/pon.3769 · Cited by 122 · see citing works
“In two other randomized clinical trials for long-term cancer survivors, computerized training was shown to improve processing speed, memory or executive functions [33,34].”
BackgroundCognition and Cognitive Impairment in Older Adults with Cancer
Magnuson, A. M., Mohile, S. G., & Janelsins, M. C. (2016) · Current Geriatrics Reports · doi:10.1007/s13670-016-0182-9 · Cited by 101 · see citing works
Self-citationDynamics of the human structural connectome underlying working memory training
Caeyenberghs, K., Metzler-Baddeley, C., Foley, S., & Jones, D. K. (2016) · The Journal of Neuroscience · doi:10.1523/jneurosci.1973-15.2016 · Cited by 91 · see citing works
Cognitive rehabilitation for cancer-related cognitive dysfunction: a systematic review
Fernandes, H. A., Richard, N. M., & Edelstein, K. (2019) · Supportive Care in Cancer · doi:10.1007/s00520-019-04866-2 · Cited by 108 · see citing works
A Systematic Review of Commercial Cognitive Training Devices: Implications for Use in Sport
Harris, D., Wilson, M., & Vine, S. J. (2018) · Frontiers in Psychology · doi:10.3389/fpsyg.2018.00709 · Cited by 97 · see citing works
“Across the studies there was good support for the benefits of Lumosity training for near transfer in several cognitive functions, such as speed of processing (Ballesteros et al., 2014), working memory (Hardy et al., 2011), and executive function (Kesler et al., 2013).”
MethodChan, R. J., McCarthy, A. L., Devenish, J., Sullivan, K. A., & Chan, A. (2015) · European Journal of Cancer · doi:10.1016/j.ejca.2014.12.017 · Cited by 96 · see citing works
“Kesler (2013) [39] USA Breast CA: Both arms: 100%”
BackgroundInfluentialChemotherapy and cognition: comprehensive review on doxorubicin-induced chemobrain
El-Agamy, S. E., Abdel‐Aziz, A. K., Esmat, A., & Azab, S. S. (2019) · Cancer Chemotherapy and Pharmacology · doi:10.1007/s00280-019-03827-0 · Cited by 96 · see citing works
Cognitive adverse effects of chemotherapy and immunotherapy: are interventions within reach?
Schagen, S. B., Tsvetkov, A. S., Compter, A., & Wefel, J. S. (2022) · Nature Reviews Neurology · doi:10.1038/s41582-021-00617-2 · Cited by 98 · see citing works
Non-pharmacological interventions for cognitive impairment due to systemic cancer treatment
Treanor, C., McMenamin, Ú. C., O'Neill, R. F., Cardwell, C. R., Clarke, M. J., Cantwell, M. M., & Donnelly, M. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011325.pub2 · Cited by 94 · see citing works
Cleland, S. E., Wyatt, L. H., Wei, L. I. C., Paul, N., Serre, M. L., West, J. J., Henderson, S. B., & Rappold, A. G. (2022) · Environmental Health Perspectives · doi:10.1289/ehp10498 · Cited by 94 · see citing works
“Use of Lumosity has been associated with improved performance in other neuropsychological tests, 35,36,76 – 78 and brain-training games can improve performance on tasks involving similar cognitive domains (as reviewed by Simons et al. 79 and Smid et al. 80 ).”
