title: Intraindividual variability in reaction time before and after neoadjuvant chemotherapy in women diagnosed with breast cancer.
abstract: OBJECTIVE
  Women treated with chemotherapy for breast cancer experience subtle cognitive deficits. Research has focused on mean performance level, yet recent work suggests that within-person variability in reaction time performance may underlie cognitive symptoms. We examined intraindividual variability (IIV) in women diagnosed with breast cancer and treated with neoadjuvant chemotherapy.
  
  
  METHODS
  Patients (n = 28) were assessed at baseline before chemotherapy (T1), approximately 1 month after chemotherapy but prior to surgery (T2), and after surgery about 9 months post chemotherapy (T3). Healthy women of similar age and education (n = 20) were assessed at comparable time intervals. Using a standardized regression-based approach, we examined changes in mean performance level and IIV (eg, intraindividual standard deviation) on a Stroop task and self-report measures of cognitive function from T1 to T2 and T1 to T3.
  
  
  RESULTS
  At T1, women with breast cancer were more variable than controls as task complexity increased. Change scores from T1 to T2 were similar between groups on all Stroop performance measures. From T1 to T3, controls improved more than women with breast cancer. IIV was more sensitive than mean reaction time in capturing group differences. Additional analyses showed increased cognitive symptoms reported by women with breast cancer from T1 to T3. Specifically, change in language symptoms was positively correlated with change in variability.
  
  
  CONCLUSIONS
  Women with breast cancer declined in attention and inhibitory control relative to pretreatment performance. Future studies should include measures of variability, because they are an important sensitive indicator of change in cognitive function.
authors.affiliation: Department of Psychology, York University, Toronto, Ontario, Canada.
authors.forename: Christie
authors.identifier: http://orcid.org/0000-0002-0507-4717
authors.initials: C
authors.lastname: Yao
authors.affiliation: Department of Psychology, York University, Toronto, Ontario, Canada.
authors.forename: Jill B
authors.initials: JB
authors.lastname: Rich
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
authors.forename: Kattleya
authors.initials: K
authors.lastname: Tirona
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.|Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Lori J
authors.identifier: http://orcid.org/0000-0002-2479-3223
authors.initials: LJ
authors.lastname: Bernstein
mesh_terms: D000328:Adult; D000368:Aged; D001288:Attention / Q000187:drug effects*; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000523:psychology / Q000601:surgery; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology*; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D011569:Psychiatric Status Rating Scales; D011930:Reaction Time / Q000502:physiology*; D057566:Self Report
keywords: attention; breast cancer; chemotherapy; cognition; executive function; intraindividual variability