Cognitive Rehabilitation in Patients With Gliomas: A Randomized, Controlled Trial
Cognitive Rehabilitation in Patients With Gliomas: A Randomized, Controlled Trial
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DOI：
10.1200/jco.2008.20.5765
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发表时间：
2009-08-01
影响因子：
45.3
通讯作者：
Aaronson, Neil K.
中科院分区：
文献类型：
--
作者：
Gehring, Karin;Sitskoorn, Margriet M.;Aaronson, Neil K.
目的神经胶质瘤患者经常出现认知障碍，包括注意力和记忆力问题。这一随机对照试验评估了多方面的认知康复计划（CRP）对认知功能和选定的生活质量领域的患者与glioma.Patients和Methods 140成人患者低级别和间变性胶质瘤，有利的预后因素，主观认知症状和客观认知缺陷的影响，从11家医院在荷兰招募。患者被随机分配到干预组或等待名单对照组。干预包括基于计算机的注意力再训练和注意力、记忆力和执行功能的补偿技能训练。参与者在基线、完成CRP后和6个月随访时完成了一系列神经心理学（NP）测试和关于认知功能、疲劳、心理健康相关生活质量和社区整合的自我报告问卷。观察到主观认知功能及其感知负担的测量具有统计学显著性干预效果，但未观察到客观NP结果或任何其他自我报告措施。在6个月的随访中，CRP组在注意力和非文字记忆的NP测试中的表现明显优于对照组，并且报告了更少的精神疲劳。其他主观结果的组间差异不显着6 months.ConclusionThe CRP有一个有益的影响，短期的认知投诉和长期的认知表现和精神疲劳。需要进行更多的研究，以确定哪些干预措施最有效。J Clin Oncol 27：3712-3722. (C)2009年美国临床肿瘤学会
PurposePatients with gliomas often experience cognitive deficits, including problems with attention and memory. This randomized, controlled trial evaluated the effects of a multifaceted cognitive rehabilitation program (CRP) on cognitive functioning and selected quality-of-life domains in patients with gliomas.Patients and MethodsOne hundred forty adult patients with low-grade and anaplastic gliomas, favorable prognostic factors, and both subjective cognitive symptoms and objective cognitive deficits were recruited from 11 hospitals in the Netherlands. Patients were randomly assigned to an intervention group or to a waiting-list control group. The intervention incorporated both computer-based attention retraining and compensatory skills training of attention, memory, and executive functioning. Participants completed a battery of neuropsychological (NP) tests and self-report questionnaires on cognitive functioning, fatigue, mental health-related quality of life, and community integration at baseline, after completion of the CRP, and at 6-month follow-up.ResultsAt the immediate post-treatment evaluation, statistically significant intervention effects were observed for measures of subjective cognitive functioning and its perceived burden but not for the objective NP outcomes or for any of the other self-report measures. At the 6-month follow-up, the CRP group performed significantly better than the control group on NP tests of attention and verbal memory and reported less mental fatigue. Group differences in other subjective outcomes were not significant at 6 months.ConclusionThe CRP has a salutary effect on short-term cognitive complaints and on longer-term cognitive performance and mental fatigue. Additional research is needed to identify which elements of the intervention are most effective. J Clin Oncol 27: 3712-3722. (C) 2009 by American Society of Clinical Oncology