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Working memory training for adult glioma patients: a proof-of-concept study

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Abstract

Background

CogMed Working Memory Training (CWMT) is a computer-based program shown to improve working memory (WM) among those with cognitive impairments. No study to date has investigated its feasibility, acceptability, and satisfaction in adult patients with glioma, despite the well-documented incidence of WM impairment in this population.

Methods

Twenty patients with glioma and objective and/or perceived WM deficits enrolled in the study: 52% high-grade, 60% female, Mage = 47 (range = 21–72 years). Adverse events were monitored to determine safety. Feasibility and acceptability were assessed based on established metrics. Satisfaction was explored by exit-interviews. Neurocognitive tests and psychological symptoms were analyzed at baseline and post-CWMT to estimate effect sizes.

Results

Of 20 enrolled patients, 16 completed the intervention (80% retention rate). Reasons for withdrawal included time burden (n = 2); tumor-related fatigue (n = 1) or loss to follow-up (n = 1). No adverse events were determined to be study-related. Adherence was 69% with reasons for nonadherence similar to those for study withdrawal. The perceived degree of benefit was only moderate. Baseline to post-CWMT assessments showed medium to large effects on neurocognitive tasks. Psychological symptoms remained stable throughout the study period.

Conclusions

CWMT was found to be safe and acceptable in adult patients with glioma. Enrollment, retention rates, and treatment adherence were all adequate and comparable to studies recruiting similar populations. Only moderate perceived benefit was reported despite demonstrated improvements in objectively-assessed WM. This may indicate that the time commitment and intervention intensity (5 weeks of 50-min training sessions on 5 days/week) outweighed the perceived benefits of the program. (Trial Registration Number: NCT03323450 registered on 10/27/2017).

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Acknowledgements

Thank you to all of our patients. We would also like to thank our research assistants Kelcie Willis and Julia Brechbiel for their contributions to this project.

Funding

VCU School of Medicine Deans Academic Enhancement Award. The project described was also supported by CTSA award No. KL2TR002648 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

Author information

Author notes

  1. Sarah Ellen Braun and Farah J. Aslanzadeh contributed equally to the writing of this manuscript.

Authors and Affiliations

  1. Department of Neurology, Virginia Commonwealth University, Richmond, VA, USA

    Sarah Ellen Braun, Mark G. Malkin & Ashlee R. Loughan

  2. Massey Cancer Center, Richmond, VA, USA

    Sarah Ellen Braun, Autumn Lanoye, Mark G. Malkin & Ashlee R. Loughan

  3. Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA

    Farah J. Aslanzadeh

  4. Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, VA, USA

    Autumn Lanoye

  5. Department of Neurology, Medical University of South Carolina, Charleston, SC, USA

    Stephanie Fountain-Zaragoza

  6. Division of Neuro-Oncology, Department of Neurology, School of Medicine, VCU Massey Cancer Center, Virginia Commonwealth University, 401 College Street MCC G-105, P.O. Box 980037, Richmond, VA, 23298-0037, USA

    Sarah Ellen Braun

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Contributions

Conceptualization: SB, PhD, FA, MS, AL, PhD, AL, PhD; Methodology: SB, PhD, AL, PhD; Formal analysis and investigation: SB, PhD, FA, MS, AL, PhD, SF-Z, PhD; Writing – original draft preparation: SB, PhD, FA, MS; Writing – review and editing: SB, PhD, FA, MS, AL, PhD, SF-Z, PhD, MM, MD, AL, PhD; Funding acquisition: AL, PhD, MM, MD; Resources: AL, PhD, MM, PhD; Supervision: AL, PhD, SB, PhD, MM, PhD.

Corresponding author

Correspondence to Sarah Ellen Braun.

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Conflict of interest

The authors have no conflict of interests to disclose.

Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

Ethical approval

Approval was obtained from the ethics committee of Virginia Commonwealth University and Massey Cancer Center. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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Braun, S.E., Aslanzadeh, F.J., Lanoye, A. et al. Working memory training for adult glioma patients: a proof-of-concept study. J Neurooncol 155, 25–34 (2021). https://doi.org/10.1007/s11060-021-03839-y

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