Can Exercise Improve Cancer Associated Cognitive Dysfunction? (chemobrain)
Following chemotherapy, some breast cancer survivors report alterations in their ability to remember, concentrate, or think, which can have significant emotional, psychological, and economic impact on their lives. Survivors have also reported feeling frustrated by the response of the medical community, who either may not acknowledge their symptoms or have no treatment options to suggest. Exercise may be a promising treatment, as improvements in cognitive function with exercise have been demonstrated in older adults and other clinical populations.
The investigators will recruit women who have completed chemotherapy for breast cancer (within the past 2 years) and report cognitive changes. Women will be randomly assigned to either a 24-week aerobic exercise intervention or delayed exercise control (offered the same exercise program following the study). At the start and end of the study the investigators will measure: i) performance on four standard neuropsychological tests that measure working memory, learning, and problem solving; ii) a questionnaire on cognitive function and its impact on quality of life; iii) functional magnetic resonance imaging (fMRI) during two of the standard neuropsychological tests which provides information on how the brain is working during the tests.
To knowledge of the investigators this is the first study to examine the effect of an exercise intervention on cognitive function in breast cancer survivors. In addition, the use of fMRI imaging is a new way to approach this research question, and may be more sensitive to change than traditional measures of cognitive function.
Descripción general del estudio
Descripción detallada
Objective 1:
Conduct a randomized trial to test the effectiveness of a 24-week aerobic exercise intervention in adult, female breast cancer survivors with self-reported cognitive changes following chemotherapy.
The investigators will test the following hypotheses:
A) The exercise intervention will improve performance on neuropsychological tests of specific cognitive domains of executive function, namely i)selective attention and response inhibition, ii)processing speed and mental flexibility, and iii) verbal memory and learning in exercisers (EX; n=15) versus delayed exercise controls (CON; n=15).
B) The exercise intervention will reduce self-reported cognitive dysfunction and its impact of function and quality of life, in EX compared to CON, measured as a decreased score on the Functional Assessment Cancer Therapy-Cognition Scale (FACT-Cog).
Objective 2:
Conduct analyses on the effect of the intervention on brain activation patterns using functional magnetic resonance imaging (fMRI).
The investigators will test the following hypotheses:
- A) At baseline, brain activation patterns will differ in breast cancer survivors reporting cognitive difficulties following chemotherapy compared to breast cancer survivors who have not received chemotherapy (who serve as breast cancer/no chemotherapy controls; not enrolled in the exercise intervention) during neuropsychological tests completed in the scanner.
B) The exercise intervention will result in a decrease in regions of cortical activation, particularly in regions that show higher activation in breast cancer survivors following chemotherapy, compared with no change in controls.
Tipo de estudio
Inscripción (Actual)
Fase
- Fase 2
Contactos y Ubicaciones
Ubicaciones de estudio
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British Columbia
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Vancouver, British Columbia, Canadá, V6T 1Z4
- University of British Columbia
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
- Women
Completed chemotherapy within past 2 years
- completed for at least 3 months
- Self report cognitive dysfunction following chemotherapy
- Stage I-IIIA breast cancer
- Physically able to undertake moderate to vigorous physical activity program
Exclusion Criteria:
- Self report > 90min/week of moderate physical activity (last 6 months)
- Mini-mental status exam score < 23
- Co-morbid conditions that may alter cognitive testing results (i.e., a clinically diagnosed major depression, anxiety disorder, or other psychiatric condition, meeting DSM IV criteria)
- History of substance abuse
- Other neurological disorder (i.e., head injury, epilepsy, tumour, neurodegenerative disease)
- Ruled ineligible for MRI scanning (i.e., metal implants)
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Tratamiento
- Asignación: Aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Único
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Sin intervención: Delayed exercise control
Participants asked to maintain usual lifestyle and provided with abbreviated version of intervention upon completion of end of study testing.
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Experimental: Exercise
Aerobic exercise Intervention as per below
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150 minutes/week of aerobic exercise at 60-70% of heart rate reserve (individualized based on baseline VO2 peak test).
The intervention is 24 weeks with an exercise progression to reach the full exercise prescription by week 8. Participants are required to attend two 45 minute supervised sessions per week and complete two additional 30 minute sessions independently at home.
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¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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Stroop Test
Periodo de tiempo: Change from baseline at 6 months
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Tests response inhibition, measure number of correct vs incorrect responses
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Change from baseline at 6 months
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
|---|---|---|
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FACT-Cog
Periodo de tiempo: Change from baseline at 6 months
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Self-reported cognitive function and quality of life
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Change from baseline at 6 months
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fMRI analyses
Periodo de tiempo: Change from baseline at 6 months
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regions of interest analysis, whole brain patterns of change
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Change from baseline at 6 months
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Graded exercise test
Periodo de tiempo: Change from baseline at 6 months
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Change from baseline at 6 months
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Hopkins Verbal Learning Test
Periodo de tiempo: Change from baseline at 6 months
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Verbal Learning, measure number of recalled and recognized words
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Change from baseline at 6 months
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Trail Making A & B
Periodo de tiempo: Change from baseline at 6 months
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Visual Conceptual and Visuomotor Tracking, measure time taken to complete
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Change from baseline at 6 months
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Kristin Campbell, PT, PhD, University of British Columbia
Publicaciones y enlaces útiles
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio
Finalización primaria (Actual)
Finalización del estudio (Actual)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Estimar)
Actualizaciones de registros de estudio
Última actualización publicada (Estimar)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Términos MeSH relevantes adicionales
Otros números de identificación del estudio
- H10-02774
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