Assessment of sensory gating, attention, and executive control in breast cancer

摘要 尽管在理解癌症和癌症治疗相关的认知功能障碍方面取得了重大进展 (CACD)，人们对传统的神经心理测试是否足以准确地 检测患者报告的认知变化。记忆缺陷是最常被报道的认知障碍 幸存者之间的问题；然而，用传统的神经心理学记忆测量方法进行评估 经常表现在正常范围内。我们认为注意过程的变化 干扰内存中信息的高效和有效编码。因此，幸存者对 记忆问题是准确的，但与注意力缺陷有关，而不是记忆缺陷。传统型 神经心理测量：1)在临床相关的时间范围内，重测信度较低 对较大的测量误差；2)侧重于认知功能的粗略定义领域，而忽略了 注意力的子成分对以后的回忆至关重要；3)无法测量预先注意的过程，如 感觉门控/过滤；4)与自我报告的认知问题无关。要解决这些问题 我们开发了一系列经过充分研究和验证的认知实验测量方法， 感觉-注意-执行(SAE)电池，它将允许分解感觉、注意力和 作为信息有效学习和编码的基础的执行子过程。我们将研究 辅助性治疗对绝经后乳腺癌患者认知功能的影响 化疗(CT：N=100)和未接受化疗(CT-：N=100)，他们将在 辅助治疗，化疗后1个月(CT患者为YOKD)以及12个月和24个月后- 使用SAE成套测试和传统的神经心理学测试进行注册。匹配的健康对照组 (n=100)将在类似的时间范围内进行评估。本提案的目标是评估以下内容 具体目标：目标1：使用SAE检查注意力和执行控制子成分的变化 CT和CT检查前和随时间延长的电池--与匹配的健康对照组进行比较；目标2：检查 使用SAE电池前和长期使用SAE电池与传统电池相比的损害发生率 CT和CT中的神经心理学测量-与匹配的健康对照组进行比较；目标3：检查 预先注意加工的测量与后来的基于表现的注意测量之间的关系 来自SAE和传统电池的记忆；以及目标4：检查自我报告之间的关联 SAE电池和传统电池的测量(感官门控库存和事实检测)和性能 神经心理测试。这项研究具有重要意义，因为使用SAE措施可以 准确识别与CACD相关的认知过程的子成分，从而实现量身定制的治疗 它是创新的，因为它利用了基于认知神经科学的评估，允许评估 信息加工链上的子成分认知过程，包括前注意过程。

ABSTRACT Despite significant progress in understanding cancer and cancer-treatment associated cognitive dysfunction (CACD), concerns have been raised about the adequacy of traditional neuropsychological tests to accurately detect cognitive changes reported by patients. Memory deficits are the most commonly reported cognitive problems among survivors; however, assessment with traditional neuropsychological measures of memory has frequently demonstrated performance in the normal range. We propose that changes in attentional processes interfere with efficient and effective encoding of information in memory. Therefore, survivors’ perception of memory problems is accurate, but related to deficits in attention rather than memory. Traditional neuropsychological measures: 1) Can have low test-retest reliability over clinically relevant timeframes leading to large measurement error; 2) Focus on coarsely defined domains of cognitive function while ignoring the subcomponents of attention critical for later recall; 3) Are unable to measure pre-attentive processes like sensory gating / filtering; and 4) Do not correlate with self-report of cognitive problems. To address these limitations, we have developed a battery of well-studied and validated cognitive experimental measures, the Sensory-Attention-Executive (SAE) battery, which will allow for decomposition of sensory, attentional and executive sub-processes that underlie efficient learning and encoding of information. We will examine cognitive changes associated with adjuvant treatment for postmenopausal breast cancer patients treated with chemotherapy (CT+: N=100) and not treated with chemotherapy (CT-: N=100), who will be assessed prior to adjuvant treatment, 1 month post-chemotherapy (yoked for CT- patients) and 12 and 24 months post- enrollment with the SAE battery and traditional neuropsychological measures. Matched healthy controls (N=100) will be assessed over similar timeframes. The objective of this proposal is to evaluate the following specific aims: Aim 1: Examine alterations in subcomponents of attention and executive control using the SAE battery at pretreatment and over time in CT+ and CT- compared to matched, healthy controls; Aim 2: Examine the prevalence of impairment at pretreatment and over time utilizing the SAE battery versus traditional neuropsychological measures in CT+ and CT- compared to matched, healthy controls; Aim 3: Examine the relationship of measures of pre-attentive processing to later, performance-based measures of attention and memory from the SAE and traditional batteries; and Aim 4: Examine associations between self-report measures (Sensory Gating Inventory and FACT-Cog) and performance on the SAE battery and traditional neuropsychological measures. This research is significant because use of the SAE measures could more precisely identify subcomponents of cognitive processes associated with CACD leading to tailored treatments and is innovative because it utilizes assessments base on cognitive neuroscience allowing for assessment of subcomponent cognitive processes along the information processing chain, including pre-attentive processes.