Computerized Cognitive Training Promising for Reducing Cognitive Late Effects in Childhood Cancer Survivors


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Cognitive Training in Cancer Survivors

Study findings show computerized cognitive training is feasible and efficacious for childhood cancer survivors, with evidence for training-related neuroplasticity.

—Heather M. Conklin, PhD, and colleagues

In a study reported in the Journal of Clinical Oncology, Heather M. Conklin, PhD, of St. Jude Children’s Research Hospital, and colleagues found that computerized cognitive training showed promise in reducing cognitive late effects in survivors of childhood cancer.1

Study Details

In the study, conducted at St. Jude Children’s Research Hospital, 68 survivors of childhood acute lymphoblastic leukemia or brain tumor with identified cognitive deficits were randomly assigned to a computerized cognitive intervention (n = 34, 18 male; mean age = 12.2 years) or wait list (n = 34, 18 male; mean age = 11.8 years). The intervention group was to complete 25 training sessions (30- to 45-minutes each) at home over 5 to 9 weeks, with weekly telephone-based coaching. Sessions consisted of ­visual-spatial and verbal working memory exercises presented as games; exercise difficulty was adjusted based on performance. Cognitive assessments and functional magnetic resonance imaging (MRI) scans (in the intervention group) were performed before and after intervention; immediate change in Wechsler Intelligence Scale for Children–4th edition (WISC-IV) spatial span backward was the primary outcome measure.

Improved Function

Compared with controls, the 30 survivors who completed the intervention showed significantly greater improvement in working memory (eg, P = .002, effect size = 0.84, for WISC-IV spatial span backward), attention (eg, P = .01, effect size = 0.65, for WISC-IV spatial span forward, and processing speed (eg, P = .02, effect size = 0.61, for Conners’ Continuous Performance Test hit reaction time), as well as a greater reduction in reported executive dysfunction (eg, P = .002, effect size = 0.84, for Conners’ Parent Rating Scale III). Functional MRI showed a significant reduction in activation of left lateral prefrontal and bilateral medial frontal areas.

The investigators concluded: “Study findings show computerized cognitive training is feasible and efficacious for childhood cancer survivors, with evidence for training-related ­neuroplasticity.” ■

Disclosure: The study was supported by the National Cancer Institute, American Cancer Society, and American Lebanese Syrian Associated Charities. For full disclosures of the study authors, visit jco.ascopubs.org.

Reference

1. Conklin HM, Ogg RJ, Ashford JM, et al: Computerized cognitive training for amelioration of cognitive late effects among childhood cancer survivors: A randomized controlled trial. J Clin Oncol 33:3894-3902, 2015.

 



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