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

Anne Bellens; Ella Roelant; Bernard Sabbe; Marc Peeters; Peter A van Dam

doi:10.1016/j.breast.2020.06.003

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

Breast. 2020 Oct:53:23-32. doi: 10.1016/j.breast.2020.06.003. Epub 2020 Jun 12.

Authors

Anne Bellens¹, Ella Roelant², Bernard Sabbe³, Marc Peeters¹, Peter A van Dam⁴

Affiliations

¹ Multidisciplinary Oncologic Center Antwerp (MOCA), Antwerp University Hospital, Edegem, B2650, Belgium; Centre for Oncological Research (CORE), University of Antwerp, Wilrijk, B2610, Belgium.
² Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital, University of Antwerp, Edegem, B2650, Belgium; StatUa, Center for Statistics, University of Antwerp, Antwerp, B2000, Belgium.
³ Department of Psychiatry, Antwerp University, Wilrijk, Belgium.
⁴ Multidisciplinary Oncologic Center Antwerp (MOCA), Antwerp University Hospital, Edegem, B2650, Belgium; Centre for Oncological Research (CORE), University of Antwerp, Wilrijk, B2610, Belgium. Electronic address: peter.vandam@telenet.be.

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.

Keywords: Breast cancer; Cognition; Cognitive impairment; Cognitive training; Video gaming.

Publication types

Randomized Controlled Trial

MeSH terms

Activities of Daily Living
Adolescent
Adult
Aged
Breast Neoplasms / psychology*
Cancer Survivors / psychology*
Cognitive Dysfunction / etiology
Cognitive Dysfunction / rehabilitation*
Female
Humans
Internet-Based Intervention
Middle Aged
Neuropsychological Tests
Pilot Projects
Prospective Studies
Psychiatric Rehabilitation / methods*
Psycho-Oncology / methods
Reaction Time
Treatment Outcome
Video Games*
Young Adult