Breast Cancer Clinical Trial
Official title:
Can Exercise Improve Cancer Associated Cognitive Dysfunction?
Following chemotherapy, some breast cancer survivors report alterations in their ability to
remember, concentrate, or think, which can have significant emotional, psychological, and
economic impact on their lives. Survivors have also reported feeling frustrated by the
response of the medical community, who either may not acknowledge their symptoms or have no
treatment options to suggest. Exercise may be a promising treatment, as improvements in
cognitive function with exercise have been demonstrated in older adults and other clinical
populations.
The investigators will recruit women who have completed chemotherapy for breast cancer
(within the past 2 years) and report cognitive changes. Women will be randomly assigned to
either a 24-week aerobic exercise intervention or delayed exercise control (offered the same
exercise program following the study). At the start and end of the study the investigators
will measure: i) performance on four standard neuropsychological tests that measure working
memory, learning, and problem solving; ii) a questionnaire on cognitive function and its
impact on quality of life; iii) functional magnetic resonance imaging (fMRI) during two of
the standard neuropsychological tests which provides information on how the brain is working
during the tests.
To knowledge of the investigators this is the first study to examine the effect of an
exercise intervention on cognitive function in breast cancer survivors. In addition, the use
of fMRI imaging is a new way to approach this research question, and may be more sensitive
to change than traditional measures of cognitive function.
Objective 1:
Conduct a randomized trial to test the effectiveness of a 24-week aerobic exercise
intervention in adult, female breast cancer survivors with self-reported cognitive changes
following chemotherapy.
The investigators will test the following hypotheses:
1. A) The exercise intervention will improve performance on neuropsychological tests of
specific cognitive domains of executive function, namely i)selective attention and
response inhibition, ii)processing speed and mental flexibility, and iii) verbal memory
and learning in exercisers (EX; n=15) versus delayed exercise controls (CON; n=15).
B) The exercise intervention will reduce self-reported cognitive dysfunction and its
impact of function and quality of life, in EX compared to CON, measured as a decreased
score on the Functional Assessment Cancer Therapy-Cognition Scale (FACT-Cog).
Objective 2:
Conduct analyses on the effect of the intervention on brain activation patterns using
functional magnetic resonance imaging (fMRI).
The investigators will test the following hypotheses:
2. A) At baseline, brain activation patterns will differ in breast cancer survivors
reporting cognitive difficulties following chemotherapy compared to breast cancer
survivors who have not received chemotherapy (who serve as breast cancer/no
chemotherapy controls; not enrolled in the exercise intervention) during
neuropsychological tests completed in the scanner.
B) The exercise intervention will result in a decrease in regions of cortical activation,
particularly in regions that show higher activation in breast cancer survivors following
chemotherapy, compared with no change in controls.
;
Allocation: Randomized, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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