Brain Training Is Key in Helping Cognitive Function in Breast Cancer Survivors

Most often, nurses help oncology teams in every facet of the treatment process for patients with breast cancer — from administering chemotherapy to managing side effects. But what about after patients enter survivorship?

Changes in cognitive function, or chemobrain, are common among patients who survive breast cancer. However, limited efforts have been put in to understanding or managing these cognitive changes in patients.

But now, there is a web site that can help with just that.

In a recent pilot study, published in Breast Cancer Research and Treatment, researchers at the University of Alabama at Birmingham found that a brain training program — Brain HQ – helps breast cancer survivors improve their cognitive function.

“Cognitive changes are distressing occurrence during and after treatment. Many cancer survivors who wish to return to work have difficulty with these changes and are not generally aware that there are ways to help improve cognition,” lead researcher Karen Meneses PhD, RN, FAAN, Professor, Associate Dean for Research and co-Director of the Nursing Program at the University of Alabama at Birmingham, said in an interview with Oncology Nursing News.

Meneses and colleagues conducted the randomized, controlled pilot study, which was designed to evaluate preliminary efficacy of speed-of-processing training using Brain HQ exercises in middle-aged and older breast cancer survivors.

Brain HQ, founded by Posit Science, is a computerized brain training program, designed to improve speed of processing information and accuracy in the brain.

“t builds on the scientific understanding of brain plasticity, on how the brain changes, and implements those principles in a set of specific brain exercises, in which quite literally doing them rewires the brain to make information processing faster and more accurate, and in doing so, improves cognitive function,” Henry Mahncke, PhD, CEO of Posit Science, said in an interview with Oncology Nursing News.

For this study, an exercise called “Double Decision” required an individual to look at a computer screen where a car or truck was centered on the computer screen. Simultaneously, a road sign appeared within the individual’s peripheral vision on the same screen. The individual was then required to remember if the center image was a car or truck, and where the sign was located exactly in their peripheral vision. These images appear slow at first, and with success in identifying them, speed up, or slow down if not identified correctly. As time goes on, the exercises become increasinly challenging.

“The exercises automatically adjust to user performance to maintain a 75% correct rate during the training session in order to promote motivation and a sense of accomplishment,” Meneses explained.

Sixty breast cancer survivors with self-reported cognitive changes were randomized to either home-based, speed-of-processing training or no-contact at all. The researchers primarily focused on investigating speed-of-processing and executive function — which was measured at study entry, 6 weeks later and 6 months later.

Those who underwent brain training were asked to complete 10 hours of training, or 2 hours per week, in a visual speed of processing exercise called “Double Decision” from the BrainHQ web application.

Breast cancer survivors reported significant improvements immediately and in the long-term. At 6 weeks, they reported improvements in standard measures of processing speed and episodic memory, and at 6 months overall improvements in objective measures of speed of processing and executive function were seen.

The program of exercises is available on BrainHQ.com, where individuals can register for free to receive an exercise a day. After a free trial, they can then subscribe for $8 a month.

As a next step, researchers may look into speed of processing training for additional malignancies.

Posit Science would also like to see these exercises become a standard of care among survivorship plans for patients with breast cancer. For example, the Oncology Nursing Society has already written patient treatment guidelines for chemobrain, and for the first time they included speed of processing cognitive training.

“One of the main areas that we see ahead of us as collaborators is to make sure the results get translated from publication and academic journals in to true changes in treatment care,” said Mahncke. “And that means working with doctors, clinical societies, groups that provide cancer care, and so forth.”

Cancer has transitioned from an incurable disease 20 years ago, to what is now considered something manageable. With that comes the responsibility of healthcare providers to think of long-term outcomes and management plans of survivors.

“It is really appropriate that patients, doctors and medical associations are turning their attention to make sure that [cancer] is not only survivable, but a person can turn to thrive afterwards in their family life, their home life and their leisure life,” Mahncke said. “And tackling these issues of brain health is important and we are really excited that our academic partners have been pushing this forward in this way.”