Mitigating Brain Fog in Breast Cancer Survivors: A Randomized Control Trial

Research Objectives: To investigate the efficacy of two cognitive interventions (versus an active control) to improve cognitive performance and mitigate cognitive complaints in breast cancer survivors.

Design: Through stratified randomization, participants were allocated into one of three intervention groups. Stratification criteria included age range, level of education, time since ending chemotherapy, and degree of cognitive complaint. Participants (i) completed baseline assessments, (ii) engaged with training for 3 months, (iii) completed post-assessments.

Setting: Eligible breast cancer survivors, from the general public, completed assessments and training through an online platform.

Participants: This study is recruiting 200 breast cancer survivors (ages 30-80) from the general population who completed chemotherapy at least 6 months ago but no more than 5 years, as confirmed by a treating physician.

Interventions: The online interventions below were delivered in 10- or 20-minute intervals (totaling 1 hour) each week for three months.
1. Strategic Memory Advanced Reasoning Training (SMART) equips participants with top-down, meta-cognitive strategies that engage higher cognitive abilities and can be applied in daily contexts to support cognitive performance.
2. BrainHQ consists of bottom-up, drill-like tasks, focused on specific processes, like processing speed.
3. Active control provides information on brain health (articles, videos, and podcasts).

Main Outcome Measures: Primary outcome measure is the BrainHealth Index, a multidimensional metric capturing clarity, emotional balance, and connectedness in a composite score. Secondary measures include: (i) Double Decision, a measure of processing speed; (ii) Delayed Match to Sample, a memory measure; (iii) Rapid Visual Information Processing, a measure of sustained attention, and (iv) two primary subscales from the Functional Assessment of Cancer Therapy - Cognitive Function (FACT-COG), a validated self-report measure of cognitive abilities.

Results: With ~20% pre-post data collection, distinct benefits for the different trainings are emerging and could become more significant as the sample increases. Whereas the SMART-trained group showed a trend toward generalized benefits on BrainHealth Index factors, i.e., cognitive clarity and emotional balance; BrainHQ group demonstrated significant gains on trained domain when compared with the SMART (p = .013) and active control group (p = .002).

Conclusions: These preliminary results support the possible effectiveness of online interventions to improve cognitive function in breast cancer survivors who report complaints, even years after ending chemotherapy.

Author(s) Disclosures: I have nothing to disclose.