Contributions of sleep/rhythms/fatigue to "chemobrain"

睡眠/节律/疲劳对“化学脑”的贡献

• 批准号: 7077789
• 负责人: Sonia Ancoli-Israel
• 金额: $ 43.08万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-07-01 至 2010-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7077789
• 关键词: actigraphy; anthracyclines; anxiety; attention; behavioral /social science research tag; biomarker; blood tests; breast neoplasms; circadian rhythms; clinical research; cognition disorders; depression; drug adverse effect; executive function; fatigue; female; human subject; inflammation; longitudinal human study; memory; neoplasm /cancer chemotherapy; neoplasm /cancer immunotherapy; neuropsychological tests; psychological aspect of cancer; questionnaires; sleep disorders; actigraphy; anthracyclines; anxiety; attention; behavioral /social science research tag; biomarker; blood tests; breast neoplasms; circadian rhythms; clinical research; cognition disorders; depression; drug adverse effect; executive function; fatigue; female; human subject; inflammation; longitudinal human study; memory; neoplasm /cancer chemotherapy; neoplasm /cancer immunotherapy; neuropsychological tests; psychological aspect of cancer; questionnaires; sleep disorders

DESCRIPTION (provided by applicant): Patients treated with chemotherapy complain of decreased cognitive functioning before and during chemotherapy, as well as for some years after the end of therapy. Objective measures of cognitive functioning confirm that a large percentage of patients receiving chemotherapy show at least acute decrements in multiple domains of cognitive test performance. This phenomenon has been termed "chemobrain." Understanding the cause of the cognitive deficits is critical as these patients require increased care, experience impaired decision making ability, experience decreased quality of life and express concern about their ability to maintain employment. Fatigue and problems sleeping are also major complaints in this population, particularly in patients with breast cancer. Yet whether chemobrain is related just to the chemotherapy, or might be secondary to fatigue and/or sleep and circadian rhythm problems has not yet been explored. Clarification of the role of sleep disturbances, hormonal changes, anxiety and depression, and other proximal causes of cognitive impairment in chemotherapy patients may be helpful in identifying potential targets for secondary intervention. The specific aims are: to examine how much cognitive impairment occurs during chemotherapy and one year after the start of chemotherapy compared to before the start of treatment; to examine the relationship between cognitive impairment and fatigue; to examine the relationship between cognitive impairment and sleep and circadian rhythms; and to examine the relationship between inflammatory markers, cognitive functioning and sleep. Over 5 years, 80 women with breast cancer and 80 controls (women with no history of any cancer) will be studied. Women will have their sleep recorded for three days with actigraphy, a complete neuropsychological test battery, have blood drawn for inflammatory markers and complete questionnaires on fatigue, sleep, menopausal status, quality of life, depression, and anxiety. These procedures will be repeated before the start of chemotherapy, during week 2 of cycle 4 of chemotherapy and one year after chemotherapy. Control women will be tested at the same time points. Each woman will also have a complete overnight sleep recording. The reported phenomena of chemobrain will be examined to see if it is related to the complaint of fatigue or sleep disruptions, both of which are known to contribute to decreases in cognitive functioning.

描述（由申请人提供）：接受化学疗法治疗的患者抱怨化疗之前和期间的认知功能降低以及治疗结束后的几年。认知功能的客观度量证实，接受化疗的大部分患者至少显示出认知测试表现多个领域的急性减少。该现象已被称为“化学邻晶”。了解认知缺陷的原因至关重要，因为这些患者需要增加护理，决策能力受损的经验，经验降低生活质量以及对维持就业能力的关注。疲劳和睡眠问题也是该人群的主要抱怨，尤其是在乳腺癌患者中。然而，尚未探索Chemobrain与化学疗法相关的，还是尚未探索疲劳和/或睡眠和昼夜节律问题。阐明睡眠障碍，荷尔蒙变化，焦虑和抑郁的作用以及化学疗法患者认知障碍的其他近端原因可能有助于确定二次干预的潜在靶标。具体的目的是：检查在化疗期间和化学疗法开始后的一年与治疗前相比，认知障碍发生了多少；检查认知障碍与疲劳之间的关系；检查认知障碍与睡眠与昼夜节律之间的关系；并检查炎症标记，认知功能和睡眠之间的关系。超过5年，将研究80名乳腺癌女性和80例对照（没有任何癌症史的女性）。妇女的睡眠将记录为三天的录音，这是一个完整的神经心理测试电池，为炎症标记吸收了血液，以及有关疲劳，睡眠，绝经状态，生活质量，抑郁和焦虑的完整问卷。这些程序将在化学疗法开始之前，在化学疗法第4周期和化学疗法后一年进行重复。控制妇女将在同一时间点进行测试。每个女人还将拥有完整的过夜睡眠记录。将检查Chemobrain的现象，以查看它是否与疲劳或睡眠中断的抱怨有关，这两种现象都会导致认知功能的降低。