Byrom, B., Carthy, M. M., Schueler, P., & Muehlhausen, W. (2018) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt.1077 · Cited by 90 · see citing works
“Some clinical research studies have shown positive improvements of executive function associated with brain training, for example, in reducing the cognitive deficits associated with chemotherapy in breast cancer survivors.(7) Also popular in the consumer market are applications enabling brain training through neurofee…”
BackgroundSchmidt, J. E., Beckjord, E. B., Bovbjerg, D. H., Low, C. A., Posluszny, D. M., Lowery, A. E., Dew, M. A., Nutt, S., Arvey, S. R., & Rechis, R. (2015) · Journal of Cancer Survivorship · doi:10.1007/s11764-015-0476-5 · Cited by 89 · see citing works
“Research in medical populations is still being developed, and recent studies have demonstrated benefit of these programs on cognitive functioning in breast cancer survivors [58], childhood cancer survivors [59], and individuals with mild 0% 10% 20% 30% 40% 50% 60% 70% 80% 90%”
Janelsins, M. C., Peppone, L. J., Heckler, C. E., Kesler, S. R., Sprod, L. K., Atkins, J. N., Melnik, M., Kamen, C. S., Giguere, J. K., Messino, M. J., et al. (2015) · Integrative Cancer Therapies · doi:10.1177/1534735415617021 · Cited by 87 · see citing works
“For example, cognitive training of memory in cancer survivors also improved depression.(43) Another cognitive training study showed improvements in anxiety and depression following similar cognitive training exercises.”
BackgroundSelf-citationCognitive Effects of Chemotherapy and Cancer-Related Treatments in Older Adults
Vega, J. N., Dumas, J. A., & NEWHOUSE, P. A. (2017) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2017.04.001 · Cited by 86 · see citing works
Pereira Dias, G., Hollywood, R., Bevilaqua, M. C. D. N., da Silveira da Luz, A. C. D., Hindges, R., Nardi, A. E., & Thuret, S. (2014) · Neuro-Oncology · doi:10.1093/neuonc/not321 · Cited by 85 · see citing works
Mackin, R. S., Insel, P. S., Truran, D., Finley, S., Flenniken, D., Nosheny, R. L., Ulbright, A., Comacho, M., Bickford, D. D., Harel, B. T., et al. (2018) · Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring · doi:10.1016/j.dadm.2018.05.005 · Cited by 83 · see citing works
Lee, K., Kim, S., Kim, S. H., Yoo, S., Sung, J. H., Oh, E. G., Kim, N. W., & Lee, J. (2023) · Journal of Medical Internet Research · doi:10.2196/38333 · Cited by 79 · see citing works
Task-based neurofeedback training: A novel approach toward training executive functions
Hosseini, S. M. H., Pritchard‐Berman, M., Sosa, N., Ceja, A., & Kesler, S. R. (2016) · NeuroImage · doi:10.1016/j.neuroimage.2016.03.035 · Cited by 80 · see citing works
Self-citationWilliams, A. M., Zent, C. S., & Janelsins, M. C. (2016) · British Journal of Haematology · doi:10.1111/bjh.14211 · Cited by 80 · see citing works
“These toxic effects can include altered brain metabolism, DNA damage and telomere shortening, resulting in long-lasting and irreversible decreases in cognitive function (Ahles & Saykin, 2007; Dutta, 2011; Koppelmans et al, 2013).”
BackgroundSelf-citationEvidence-Based Interventions for Cancer- and Treatment-Related Cognitive Impairment
Ah, D. M. V., Jansen, C. E., & Allen, D. H. (2014) · Clinical journal of oncology nursing · doi:10.1188/14.cjon.s3.17-25 · Cited by 79 · see citing works
“…Cognitive training: group (Hassler et al., 2010; Poppelreuter et al., 2009; Von Ah et al., 2012) • Cognitive training: individual (Gehring et al., 2009; Kesler et al., 2013; Miotto et al., 2013; Zucchella et al., 2013) Effectiveness Not Established • Cognitive-behavioral training (Cherrier et al.,…”
InfluentialThe effect of cancer treatment on cognitive function.
Asher, A., & Myers, J. S. (2015) · PubMed · Cited by 78 · see citing works
Sharafeldin, N., Bosworth, A., Patel, S. K., Chen, Y., Morse, E., Mather, M. A., Sun, C., Francisco, L., Forman, S. J., Wong, F. L., et al. (2017) · Journal of Clinical Oncology · doi:10.1200/jco.2017.74.2270 · Cited by 78 · see citing works
Why Are Objective and Perceived Cognitive Function Weakly Correlated in Patients With Cancer?
