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Computerized cognitive training in prostate cancer patients on androgen deprivation therapy: a pilot study

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Abstract

Purpose

Prostate cancer patients who have undergone androgen deprivation therapy (ADT) may experience cognitive impairment, yet there is an unmet need for nonpharmacological interventions to address cognitive impairment in this population. This study examines the feasibility, acceptability, and preliminary efficacy of a home-based computerized cognitive training (CCT) program to treat cancer-related cognitive impairment.

Methods

Sixty men who had received ≥ 3 months of ADT were screened for at least mild cognitive or neurobehavioral impairment and randomized to 8 weeks of CCT or usual care. Follow-up assessments occurred immediately post-intervention or equivalent (T2) and 8 weeks later (T3). The acceptability of CCT was also assessed.

Results

Feasibility:A priori feasibility thresholds were partially met (i.e., randomization rate > 50%, retention rate > 70% excluding CCT drop-outs, but < 70% for intent-to-treat). Acceptability: Participants were mostly satisfied with CCT and found it somewhat enjoyable, though barriers to uptake existed. Preliminary efficacy: Linear mixed models indicated significant time by group effects favorable to CCT in reaction time (p = .01), but unfavorable to CCT in verbal and visual memory (ps < .05). Memory was temporarily suppressed in the CCT group at T2, but normalized by T3. There was no effect of CCT on self-reported cognitive functioning, neurobehavioral functioning, nor quality of life.

Conclusions

This study provides tentative support for the feasibility and acceptability of CCT to treat mild cognitive impairment in ADT patients. CCT had a beneficial effect on reaction time, but temporarily suppressed memory. CCT’s benefits may be limited to a narrow area of functioning. Larger-scale studies are needed.

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Acknowledgements

We thank Posit Science and CNS Vital Signs for providing their programs to this study at no cost.

Funding

This work was supported by the American Cancer Society (L.W., grant no. PF-12-041-01-CPPB) and the National Cancer Institute of the National Institutes of Health (L.W., grant no. 5K07CA184145-03).

Author information

Authors and Affiliations

  1. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North St. Clair, 19th floor, Chicago, IL, 60611, USA

    Lisa M. Wu & Katrin Bovbjerg

  2. Unit for Psychooncology and Health Psychology, Department of Oncology and Department of Psychology and Behavioural Sciences, Aarhus University Hospital and Aarhus University, Aarhus, Denmark

    Ali Amidi

  3. Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA

    Molly L. Tanenbaum

  4. Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Gary Winkel

  5. Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Wayne A. Gordon

  6. Department of Medicine and Urology, Northwell Health, Great Neck, NY, USA

    Simon J. Hall & Michael A. Diefenbach

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  1. Lisa M. Wu
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Corresponding author

Correspondence to Lisa M. Wu.

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Informed consent was obtained from all participants.

Conflicts of interest

Wu and Amidi report personal fees from Bayer Pharmaceutical outside the submitted work. The other authors have no conflicts of interest to declare. Wu has full control of all primary data and agrees to allow the journal to review this data if requested.

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Wu, L.M., Amidi, A., Tanenbaum, M.L. et al. Computerized cognitive training in prostate cancer patients on androgen deprivation therapy: a pilot study. Support Care Cancer 26, 1917–1926 (2018). https://doi.org/10.1007/s00520-017-4026-8

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  • DOI: https://doi.org/10.1007/s00520-017-4026-8

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