||5R03CA249548-02 Interpret this number
||Sloan-Kettering Inst Can Research
||Neural and Cognitive Mechanisms of Attention and Memory Deficits in Cancer Survivors
Despite evidence that cancer survivors frequently report difficulties with long-term memory, traditional
neuropsychological test batteries often fail to detect significant memory deficits in this population. Instead,
recent research has suggested that complaints of `forgetfulness' often associated with cancer-related cognitive
dysfunction (CRCD) can actually be attributed to failures during initial learning that result from attentional
difficulties, rather than memory decay. However, no studies to date have directly tested how attentional
failures in CRCD impact downstream memory processes such as initial learning success and subsequent
retrieval performance. Moreover, the finding that survivors often mischaracterize attention problems as
memory problems during retrieval raises the question of whether survivors have accurate awareness of their
own cognitive failures in real time (metamemory). Accurate awareness of errors is critical to the efficacy of
current cognitive remediation methods that rely on survivors' ability to accurate detect errors as they occur. To
address these gaps in knowledge, we have developed an experiment that draws on methods from cognitive
neuroscience of memory and metacognition to examine effects of attention on initial learning and subsequent
retrieval in CRCD, as well as assess survivors' awareness of their own cognitive processes throughout the
task. We will use electroencephalography (EEG) to examine the cognitive and neural underpinnings of
attention and memory processes in breast cancer patients treated with chemotherapy and radiation (N=24), as
compared to age-matched healthy adults (N=24). Participants will undergo EEG recording while completing a
long-term memory task, including on-line subjective assessments of their own learning and retrieval
performance. The objective of this proposal is to use EEG in conjunction with a cognitive-experimental
paradigm to evaluate the following specific aims: Aim 1: Examine whether cancer survivors demonstrate
abnormal ERP components during initial learning, and whether these are correlated with subsequent retrieval
failures; and Aim 2: Use a metamemory task to assess the accuracy of survivors' subjective confidence in their
initial learning and retrieval ability.
This research is significant because use of cognitive-experimental measures could more precisely identify
effects of attentional failures on initial learning in CRCD and evaluate whether survivors are deficient in the
ability to accurately detect these failures in real time, which will inform the development of effective treatment
interventions. This research is innovative because it uses cognitive neuroscience-based methods to test both
neural and cognitive mechanisms involved in attention, learning, and retrieval, and utilizes a metamemory
paradigm to evaluate survivors' accuracy in detecting cognitive errors during learning. The use of these tasks
allows for measurement of both objective and subjective cognitive processes along the learning and memory
timeline which, to date, have not been evaluated in cancer survivors suffering from CRCD.
Association of markers of tumor aggressivity and cognition in women with breast cancer before adjuvant treatment: The Thinking and Living with Cancer Study.
, Zhou X.
, Ahn J.
, Small B.J.
, Zhai W.
, Bethea T.
, Carroll J.E.
, Cohen H.J.
, Dilawari A.
, Extermann M.
, et al.
Breast cancer research and treatment, 2022 Jul; 194(2), p. 413-422.