Impact of transcranial direct current stimulation on sustained attention in breast cancer survivors: Evidence for feasibility, tolerability, and initial efficacy

Abstract

Background: A significant subset of breast cancer survivors experience cognitive difficulties in attention and memory, which persist for years following treatment. Transcranial direct current stimulation (tDCS) has been shown to be effective in improving working memory, attention, processing speed, and other cognitive functions in both healthy and clinical populations. To date, no studies have examined tDCS for rehabilitation of cancer-related cognitive dysfunction. Objective/hypothesis: We aimed to provide preliminary evidence for feasibility, tolerability, acceptability, and efficacy of tDCS in improving performance on a measure of sustained attention. Methods: In a within-subjects design, 16 breast cancer survivors underwent 2 consecutive days of active tDCS over the prefrontal cortex, and 2 days of sham tDCS, counterbalanced for order of stimulation condition, while performing a continuous performance test. Results: Stimulation was feasible and tolerable, with 89% of participants completing all sessions, and none reporting more than mild to moderate discomfort. Analyses of efficacy showed that during active stimulation, participants had significantly lower standard errors of reaction times overall, indicating better sustained attention ability, as compared to sham stimulation (p < 0.05). Furthermore, the effect of stimulation on standard errors of reaction times differed by inter-stimulus interval (ISI): for 1 and 2 s ISIs, there was no significant difference in performance between sham and active tDCS conditions, but for 4 s ISIs, stimulation improved variability in response times relative to sham (p < 0.05). Conclusions: Results suggest that tDCS is feasible, tolerable, and may be an effective intervention to improve sustained attention difficulties in survivors with cancer-related cognitive dysfunction.

The neuroelectrophysiological and behavioral effects of transcranial direct current stimulation on executive vigilance under a continuous monotonous condition

“…Anodal tDCS was targeted to the left DLPFC using a bipolar montage with the anode placed at F3 and the cathode placed over the contralateral supraorbital area at Fp2 (according to the 10–20 electrode placement system) ( Gaynor et al, 2020 ). This is a common montage in studies targeting left DLPFC for enhancing cognitive function ( Nienow et al, 2016 ).…”

Yoga Improves Quality of Life among Breast Cancer Patients

“…Yoga is an interesting intervention because it can be done easily and low risk which requires only a little equipment, the effects of yoga for the body can provide many physical and psychological benefits, one of that is to improve the quality of life in breast cancer patients (Gaynor et al, 2020). Yoga is a therapy that combines mind body, breathing exercises, meditation, imagination, which is most widely used among cancer patients, especially breast cancer patients (Bao ting et al, 2020).…”

Uso da estimulação transcraniana por corrente contínua em pacientes com câncer de mama com alterações cognitivas causadas pela quimioterapia: revisão integrativa

“…Com exceção do estudo de caso realizado por Knotkova et al (2014), todos os outros foram ou estão sendo conduzidos como Ensaios Clínicos, entretanto, todos os pesquisadores trouxeram a proposta de aplicar a ETCC em pacientes com CM para verificar seus efeitos nas alterações cognitivas resultantes da quimioterapia. Um estudo Em relação ao posicionamento dos eletrodos, apenas três estudos especificaram a localização tomando como referência o sistema 10-20 da eletroencefalografia, de modo que a estimulação ativa foi destinada ao ponto F3 (córtex pré-frontal dorsolateral esquerdo -CPFDL), enquanto o ponto F4 manteve-se na configuração passiva (Knotkova et al 2014;Smith & Blackwood 2017;Gaynor et al 2020).…”

“…Os dois estudos já finalizados (Knotkova et al 2014;Gaynor et al 2020) registraram boa tolerância e viabilidade relacionadas ao uso da ETCC, bem como melhoras nos escores dos testes de cognição global, atenção, função cognitiva autorreferida e qualidade de vida. No caso do ensaio clínico desenvolvido por Knotkova et al (2014), esses achados foram superiores aos encontrados no grupo controle.…”

“…Gaynor et al (2020) -mais de 6 meses após a conclusão do tratamento com Trastuzumabe, Docetaxel e Carboplatin, cuja administração teve duração de 34 semanas;Knotkova et al (2014) …”