Introduction We investigated whether a web-based cognitive training video game is an effective approach to improve cognitive decline in combination with our standard of care for rehabilitation of breast cancer (BC) patients. Materials and methods Self-selected BC patients between 18 and 71 years old complaining of disturbing cognitive impairment were studied. The patients received access to a web-based internet video game and online cognitive assessments (Aquasnap, Cambridge, MyCQ™). The early intervention group (n = 23) had a training program of 6 months of at least three times a week for a minimum of 60 min of game playing per week at home in addition to standard of care rehabilitation. The delayed intervention (n = 23) received standard of care for three months, followed by three months of similar MyCQ training. Outcome measures were the MyCQ (sub)scores and Activity of Daily Life (ADL), mood, subjective cognition and functional cognitive status measured by classic neuropsychological tests. Results At baseline the means for CFQ (a measure of self-reported cognitive failure), anxiety, PSQI and self-reflectiveness were beyond normal range in both groups. CFQ improved significantly better in the intervention group (p = 0.029). Combining the evolution over time in the entire population a significant improvement was seen for overall MyCQ score, level of fear, physical and emotional role limitation, and health change (all p < 0.05), but self-reflectivess deteriorated (p < 0.05)). Significant differences in the various MyCQ subtests over time were: improved speed in choice reaction time, visual memory recognition, N back 1 and 2, coding, trail making test B, improved accuracy of N back 1 and 2 (all p < 0.05). Conclusion A program of cognitive training improves cognitive functioning over time. “Aquasnap” has a beneficial effect on the perception of subjective cognitive functioning (CFQ) but the exact role of video gaming in this process remains uncertain.
Background: Chemotherapy-induced nausea/vomiting (CINV) is one of the important adverse events which must be prevented. We usually use corticosteroid, 5-HT3 receptor blocker and NK-1 receptor blocker to prevent CINV of high emetogenic chemotherapy (HEC). NK-1 receptor blocker is an optional treatment to prevent CINV of MEC. But there are few reports about 5-HIAA/substance P (SP) of patients who received MEC. Methods: We measured the changes in plasma concentration of 5-HIAA/SP by collecting blood samples before and 4, 24, 48, 72, and 96 hours after chemotherapy from patients (pts) with gastrointestinal caner who are planned to receive HEC (for up to 5 pts in cohort 1, for validation of measurement) or MEC (cohort 2). We also collected patients' reported outcomes to record CINV using Visual Analog Scale (VAS). 5-HIAA was measured by SRL Inc. and SP was measured by KM assay center. Results: We could measure plasma concentration of both 5-HIAA and SP in all 3 consecutive HEC cases, and 36 pts of MEC were registered. One pts was ineligible and 4 did not write VAS, so 31 pts were fully analyzed. Delayed-phase nausea (DN) was occurred in 15 of 31 pts. The median rates of change (%) of plasma concentration of 5-HIAA in 4, 24, 48, 72, 96 hours after MEC administration compared with the baseline in pts "without" vs "with" DN were 131.04 vs 63.33 (p ¼ 0.0086), -2.17 vs 7.14 (p ¼ 0.46), -10.17 vs 9.30 (p ¼ 0.12), 5.17 vs 0.00 (p ¼ 1.00), 5.26 vs 2.29 (p ¼ 0.56), respectively. Those of SP were 9.46 vs 21.83 (p ¼ 0.61), -0.01 vs -0.30 (p ¼ 0.97), -2.74 vs -2.83 (p ¼ 0.99), 2.83 vs 2.78 (p ¼ 1.00), 4.59 vs -1.30 (p ¼ 0.59), respectively. Conclusions: Small change between 5-HIAA 4 hours after MEC and before administration might be an early predictive marker of DN. There was no significant difference in plasma SP concentration in the presence or absence of DN after administration of MEC.
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