Costa, D. S. J., & Fardell, J. E. (2019) · Journal of Clinical Oncology · doi:10.1200/jco.18.02363 · Cited by 78 · see citing works
Gettens, K. M., & Gorin, A. A. (2017) · Journal of Behavioral Medicine · doi:10.1007/s10865-017-9831-5 · Cited by 75 · see citing works
“…clinical populations, including binge eating disorder (BED), breast cancer patients, pediatric overweight and obesity, and ADHD patients (Grilo & Masheb, 2005; Halperin et al., 2013; Hannesdottir et al., 2014; Juarascio, et al., 2015; Kesler et al., 2013; Tamm et al., 2014; Verbeken et al., 2013).”
BackgroundKing, S. H., & Green, H. J. (2015) · Frontiers in Oncology · doi:10.3389/fonc.2015.00072 · Cited by 74 · see citing works
“Research has supported beneficial effects of psychological interventions for cancer-related cognitive impairment in studies of mixed tumor types (75, 81, 84, 87) as well as in studies limited to women treated for breast cancer (82, 83, 85, 86, 88, 89).”
BackgroundRecovery from chemotherapy-induced white matter changes in young breast cancer survivors?
Billiet, T., Emsell, L., Vandenbulcke, M., Peeters, R., Christiaens, D., Leemans, A., Van Hecke, W., Smeets, A., Amant, F., Sunaert, S., et al. (2018) · Brain Imaging and Behavior · doi:10.1007/s11682-016-9665-8 · Cited by 81 · see citing works
Santos, M. D., Hardy‐Léger, I., Rigal, O., Licaj, I., Dauchy, S., Lévy, C., Noal, S., Ségura, C., Delcambre, C., Allouache, D., et al. (2020) · Cancer · doi:10.1002/cncr.33186 · Cited by 74 · see citing works
Cognitive impairment and chemotherapy: a brief overview
Vitali, M., Ripamonti, C. I., Roila, F., Proto, C., Signorelli, D., Imbimbo, M., Corrao, G., Brissa, A., Gallucci, R., de Braud, F., et al. (2017) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2017.08.001 · Cited by 69 · see citing works
Feng, Y., Zhang, X. D., Zheng, G., & Zhang, L. J. (2019) · Brain Imaging and Behavior · doi:10.1007/s11682-019-00074-y · Cited by 64 · see citing works
“Thus, the early accurate diagnosis of chemotherapy induced cognitive impairment is crucial for guiding clinical preventive management and the later functional exercise in breast cancer survivors (Kesler et al. 2013a).”
BackgroundZeng, Y., Dong, J., Huang, M., Zhang, J.-E., Zhang, X., Xie, M., & Wefel, J. S. (2020) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2019.103514 · Cited by 67 · see citing works
Post-treatment Neurocognition and Psychosocial Care Among Breast Cancer Survivors
Buchanan, N. D., Dasari, S. R., Rodriguez, J. L., Smith, J. L., Hodgson, M. E., Weinberg, C. R., & Sandler, D. P. (2015) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2015.08.013 · Cited by 64 · see citing works
Gokal, K., Munir, F., Ahmed, S. I., Kancherla, K., & Wallis, D. J. (2018) · PLoS ONE · doi:10.1371/journal.pone.0206874 · Cited by 62 · see citing works
“Mixed effects on objective cognitive function have been found post-treatment in breast cancer survivors, through the implementation of cognitive behavioural training [26], memory and health training [30], cognitive training [27], [29] and physical activity [32], [33], [36], [38], [39].”
