A 78-year-old patient with a right hemispheric sensorimotor ischemic stroke suffered from problems in ownership of her left arm (somatoparaphrenia). After recovering from motor weakness, however, body ownership problems remained present. To assess whether disturbed feelings of ownership coincided with an enhanced or diminished susceptibility for gaining ownership over a foreign hand, we applied the 'Rubber Hand Illusion' (RHI) to the ipsi- and contralesional hand. The RHI was significantly stronger for the contralesional left arm than for the right arm. In addition, solely visual exposure to the left rubber hand was sufficient to elicit strong feelings of ownership over the rubber hand. These findings suggest that disturbances in the feeling of body ownership allow a foreign hand to be incorporated more easily.
Objective
Patients with breast cancer face cognitive impairment that affects their quality of life; partially attributable to treatment. Our aim was to detail the prevalence and change of cognitive impairment during the course of treatment. We also investigated the effect of therapy (chemotherapy [CT]) vs. radiotherapy and/or endocrine therapy vs. healthy controls).
Methods
This article reviews longitudinal cohort studies published to date in Medline and Embase that (i) assess cognition before and after therapy, (ii) report prevalence cognitive impairment or change, and (iii) use standardized and valid neuropsychological tests. We used the original authors' criteria for cognitive impairment.
Results
The title and abstract of 891 articles were screened, resulting in the identification of 90 potentially relevant articles while applying the eligibility criteria. After full‐text examination, 17 studies were included. Prevalence of cognitive impairment range from 25% before therapy, through 24% after therapy to 21% at maximal 1‐year follow‐up (FU). Compared to their pretreatment cognitive functioning, 24% of patients decline after treatment and 24% at 1‐year FU. Some studies also reported cognitive improvement showing that 15% and 31% of patients improve, respectively. In general, patients undergoing CT have a higher chance of cognitive impairment and decline than no‐CT patients and healthy controls.
Conclusions
This study shows that one out of four breast cancer patients shows cognitive impairment prior to treatment administration CT and a significant number of patients decline during the course of disease, suggesting that cognitive impairment is not exclusively related to CT and/or no‐CT therapies. This study shows that assessment of cognitive functioning, ideally over time, is crucial and may help the implementation of personalized rehabilitation pathways.
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