The Effect of EEG Biofeedback on Reducing Postcancer Cognitive Impairment
The Effect of EEG Biofeedback on Reducing Postcancer Cognitive Impairment
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DOI：
10.1177/1534735413477192
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发表时间：
2013-11-01
影响因子：
2.9
通讯作者：
Lundy, Allan
中科院分区：
文献类型：
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作者：
Alvarez, Jean;Meyer, Fremonta L.;Lundy, Allan
背景和假设。在相当数量的乳腺癌幸存者中观察到癌症后认知障碍(PCCI)，在某些亚组中持续长达20年。尽管代偿策略经常被建议，但尚未确定恢复性干预措施。这项研究考察了脑电生物反馈(神经反馈)的可行性及其在减少PCCI以及经常伴随PCCI的疲劳、睡眠障碍和心理症状方面的潜在有效性。研究设计。这是一项为期6个月的前瞻性研究，在等待名单控制期后进行积极干预。参与者是女性乳腺癌幸存者(n=23)，化疗后6至60个月，有自我报告的认知障碍。方法：研究方法。四种自我报告结果测量(癌症治疗功能评估-认知功能[FACT-COG]、慢性病治疗功能评估-疲劳[面孔-疲劳]、匹兹堡睡眠质量指数[PSQI]和简明症状清单[BSI]-18)在10周等待名单控制期内进行3次，在10周(20节)神经反馈训练期间进行3次，在神经反馈后4周进行1次。结果。所有23名参与者都完成了这项研究，证明了脑电生物反馈在这一人群中的可行性。最初，与一般人群常模相比，样本在所有指标上都显示出显著的功能障碍。重复测量方差分析显示，在所有4项认知测量(感知认知障碍、他人评论、感知认知能力、对生活质量的影响[QOL])、疲劳量表和4个心理量表(躯体化、抑郁、焦虑和总体严重程度指数)以及8个睡眠量表中的3个(质量、日间功能障碍和整体)方面，均有非常显著的改善(P<；.001)。其他两个睡眠量表(潜伏期和干扰)在P<；.01有显著意义，而1(用药)在P<；.05；2无显著意义。在整个培训过程中，改进总体上是线性的，并在后续测试中保持不变。在跟踪测试中，样本在4个事实-Cog测量(损害、对生活质量的影响和评论)、面部疲劳、PSQI睡眠质量和习惯效率或BSI-18心理障碍测量中的任何一个上不再与正常人群有显著差异。结论。这项有限研究的数据表明，脑电生物反馈有可能减少癌症治疗的负面认知和情绪后遗症，以及改善疲劳和睡眠模式。
Background and hypotheses. Postcancer cognitive impairment (PCCI) is observed in a substantial number of breast cancer survivors, persisting for as long as 20 years in some subgroups. Although compensatory strategies are frequently suggested, no restorative interventions have yet been identified. This study examined the feasibility of EEG biofeedback (neurofeedback) and its potential effectiveness in reducing PCCI as well as the fatigue, sleep disturbance, and psychological symptoms that frequently accompany PCCI. Study design. This was a 6-month prospective study with a waitlist control period followed by an active intervention. Participants were female breast cancer survivors (n = 23), 6 to 60 months postchemotherapy, with self-reported cognitive impairment. Methods. Four self-report outcome measures (Functional Assessment of Cancer Therapy-Cognitive Function [FACT-Cog], Functional Assessment of Chronic Illness Therapy-Fatigue [FACIT-Fatigue], Pittsburgh Sleep Quality Index [PSQI], and Brief Symptom Inventory [BSI]-18) were administered 3 times during a 10-week waitlist control period, 3 times during a 10-week (20-session) neurofeedback training regimen, and once at 4 weeks postneurofeedback. Results. All 23 participants completed the study, demonstrating the feasibility of EEG biofeedback in this population. Initially, the sample demonstrated significant dysfunction on all measures compared with general population norms. Repeated-measures ANOVAs revealed strongly significant improvements (P < .001) on all 4 cognitive measures (perceived cognitive impairment, comments from others, perceived cognitive abilities, and impact on quality of life [QOL]), the fatigue scale, and the 4 psychological scales (somatization, depression, anxiety and global severity index) as well as on 3 of 8 sleep scales (quality, daytime dysfunction, and global). Two of the other sleep scales (latency and disturbance) were significant at P < .01, and 1 (use of medication) at P < .05; 2 were not significant. Improvements were generally linear across the course of training, and were maintained at the follow-up testing. At the follow-up testing, the sample no longer differed significantly from normative populations on 3 of the 4 FACT-Cog measures (impairment, impact on QOL, and comments), FACIT-Fatigue, PSQI sleep quality and habitual efficiency, or any of the BSI-18 measures of psychological disturbance. Conclusions. Data from this limited study suggest that EEG biofeedback has potential for reducing the negative cognitive and emotional sequelae of cancer treatment as well as improving fatigue and sleep patterns.