BackgroundBellens, A., Roelant, E., Sabbe, B., Peeters, M., & van Dam, P. A. (2020) · The Breast · doi:10.1016/j.breast.2020.06.003 · Cited by 60 · see citing works
Cognitive Function in Older Adults With Cancer: Assessment, Management, and Research Opportunities
Magnuson, A. M., Ahles, T. A., Chen, B. T., Mandelblatt, J. S., & Janelsins, M. C. (2021) · Journal of Clinical Oncology · doi:10.1200/jco.21.00239 · Cited by 62 · see citing works
Self-citationWinocur, G., Johnston, I., & Castel, H. (2018) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2018.05.017 · Cited by 60 · see citing works
A narrative review of risk factors and interventions for cancer- related cognitive impairment
Bai, L., & Yu, E. (2021) · Annals of Translational Medicine · doi:10.21037/atm-20-6443 · Cited by 58 · see citing works
“The areas consist of executive functioning, working memory, attention, memory, processing speed, and visual-spatial skills were found to be improved due to the intervention (121,122).”
BackgroundInterventions for Cognitive Deficits in Breast Cancer Survivors Treated With Chemotherapy
Vance, D. E., Sandson, J., Bail, J. R., Triebel, K. L., Niccolai, L. M., Gerstenecker, A. T., & Meneses, K. (2016) · Cancer Nursing · doi:10.1097/ncc.0000000000000349 · Cited by 58 · see citing works
Web‐based cognitive rehabilitation for survivors of adult cancer: A randomised controlled trial
Mihuta, M. E., Green, H. J., & Shum, D. (2017) · Psycho-Oncology · doi:10.1002/pon.4615 · Cited by 58 · see citing works
“Improved objective executive functioning, processing speed, and verbal fluency and improved subjective executive functioning skills were reported in the treatment group postintervention.(14) In another study, Damholdt and colleagues recruited 157 breast cancer survivors and randomly allocated 94 to Web‐based CT with e…”
BackgroundMethodCheng, H., Li, W., Chen, G., Zhang, B., Jia, Q., & Wang, K. (2016) · PubMed Central · Cited by 56 · see citing works
Lange, M., Heutte, N., Morel, N., Eustache, F., Joly, F., & Giffard, B. (2015) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2015.1036890 · Cited by 52 · see citing works
“, 2006) and with other questionnaires of cognitive complaints among cancer patients (Berman et al., 2013; Castellon et al., 2004; Kesler et al., 2013).”
BackgroundMethodSalerno, E. A., Rowland, K. M., Kramer, A. F., & McAuley, E. (2019) · BMC Cancer · doi:10.1186/s12885-019-5589-1 · Cited by 53 · see citing works
Piecewise power laws in individual learning curves
Donner, Y., & Hardy, J. L. (2015) · Psychonomic Bulletin & Review · doi:10.3758/s13423-015-0811-x · Cited by 51 · see citing works
“These tasks are described more thoroughly elsewhere (Kesler et al., 2013; Mayas, Parmentier, Andrés, & Ballesteros, 2014; Sternberg et al., 2013).”
MethodTringale, K. R., Nguyen, T. T., Bahrami, N., Marshall, D. C., Leyden, K. M., Karunamuni, R. A., Seibert, T. M., Gorman, M. K., Connor, M. J., Jr., Burkeen, J., et al. (2018) · Radiotherapy and Oncology · doi:10.1016/j.radonc.2018.11.018 · Cited by 51 · see citing works
“, psychostimulants)[38] during a critical period and before permanent injury has occurred[39].”
BackgroundAh, D. M. V., & Crouch, A. (2020) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2019.150977 · Cited by 50 · see citing works
Cognitive behavioral therapy for cancer-related cognitive dysfunction
Kucherer, S., & Ferguson, R. J. (2016) · Current Opinion in Supportive and Palliative Care · doi:10.1097/spc.0000000000000247 · Cited by 49 · see citing works
Brown, T., Sykes, D., & Allen, A. R. (2021) · Biomedicines · doi:10.3390/biomedicines9020189 · Cited by 49 · see citing works
Chemobrain in Breast Cancer: Mechanisms, Clinical Manifestations, and Potential Interventions
Onzi, G. R., D’Agustini, N., García, S. C., Guterres, S. S., Pohlmann, P. R., Rosa, D. D., & Pohlmann, A. R. (2022) · Drug Safety · doi:10.1007/s40264-022-01182-3 · Cited by 48 · see citing works
Pergolotti, M., Battisti, N. M. L., Padgett, L. S., Sleight, A. G., Abdallah, M. M., Newman, R. M., Dyk, K. V., Covington, K. R., Williams, G. R., van den Bos, F., et al. (2019) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2019.09.002 · Cited by 47 · see citing works
“computer-based exercises aimed at increasing executive function skills such as cognitive flexibility, processing speed, working memory, and verbal fluency [140,141].”
