The association of chemotherapy-induced peripheral neuropathy with reduced executive function in chemotherapy-treated cancer survivors: A cross-sectional study.

Autor: McNeish BL; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA. Electronic address: mcneishbl@upmc.edu., Dittus K; University of Vermont Cancer Center, Burlington, VT, USA; Department of Medicine, University of Vermont, Burlington, VT, USA. Electronic address: kim.dittus@uvmhealth.org., Mossburg J; Department of Physical Therapy, University of Vermont, Burlington, VT, USA., Krant N; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA. Electronic address: Nicholas.krant@med.uvm.edu., Steinharter JA; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA. Electronic address: john.steinharter@med.uvm.edu., Feb K; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA., Cote H; Department of Physical Therapy, University of Vermont, Burlington, VT, USA. Electronic address: hunter.cote@uvm.edu., Hehir MK; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA. Electronic address: Michael.Hehir@uvmhealth.org., Reynolds R; University of Vermont Cancer Center, Burlington, VT, USA. Electronic address: Rebecca.reynolds@uvmhealth.org., Redfern MS; Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: mredfern@pitt.edu., Rosano C; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: RosanoC@edc.pitt.edu., Richardson JK; Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA. Electronic address: jkrich@med.umich.edu., Kolb N; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurological Sciences, Larner College of Medicine at the University of Vermont, Burlington, VT, USA. Electronic address: noah.kolb@uvmhealth.org.
Jazyk: angličtina
Zdroj: Journal of geriatric oncology [J Geriatr Oncol] 2024 May; Vol. 15 (4), pp. 101765. Date of Electronic Publication: 2024 Apr 05.
DOI: 10.1016/j.jgo.2024.101765
Abstrakt: Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is common and disabling among cancer survivors. Little is known about the association of CIPN with other measures of the nervous system's integrity, such as executive dysfunction. We compared measures of executive function in older chemotherapy-treated cancer survivors with and without CIPN.
Materials and Methods: This cross-sectional study enrolled 50 chemotherapy-treated cancer survivors (65.6 ± 11.5 years, 88% female) post-chemotherapy treatment who were previously referred for outpatient rehabilitation at the request of the cancer survivor or a medical provider. Twenty-two participants (44%) had CIPN defined by patient-reported distal paresthesia or numbness, which began with chemotherapy and continued to the time of cognitive testing. Measures of executive function included Trails-B, Stroop, and rapid reaction accuracy (RRA) and were evaluated between cancer survivors with and without CIPN using t-tests. Multivariable models were then used to determine whether CIPN was an independent determinant of the measures of executive function (Trails-B, Stroop Incongruent, and RRA). Models were adjusted for age, sex, history of anxiety, and benzodiazepine use due to their known associations with CIPN and executive function.
Results: Cancer survivors with CIPN (CIPN+) had reduced executive function compared to survivors without CIPN (CIPN-) on Trails-B (CIPN+: 84.9 s ± 44.1 s, CIPN-: 59.1 s ± 22.5 s, p = 0.01), Stroop (CIPN+: 100.6 s ± 38.2 s, CIPN-: 82.1 s ± 17.3 s, p = 0.03), and RRA (CIPN+: 60.3% ± 12.9%, CIPN-: 70.6% ± 15.7%, p = 0.01). There were no differences in cancer stage severity or functional status by patient report or sit-to-stand function. The association between CIPN and reduced executive function was found in multivariable models after adjusting for age, sex, anxiety, and benzodiazepine use for Trails-B (ß:17.9, p = 0.046), Stroop (ß:16.9, p = 0.02), and RRA (ß:-0.072, p = 0.03).
Discussion: In this population, CIPN is associated with reduced executive function in older cancer survivors treated with chemotherapy. Future research is required to further understand this preliminary association, the causality, and the potential risk factors.
Competing Interests: Declaration of Competing Interest MKH reports receiving consulting fees from Argenx, Alexion, UCB Pharma, Janssen, and Immunovant; honoraria from Medscape, Springer Health, AANEM, Medlink Neurology, and Continuum Lifelong Learning in Neurology; grants from University of Vermont Medical Center and Myasthenia Gravis Foundation of America; and leadership roles in the Neuromuscular Study Group and AANEM Neuromuscular Fellowship Committee. NK reports funding from the National Cancer Institute; receiving consulting fees from the Eisana Corporation; and receiving honoraria from AANEM. JKR reports funding from the Newman Family Foundation; payment for expert testimony; sharing a patent for the ReacStick with colleagues James Ashton-Miller, James T. Eckner, and Hogene Kim.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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