A video-game based cognitive training for breast cancer survivors with cognitive impairment: A prospective randomized pilot trial

Abstract

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.

Management of Cancer-Related Cognitive Impairment: A Systematic Review of Computerized Cognitive Stimulation and Computerized Physical Activity

“…After the full-text assessment, 20 studies were finally included in this review. Among the included studies, sixteen evaluated computerized cognitive stimulations [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] and four evaluated a computerized physical activity program [59][60][61][62]. Thirteen studies were randomized-control studies [44][45][46][47][48]51,[54][55][56][57][61][62][63] and seven pilot studies (reporting also efficacy of the intervention) [43,49,50,52,53,58,60].…”

“…Among the included studies, sixteen evaluated computerized cognitive stimulations [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58] and four evaluated a computerized physical activity program [59][60][61][62]. Thirteen studies were randomized-control studies [44][45][46][47][48]51,[54][55][56][57][61][62][63] and seven pilot studies (reporting also efficacy of the intervention) [43,49,50,52,53,58,60]. Most studies have been judged to have an overall high level of risk of bias, three studies arose some concerns regarding the risk of bias [44,48,59] and only one study resulted in having a low risk of bias [46] (Figures 2 and 3).…”

“…Design: Among the sixteen computerized cognitive stimulation studies [43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58], ten were randomized controlled studies [44][45][46][47][48]51,53,[55][56][57], and six were feasibility/pilot studies [43,49,50,52,54,58].…”

Multimodal Web-Based Intervention for Cancer-Related Cognitive Impairment in Breast Cancer Patients: Cog-Stim Feasibility Study Protocol

“…While the beneficial effects of both cognitive stimulation and physical activity have been proved [ 2 , 23 , 24 , 25 , 26 ], many barriers limit the setup of such interventions in supportive care units in hospitals. Web-based interventions have been used to reduce some of these barriers, including the cost of interventions, while increasing convenience for patients, also reaching patients who are normally isolated and cannot benefit from these interventions [ 67 ] and have resulted as efficient in the improvement of CRCI [ 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. Nevertheless, little is known about patients’ preferences in terms of length of the program, length, and frequency of the sessions.…”

“…E-Health approaches represent one solution to overcome these barriers because it allows home-based and remotely supervised interventions. The potential of such approaches has already been shown in multiple domains of mental health [39][40][41][42] and also for the improvement of quality of life [43] and CRCI in cancer patients [44][45][46][47][48][49][50]. Furthermore, e-Health interventions have been shown to improve patients' engagement [51] and to promote physical activity [52].…”