Two different sides of 'chemobrain': determinants and nondeterminants of self-perceived cognitive dysfunction in a prospective, randomized, multicenter study.
OBJECTIVE
Complaints of cognitive dysfunction are frequent among cancer patients. Many studies have identified neuropsychological compromise associated with cancer and cancer therapy; however, the neuropsychological compromise was not related to self-reported cognitive dysfunction. In this prospective study, the authors examined if confounding factors masked an underlying association of self-perceived cognitive function with actual cognitive performance. Determinants of self-perceived cognitive dysfunction were investigated.


METHODS
Self-perceived cognitive function and cognitive performance were assessed before treatment, at the end of treatment, and 1 year after baseline in 101 breast cancer patients randomized to standard versus intensified chemotherapy. Linear mixed-effects models were applied to test the relationships of performance on neuropsychological tests, patient characteristics, and treatment variables to self-reported cognitive function. Change of cognitive performance was tested as a predictor of change in self-reports.


RESULTS
Self-perceived cognitive function deteriorated during chemotherapy and had partially recovered 1 year after diagnosis. The personality trait negative affectivity, current depression, and chemotherapy regimen were consistently related to cognitive self-reports. No significant associations with performance in any of the 12 cognitive tests emerged. Change of cognitive performance was not reflected in self-reports of cognitive function.


CONCLUSIONS
Neuropsychological compromise and self-perceived cognitive dysfunction are independent phenomena in cancer patients. Generally, cancer-associated neuropsychological compromise is not noticed by affected patients, but negative affectivity and treatment burden induce pessimistic self-appraisals of cognitive functioning regardless of the presence of neuropsychological compromise. Clinicians should consider this when determining adequate therapy for patients who complain of 'chemobrain'.
Hermelink
Kerstin
K
Department of Gynecology and Obstetrics, Ludwig Maximilian University, Munich, Germany. kerstin.hermelink@med.uni-muenchen.de
Küchenhoff
Helmut
H
Untch
Michael
M
Bauerfeind
Ingo
I
Lux
Michael Patrick
MP
Bühner
Markus
M
Manitz
Juliane
J
Fensterer
Veronika
V
Münzel
Karin
K
D000328:Adult; D000339:Affect; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000523:psychology; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009483:Neuropsychological Tests; D010465:Perception; D011446:Prospective Studies; D011788:Quality of Life; D057566:Self Report