Post-treatment cognitive dysfunction in women treated with thyroidectomy for papillary thyroid carcinoma

Jung, Misook; Visovatti, Moira

doi:10.1007/s00520-016-3481-y

Cited by 17 publications

(14 citation statements)

References 40 publications

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“…Recently, Jung and Visovatti [ 17 ] compared female thyroid cancer survivors with healthy women, and observed that sleep problems and fatigue symptoms were predicted by lower perceived cognitive effectiveness, worse cognitive performance and reduced QoL. Berti et al [ 18 ] suggest that, while sleep analysis should be included in thyroid cancer research and in clinical practice, the PSQI may not be sufficient to identify patients with poor sleep quality who need additional support to deal with the side-effects of disease and its treatment.…”

Section: Discussionmentioning

confidence: 99%

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A comparative cross-sectional study on sleep quality in patients with a history of differentiated thyroid carcinoma and its correlation with quality of life

et al. 2021

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Purpose To evaluate sleep quality in differentiated thyroid carcinoma (DTC) patients and correlate sleep disturbances with quality of life (QoL). Methods 119 DTC patients were enrolled (DTC group). The Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI) inventories were administered. The Thyroid-specific Patient-Reported Outcome (ThyPRO) questionnaire, the Billewicz scale (BS) and an ad-hoc visual analogic scale (VAS) were used to measure QoL and subjective therapy-related complaints. The same examinations were conducted in 53 subjects (control group) who had undergone surgery for benign thyroid pathology. Results L-T4 dosages and TSH levels differed between the groups. BS and VAS scores were comparable. PSQI documented a similar percentage of poor sleepers in the DTC (74%) and control (62%) groups. ISI showed no difference in subjects without clinically significant insomnia: DTC (43%) and controls (48%). ThyPRO showed significantly worse scores in DTC than control subjects. In DTC patients, PSQI (P = 0.002) and ISI (P = 0.04) correlated significantly with age. In control subjects, TSH displayed a significant positive association with PSQI (P = 0.02) and ISI (P < 0.05). The ThyPRO general score correlated significantly with PSQI in DTC patients. In both groups, ISI correlated significantly with several ThyPRO scales and the ThyPRO general score. “Anxiety” and “emotional susceptibility” were the scales most significantly related with PSQI and ISI. Conclusion In disease-free DTC patients and subjects who undergo thyroid surgery for benign pathology, abnormal sleep components and insomnia are similar. The ThyPRO questionnaire closely reflects sleep disturbances in all subjects. Recognising and treating sleep disturbances might improve QoL.

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Section: Discussionmentioning

confidence: 99%

“…This finding highlights the importance of assessing sleep disturbance in long-term survivors of DTC. To date, only a few studies [15][16][17][18][19] have examined the quality of sleep in DTC patients and to our knowledge only the study by Pelttari et al attempted to correlate sleep and QoL in these patients.…”

Section: Introductionmentioning

confidence: 99%

A comparative cross-sectional study on sleep quality in patients with a history of differentiated thyroid carcinoma and its correlation with quality of life

et al. 2021

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“…Jaracz et al adopted the Wisconsin Card Sorting Test, Oral Word Association Test, Trail Making Test, Stroop Color-Word Interference Test, and Digit span test in 31 DTC patients who treated with 131 I and l -T4 suppression after thyroidectomy, in which the results showed that patients’ executive function, information processing speed and attention were significantly decreased in comparison with those in the control group, however, there was no significant difference in Stroop Color-Word Interference test and Digit span test [7]. However, Moon et al [11] studied 50 elderly DTC patients, and the results showed that long-term TSH suppression therapy had no significant influence on cognitive function, and even for patients with higher serum T4 levels, they had better results in MMSE and Trail Making Test A. Jung et al [10] studied 90 DTC women, after receiving thyroxine replacement therapy, they showed significant impairment of attention and working memory, and these cognitive impairments were associated with thyroid cancer, age, and level of education. The results of the present study showed that there were both similarities and differences in cognitive impairment between TSH suppression therapy after DTC surgery and l -T4 replacement therapy after thyroidectomy.…”

Section: Discussionmentioning

confidence: 99%

“…Although TSH suppression therapy is essentially different from primary hyperthyroidism, long-term TSH suppression therapy can cause cognitive and emotional impairment. A number of studies suggested that TSH suppression therapy may lead to cognitive impairment in DTC patients, involving executive function, information processing speed, attention, and it easily leads to emotional, sleep, human communication and other disorders [7–10]. However, some studies suggested that long-term TSH suppression therapy had no significant effect on cognitive function in elderly patients [11].…”

