Neural and Cognitive Mechanisms of Attention and Memory Deficits in Cancer Survivors

项目摘要 尽管有证据表明癌症幸存者经常报告长期记忆困难，但传统的 神经心理学成套测试通常不能检测出这一人群中的显著记忆缺陷。相反地， 最近的研究表明，对“健忘”的抱怨往往与癌症相关的认知障碍有关。 注意力障碍（CRCD）实际上可以归因于初始学习过程中的失败， 困难，而不是记忆衰退。然而，到目前为止，还没有研究直接测试注意力是如何 CRCD的失败会影响下游的记忆过程，如最初的学习成功和随后的学习成功。 检索性能此外，幸存者经常将注意力问题错误地描述为 在检索过程中的记忆问题提出了一个问题，即幸存者是否有准确的意识， 自己在真实的时间中的认知失败（元记忆）。准确地认识错误对于提高 目前的认知补救方法依赖于幸存者在错误发生时准确检测错误的能力。到 为了解决这些知识上的差距，我们开发了一个实验， 记忆和元认知的神经科学，以研究注意力对初始学习和随后的学习的影响。 检索CRCD，以及评估幸存者的意识，他们自己的认知过程中， 任务我们将使用脑电图（EEG）检查认知和神经基础， 接受化疗和放疗的乳腺癌患者（N=24）的注意力和记忆过程， 与年龄匹配的健康成人（N=24）相比。参与者将在完成一项 长期记忆任务，包括在线主观评估自己的学习和检索 性能这项建议的目的是将脑电图与认知实验相结合， 目的1：检查癌症幸存者是否表现出 异常ERP成分在初始学习，以及这些是否与随后的检索相关 目标2：使用元记忆任务来评估幸存者对他们的主观信心的准确性。 初始学习和检索能力。 这项研究是有意义的，因为使用认知实验的措施可以更准确地识别 注意力缺失对CRCD患者初始学习的影响，并评估幸存者是否缺乏 能够在真实的时间内准确检测这些故障，这将为有效治疗的发展提供信息 干预措施。这项研究是创新的，因为它使用基于认知神经科学的方法来测试两者 神经和认知机制参与注意力，学习和检索，并利用元记忆 范式，以评估幸存者在学习过程中发现认知错误的准确性。使用这些任务 允许测量客观和主观的认知过程沿着学习和记忆 时间轴，迄今为止，尚未在患有CRCD的癌症幸存者中进行评估。

PROJECT ABSTRACT Despite evidence that cancer survivors frequently report difficulties with long-term memory, traditional neuropsychological test batteries often fail to detect significant memory deficits in this population. Instead, recent research has suggested that complaints of `forgetfulness' often associated with cancer-related cognitive dysfunction (CRCD) can actually be attributed to failures during initial learning that result from attentional difficulties, rather than memory decay. However, no studies to date have directly tested how attentional failures in CRCD impact downstream memory processes such as initial learning success and subsequent retrieval performance. Moreover, the finding that survivors often mischaracterize attention problems as memory problems during retrieval raises the question of whether survivors have accurate awareness of their own cognitive failures in real time (metamemory). Accurate awareness of errors is critical to the efficacy of current cognitive remediation methods that rely on survivors' ability to accurate detect errors as they occur. To address these gaps in knowledge, we have developed an experiment that draws on methods from cognitive neuroscience of memory and metacognition to examine effects of attention on initial learning and subsequent retrieval in CRCD, as well as assess survivors' awareness of their own cognitive processes throughout the task. We will use electroencephalography (EEG) to examine the cognitive and neural underpinnings of attention and memory processes in breast cancer patients treated with chemotherapy and radiation (N=24), as compared to age-matched healthy adults (N=24). Participants will undergo EEG recording while completing a long-term memory task, including on-line subjective assessments of their own learning and retrieval performance. The objective of this proposal is to use EEG in conjunction with a cognitive-experimental paradigm to evaluate the following specific aims: Aim 1: Examine whether cancer survivors demonstrate abnormal ERP components during initial learning, and whether these are correlated with subsequent retrieval failures; and Aim 2: Use a metamemory task to assess the accuracy of survivors' subjective confidence in their initial learning and retrieval ability. This research is significant because use of cognitive-experimental measures could more precisely identify effects of attentional failures on initial learning in CRCD and evaluate whether survivors are deficient in the ability to accurately detect these failures in real time, which will inform the development of effective treatment interventions. This research is innovative because it uses cognitive neuroscience-based methods to test both neural and cognitive mechanisms involved in attention, learning, and retrieval, and utilizes a metamemory paradigm to evaluate survivors' accuracy in detecting cognitive errors during learning. The use of these tasks allows for measurement of both objective and subjective cognitive processes along the learning and memory timeline which, to date, have not been evaluated in cancer survivors suffering from CRCD.