BackgroundPark, J., Jung, Y. S., Kim, K. S., & Bae, S. H. (2017) · Supportive Care in Cancer · doi:10.1007/s00520-017-3589-8 · Cited by 46 · see citing works
Optimizing Cognitive Function in Persons With Chronic Pain
Baker, K. S., Georgiou‐Karistianis, N., Gibson, S. J., & Giummarra, M. J. (2016) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000423 · Cited by 44 · see citing works
Ding, K., Zhang, X., Zhao, J., Zuo, H., Bi, Z., & Cheng, H. (2020) · Integrative Cancer Therapies · doi:10.1177/1534735420938450 · Cited by 45 · see citing works
Morean, D. F., O’Dwyer, L., & Cherney, L. R. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.05.012 · Cited by 44 · see citing works
Wu, L. M., Amidi, A., Tanenbaum, M. L., Winkel, G. H., Gordon, W. A., Hall, S. J., Bovbjerg, K., & Diefenbach, M. A. (2017) · Supportive Care in Cancer · doi:10.1007/s00520-017-4026-8 · Cited by 44 · see citing works
“In two breast cancer CCT trials—one that targeted speed of processing (using BrainHQ) and memory and the other that targeted executive functioning—CCT led to domain-specific cognitive improvements that transferred to higher-level cognitive functions, symptom distress and quality of life in the former, and self-reporte…”
BackgroundResultMindfulness-Based Stress Reduction on breast cancer symptoms: systematic review and meta-analysis
Castanhel, F. D., & Liberali, R. (2018) · Einstein (São Paulo) · doi:10.31744/einstein_journal/2018rw4383 · Cited by 45 · see citing works
“(48) Between 17% and 75% of patients with breast cancer, who perform chemotherapy, showed altered brain structure and function which suggests a pattern of diffuse brain injury that underlies the cognitive deficits that may occur during the first 6 months, followed by a recovery of 1 to 2 years and/or a period of stabi…”
BackgroundTraining cognitive control to reduce emotional vulnerability in breast cancer
Swainston, J., & Derakshan, N. (2018) · Psycho-Oncology · doi:10.1002/pon.4727 · Cited by 42 · see citing works
Neuropsychological Practice in the Oncology Setting
Noll, K. R., Bradshaw, M. E., Rexer, J. L., & Wefel, J. S. (2017) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acx131 · Cited by 41 · see citing works
“For those with “chemobrain” and other cancer-related cognitive issues, cognitive training may be beneficial (Kesler et al., 2013; Morean, O’Dwyer, & Cherney, 2015).”
BackgroundMustian, K. M., Cole, C. L., Lin, P., Asare, M., Fung, C., Janelsins, M. C., Kamen, C. S., Peppone, L. J., & Magnuson, A. M. (2016) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2016.09.002 · Cited by 39 · see citing works
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Cheng, A. S. K., Wang, X., Niu, N., Liang, M., & Zeng, Y. (2022) · Neuropsychology Review · doi:10.1007/s11065-021-09532-1 · Cited by 41 · see citing works
Shining the Light of Research on Lumosity
Bainbridge, K., & Mayer, R. E. (2017) · Journal of Cognitive Enhancement · doi:10.1007/s41465-017-0040-5 · Cited by 39 · see citing works
“en receiving chemotherapy for breast cancer, in 48 sessions spread over 12 weeks, using Lumosity games (Kesler et al. 2013).”