Section: Introductionmentioning

confidence: 99%

Naming difficulties after thyroid stimulating hormone suppression therapy in patients with differentiated thyroid carcinoma: a prospective cohort study

et al. 2019

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Background Thyroid stimulating hormone (TSH) suppression therapy after differentiated thyroid carcinoma surgery causes cognitive impairment. However, data on naming difficulties (anomia)—related specific cognitive impairment are lacking. Methods A prospective cohort study was conducted, in which, patients with differentiated thyroid carcinoma and benign thyroid nodules were given oral L-T4 therapy after surgery, after meeting the criteria of TSH suppression therapy and thyroxine replacement therapy, respectively, the patients were continually given l -T4 therapy for 6 and 12 months, and then, the neuropsychological test was performed. Results Of the 255 subjects, 212 cases (83.13%) completed all the tests, including 33 cases in the normal control group (NC group), 110 cases in the TSH suppression therapy group (TS group), and 69 cases in the thyroxine replacement therapy group (TR group). There was no significant difference in background data among the three groups ( P > 0.05). The scores of mini-mental state examination, clock drawing test, digit symbol substitution test, personal history, temporal and spatial orientation, digit order relation, visual object recognition, associative learning, and color naming in the TS and TR groups were not significantly different from those in the NC group after 6 and 12 months of L-T4 therapy ( P > 0.05); the scores of picture recall, visual recall, comprehension memory, and digit span forward in the TS and TR groups were notably lower than those in the NC group ( P < 0.01); the scores of confrontation naming and listing the names in the TS group were significantly lower than those in the NC and TR groups, and the scores decreased with the prolongation of TSH suppression therapy ( P < 0.01). Conclusion TSH suppression therapy after differentiated thyroid carcinoma surgery could lead to short-term memory impairment, attention impairment, word selection anomia, and depression, of which, word selection anomia was aggravated with the prolongation of TSH suppression therapy. Therefore, we suggested that optimal TSH goals for individual patients must balance the potential benefit of TSH suppression therapy with the possible harm from subclinical hyperthyroidism especially in low risk differentiated thyroid carcinoma patients (ClinicalTrials.gov Protocol Registration System: ClinicalTrials.gov ID NCT0266532, Registered on 21 June 2016).

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“…Higher scores indicate better cognitive functioning. The AFI is a valid and reliable instrument in individuals with cancer [12,15]. The Cronbach's alpha coefficients for Time 1 and Time 2 were .88 and .92, respectively, indicating satisfactory reliability.…”

Section: Attentional Function Indexmentioning

confidence: 93%

Impact of changes in perceived attentional function on postsurgical health-related quality of life in breast cancer patients awaiting adjuvant treatment

Jung

Visovatti

Sohn

et al. 2020

Health Qual Life Outcomes

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Purpose: Few studies have assessed pre-surgery cognitive impairment or the impact of pre-surgery cognitive impairment on quality of life. The purpose of this study was to assess changes in perceived cognitive function from pre-surgery to 1 month post-surgery and to determine whether cognitive function predicted health-related quality of life in women who awaited adjuvant treatment for breast cancer. Methods: This study used a descriptive pre-post design to assess women newly diagnosed with breast cancer prior to any treatment (N = 132). Cognition was assessed using the Attentional Function Index (AFI) and health-related quality of life was assessed using the Functional Assessment of Cancer Therapy-General (FACT-G). Statistical methods included descriptive, comparative and regression analyses. Covariates assessed and controlled for in analyses included depressed mood, fatigue, disturbed sleep, surgery-related symptoms (lymphedema/decreased mobility), and cultural tendency. Results: Perceived attention and memory function decreased from pre-surgery to 1 month post-surgery alongside alterations in arm function and a decrease in depressed mood (p < 0.05). Regression analysis indicated that, after controlling for covariates, poorer perceived attention and memory function, surgery-specific symptoms, and a greater tendency toward collectivism predicted poorer quality of life. Conclusion: Perceived function on tasks requiring attention and working memory 1 month post-surgery was poorer compared to pre-surgery suggesting that the mental and physical demands of a new diagnosis of breast cancer and surgery may effect cognitive function. Additionally, changes in perceived cognitive function significantly predicted perceived quality of life in women awaiting adjuvant treatment for breast cancer. Findings suggest that breast cancer patients are at risk for an early decline in cognitive function and that interventions aimed at supporting and optimizing function may improve quality of life early in the disease trajectory.

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Post-treatment cognitive dysfunction in women treated with thyroidectomy for papillary thyroid carcinoma

Cited by 17 publications

References 40 publications

A comparative cross-sectional study on sleep quality in patients with a history of differentiated thyroid carcinoma and its correlation with quality of life

A comparative cross-sectional study on sleep quality in patients with a history of differentiated thyroid carcinoma and its correlation with quality of life

Naming difficulties after thyroid stimulating hormone suppression therapy in patients with differentiated thyroid carcinoma: a prospective cohort study

Impact of changes in perceived attentional function on postsurgical health-related quality of life in breast cancer patients awaiting adjuvant treatment

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