Innovations In Clinical Neuroscience

JAN-FEB 2018

A peer-reviewed, evidence-based journal for clinicians in the field of neuroscience

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R E V I E W 40 ICNS Innovations in Clinical Neuroscience • January–February 2018 • Volume 15 • Number 1–2 The International Cognition and Cancer Task Force (ICCTF) was developed in October 2006 with the goal of furthering the understanding of the impact that cancer and cancer-related treatment can have on cognitive and behavioral functioning in adults with non-CNS cancers. 89 The ICCTF has noted that, "objective neuropsychological tests remain the gold standard for measuring cognitive function" in the assessment of cognitive effects of cancer and cancer treatments. 3,6 The ICCTF organized two working groups that subsequently published recommendations for common criteria to define cognitive impairment and cognitive changes, as well as specific suggestions for a core set of cognitive tests to be used to assess cognitive function in patients with cancer (Table 2). 3 It is always prudent to approach standardization of cognitive tests cautiously because previous efforts for specific conditions (e.g., Alzheimer's disease) have yielded sub-optimal solutions. 90,91 However, the ICCTF group suggested that a collaborative approach that can leverage data across studies using common definitions and recommended a core set of cognitive tests for specific cognitive domains might yield a "best practice" guidance. 3,92–94 Careful attention must also be paid to issues of cross-cultural applicability and to assay sensitivity. 3,95 Potential confounding factors that can negatively impact the assessment of cognitive functioning should also be evaluated in patients with cancer. 5 Common comorbid conditions like depression, pain, fatigue, and sleep disturbance might affect the reliability of the neuropsychological evaluation. In addition, all medications, including over-the-counter medications and supplements, should be reviewed to assess their possible impact on cognitive functioning. COMPUTERIZED TESTING FOR ASSESSMENT OF COGNITIVE FUNCTIONING Computerized testing has been adapted to assess cognitive function both in clinical trials with cancer patients and in practice. 24,79,96,97 Computerized cognitive assessments offer some logistical and economic advantages and flexibility over traditional pencil-and-paper cognitive tests. In this brief review, we describe three alternative computerized platforms that have been applied to cognitive assessment in cancer patients. The CDR computerized system is a customizable battery of brief cognitive tests TABLE 2. International Cognition and Cancer Task Force (ICCTF) recommendation of cognitive assessments CORE ASSESSMENT Recommended Cognitive Domain Recommended Cognitive Assessment Measures Specific Cognitive Skills Evaluated Similar Cognitive Assessment Measures Learning and memory Hopkins Verbal Learning Test–Revised (HVLT-R) Verbal learning and memory assessed by list learning, immediate recall, delayed recall, and recognition California Verbal Learning Test - II (CVLT-II), Rey Auditory Verbal Learning Test (RAVT), Brief Visuospatial Memory–Revised (BVMT-R, Visual Learning and Memory) Executive function Trail Making Test Multiple cognitive skills involved in performing task, including attention, working memory, information processing speed, and mental flexibility Delis-Kaplan Executive Function Scale (D-KEFS) Trail Making Controlled Oral Word Association (COWA) (also known as FAS Test) Spontaneous generation of words Delis-Kaplan Executive Function Scale (D-KEFS) Verbal Fluency Processing speed Trail Making Test Multiple cognitive skills involved in performing task, including attention, working memory, information processing speed, and mental flexibility Delis-Kaplan Executive Function Scale (D-KEFS) Trail Making, Wechscler Adult Intelligence Scale-IV (WAIS-IV) Coding, Symbol Digit Modalities Test (SDMT) SUPPLEMENTAL ASSESSMENT Recommended Cognitive Domain Recommended Cognitive Assessment Measures Specific Cognitive Skills Evaluated Working memory Auditory Consonant Trigrams (ACT) Short term or working memory task requiring on-line maintenance of information while performing an interference task during a delay Paced Auditory Serial Attention Test (PASAT) Serial attention task assessing working memory, divided attention, and information processing speed Brief Test of Attention (BTA) Auditory divided attention Wechsler Adult Intelligence Scale -IV (WAIS-IV) Letter Number Sequencing Working memory, attention, and mental control

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