Telehealth and Memory Study (TAMS)
Mobile Device CBT for Chemotherapy-Related Cognitive Dysfunction: A Multi-Center Randomized Controlled Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Jessica Harrison, B.S.
- Phone Number: 412-623-7009
- Email: harrisonj7@upmc.edu
Study Contact Backup
- Name: Chloe M Sinagra, B.S.
- Phone Number: 412-623-5975
- Email: sinagrac@upmc.edu
Study Locations
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Indiana
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Indianapolis, Indiana, United States, 46202
- Indiana University
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Pennsylvania
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Pittsburgh, Pennsylvania, United States, 15232
- UPMC Hillman Cancer Center
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of stage I-III breast cancer
- 1-5 years post-treatment and currently disease free
- Treatment involved adjuvant or neoadjuvant chemotherapy
- Report cognitive problems of memory and concentration attributed to chemotherapy with a score of 10 or below on the FACT-Cog Impact on Quality of Life Scale (a score ~1SD below pre-chemotherapy treatment norms; this criterion was used in our prior R21 study, ensures a clinically meaningful level of cognitive concerns,41 and discriminates high and low PCI scores in prior research42)
- Able to speak and read English
- Age >18
- Able to provide IRB-approved written informed consent
- Willing to use videoconferencing.
Exclusion Criteria:
- Previous CNS radiation, intrathecal therapy, or CNS-involved surgery
- Previous cancer history with the exception of non-melanoma skin cancer
- Previous exposure to chemotherapy with another cancer or due to other medical condition (e.g., methotrexate exposure for treatment of rheumatoid arthritis)
- Significant neurodevelopmental, neurobehavioral, or medical risk factors likely to affect cognitive functioning (e.g., history of neurological disorder or TBI of greater than mild severity, such as loss of consciousness >30 minutes, medical disorder that is unstable or likely to affect cognition such as metabolic disorder, heart attack or stroke, uncontrolled diabetes or endocrine dysfunction)
- Currently meeting DSM-5 mental disorder criteria, including but not limited to neurodevelopmental, substance abuse, mood (e.g., Maj.Dep), anxiety, or psychotic disorders
- Scoring 3 or below on the 6-item cognitive screen designed to detect severe memory disorders;43
- Severe uncorrected sensory impairment (severe hearing or visual impairment)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Triple
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Memory and Attention Adaptation Training (MAAT)
A videoconference-delivered cognitive-behavioral therapy (CBT) for treatment of chemotherapy-related cognitive dysfunction (CRCD) among cancer survivors consisting of 8 weekly 45-minute visits with a survivor workbook, that targets: 1) enhancement of survivor self-awareness of "at risk" situations where memory failures occur; 2) emotion regulation through modification of survivor causal attributions and negative cognitive appraisals of memory failures; and 3) training in compensatory strategies to improve performance on daily tasks for which memory.
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A cognitive-behavioral therapy (CBT) for treatment of chemotherapy-related cognitive dysfunction (CRCD) among cancer survivors.
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Active Comparator: Supportive Therapy (ST)
Standard attention control condition therapy for treatment of chemotherapy-related cognitive dysfunction (CRCD) among cancer survivors consisting of 8, 45-minutes visits.
ST, emphasizes "non-specific" psychotherapeutic factors of clinician-participant alliance: empathy, support and warmth.
ST will be directed at concerns with cancer survivorship and CRCD.
Clinicians will set expectations with ST participants that they will be provided validation of experience, support, and encouragement of building their own coping resources if asked directly about what to do about cognitive problems.
ST emphasizes reflective listening to help deepen knowledge of the emotional experience of the participant.
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Standard attention control condition therapy for treatment of chemotherapy-related cognitive dysfunction (CRCD) among cancer survivors.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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FACT-Cog PCI
Time Frame: At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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The FACT-Cog is a 37-item self-report measure that uses 5- point (0-4) Likert-type ratings that produce four scales: 1) Impact on quality of life; 2) Perceived cognitive impairments; 3) Comments from others; and 3) Perceived cognitive abilities.
Higher scores indicate better function and quality of life on each scale.
While each scale is scored and interpreted separately, they comprise the total Fact-cog assessment.
The FACT-Cog has good evidence of reliability and construct validity.
We are assessing change in PCI -- from baseline to post-treatment, to 6-month follow-up-- as our primary measure of outcome.
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At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
California Verbal Learning Test-3 (CVLT-3)
Time Frame: At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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The California Verbal Learning Test is a neuropsychological assessment of episodic verbal and working memory and processing speed.
Participants listen to series of words and is then asked to recall the terms and the category to which they belong.
This assessment attempts to measure how much a subject learned and also reveal strategies employed and the types of errors made.
Higher CVLT-3 scores are associated with better memory and processing function.
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At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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Controlled Oral Word Association Test (COWAT)
Time Frame: At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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The Controlled Oral Word Association Test (COWAT), is a neuropsychological measure of verbal fluency.
The COWAT consists of three word conditions.
Participants are asked to produce as many words as they can that begin with the F, A, or S within a 1 minute time period.
The total number of words that the individual is able to produce provides a score.
Typically, if someone scores less than 17 words, the test administrator will use additional tests to further evaluate cognition.
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At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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Digit Span test
Time Frame: At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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The Digit Span test is a neurocognitive subset of both the Wechsler Adult Intelligence Scale (WAIS) and the Wechsler Memory Scales (WMS) that assesses working memory.
Participants read a sequence of numbers and are asked to repeat the same sequence back to the examiner in order (forward span) or in reverse order (backward span).
This assessment generates three "raw" scores and one overall age-appropriate normed (standard) score.
Higher scores indicate better working memory and neurocognitive function.
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At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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Symbol Digit Modalities Test (SDMT)
Time Frame: At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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The Symbol Digit Modalities Test (SDMT) is a neurocognitive screening instrument used to assess neurological dysfunction.
Participants are required to use a coded key to match nine abstract symbols paired with numerical digits.
Ten (10) practice items before commencing the test.
The final score is the correct number of substitutions in 90 seconds, and scores range between 0 and 110.
Higher scores indicate better neurocognitive functioning.
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At Baseline, Post-Treatment (8 weeks) and 6-Month Follow-up
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functional Magnetic Resonance Imaging (fMRI)
Time Frame: At Baseline and Post-Treatment (8 weeks)
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fMRI assessment of a working memory task (N-Back) will assess brain activation patterns through detection in bloodflow changes.
The fMRI N-Back working memory task has been demonstrated to reflect increased activation in response to MAAT treatment among individuals with traumatic brain injury.
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At Baseline and Post-Treatment (8 weeks)
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Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Robert J Ferguson, PhD, St. Jude Children's Research Hospital
- Principal Investigator: Donna Posluszny, PhD, University of Pittsburgh
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Mental Disorders
- Neurocognitive Disorders
- Chemically-Induced Disorders
- Drug-Related Side Effects and Adverse Reactions
- Cognitive Dysfunction
- Chemotherapy-Related Cognitive Impairment
- Cognition Disorders
- Therapeutics
- Patient Care
- Health Services
- Health Care Facilities Workforce and Services
- Palliative Care
Other Study ID Numbers
Other Study ID Numbers
- HCC 20-064
- R01CA244673-01A1 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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