BackgroundMethodInfluentialLiou, K. T., Root, J. C., Garland, S. N., Green, J. A., Li, Y., Li, Q. S., Kantoff, P. W., Ahles, T. A., & Mao, J. J. J. (2020) · Cancer · doi:10.1002/cncr.32847 · Cited by 39 · see citing works
Zeng, Y., Cheng, A. S. K., & Chan, C. C. H. (2016) · Integrative Cancer Therapies · doi:10.1177/1534735416638737 · Cited by 38 · see citing works
“For example, CT interventions by an online and home-based program significantly improved multiple executive function skills, as reported by objective and self-report measures.(14) CR interventions have positive effects in formal neurocognitive tests, such as the domains of immediate and delayed memory by RBANS, and se…”
BackgroundIulio, F. D., Cravello, L., Shofany, J., Paolucci, S., Caltagirone, C., & Morone, G. (2019) · Neurological Sciences · doi:10.1007/s10072-019-03898-0 · Cited by 37 · see citing works
Cognitive Changes Associated With Cancer and Cancer Treatment: State of the Science
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“, 2008; McDougall, 2001; McDougall, Becker, Acee, Vaughan, & Delville, 2011; Schuurs & Green, 2012; Sherer, Meyers, & Bergloff, 1997), cognitive training (Gehring et al., 2009; Hassler et al., 2010; Kesler et al., 2013; Miotto et al., 2013; Poppelreuter, Weis, & Bartsch, 2009; Von Ah et al., 2012; Zucchella et al., 20…”
Neurocognitive Effects Following Cranial Irradiation for Brain Metastases
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Improvement of quality of life and psychological distress after inpatient cancer rehabilitation
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“Studies investigating brain‐training were heterogenous, with some including patients with cognitive impairment(57,77) and others not.(76) In addition, brain‐training interventions were administered either during chemotherapy,(77) once chemotherapy is completed,(78) or up to 5 years following treatment.”
BackgroundMethodResultInfluentialSymptoms: Fatigue and Cognitive Dysfunction
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“Indeed, several studies of breast cancer patients have demonstrated relationships between systemic levels of infl ammation and brain imaging structural and metabolic changes (Kesler et al. 2013b ; Pomykala et al. 2013 ).”
BackgroundBaseline Cognition Assessment Among Patients With Oropharyngeal Cancer Using PROMIS and NIH Toolbox
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MACKENZIE, L., & MARSHALL, K. (2021) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.21.06898-2 · Cited by 31 · see citing works
- Authors
- Kesler, S., Hadi Hosseini, S. M., Heckler, C., Janelsins, M., Palesh, O., Mustian, K., & Morrow, G.
- Affiliations
- Stanford Medicine (US)
- University of Rochester Medicine (US)
- Corresponding author
- Kesler, Shelli
- Venue
- Clinical Breast Cancer
- Publisher
- Elsevier BV
- Published
- 2013-08
- Volume
- 13
- Issue
- 4
- Pages
- 299-306
- ISSN
- 1526-8209 (ISSN-L)
- PMC
- PMC3726272
- OpenAlex
- W1988359564
- Cited by
- 300
- References
- 71
- Citations by year
- 2026: 10 · 2025: 19 · 2024: 20 · 2023: 19 · 2022: 23 · 2021: 26 · 2020: 25 · 2019: 34 · 2018: 22 · 2017: 29 · 2016: 29 · 2015: 25 · 2014: 17 · 2012: 1
- FWCI
- 19.24
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Breast Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Johns Hopkins University
- National Institutes of Health (1dp2od004445-01)
- National Cancer Institute (K07CA168886)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- cognitive training, executive function, breast cancer survivors, chemotherapy, cognitive impairment, cognitive flexibility, verbal fluency, processing speed, verbal memory, online intervention, home-based intervention, feasibility, quality of life
- MeSH terms
- Adult, Breast Neoplasms, Cognition Disorders, Feasibility Studies, Female, Follow-Up Studies, Health Promotion, Humans, Middle Aged, Prognosis, Quality of Life, Cognitive Behavioral Therapy, Survivors, Executive Function
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