Effectiveness of Executive Function-Based Cognitive Rehabilitation on Brain Fog, Working Memory, and Problem-Solving in Patients with Breast Cancer: A Pilot Randomized Controlled Trial Breast Cancer Rehab
Abstract
Background: Cognitive difficulties associated with cancer are among the most frequent and enduring effects of breast cancer and its treatment. This pilot study evaluated the effectiveness of an executive function-based cognitive rehabilitation on brain fog, working memory, and problem-solving performance in women with breast cancer undergoing chemotherapy.
Methods: A randomized controlled pilot study with a pretest-posttest design was conducted among 14 women with breast cancer who were randomly assigned to an intervention group (n = 7) or a control group (n = 7). Baseline cognitive functioning was assessed using the Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG). Outcome measures included the Working Memory subtests of the Wechsler Memory Scale-III, the N-Back Task, the Tower of London Task, and the Brain Fog Scale. The intervention consisted of 15 individual sessions of executive function-based cognitive rehabilitation incorporating executive strategy training, compensatory techniques, and guided application of cognitive skills to everyday activities. Data were analyzed using univariate analyses of covariance (ANCOVAs).
Results: Compared with the control group, participants receiving the intervention showed significant improvements in working memory and problem-solving performance, together with significant reductions in brain fog (all P < .05). No significant between-group difference was observed in N-Back response time.
Conclusion: Executive function-based cognitive rehabilitation was associated with improvements across multiple dimensions of cancer-related cognitive impairment. These preliminary findings support further evaluation of this multidimensional intervention in larger studies of patients with breast cancer.
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