Interventions for cognitive problems in adults with brain cancer: A narrative review

Eur J Cancer Care (Engl). 2019 May;28(3):e13088. doi: 10.1111/ecc.13088. Epub 2019 May 14.

Abstract

Introduction: Many patients with brain cancer experience cognitive problems. In this narrative review, we comprehensively evaluated empirical studies on various intervention approaches for cognitive problems in these patients.

Methods: Intervention studies that reported effects on cognitive functioning (either objectively tested or subjectively reported) in adult patients with primary and/or secondary brain tumours were identified through online searches in PubMed (MEDLINE) and Web of Science up to 13 March 2019.

Results: Of the 364 identified records, 10 pharmacological (including five randomised placebo-controlled trials), 10 cognitive rehabilitation (including five [pilot] RCTs) and two multiple-group exercise studies matched the inclusion criteria. Seventeen of 22 studies had final sample sizes smaller than 40. Several cognitive rehabilitation studies and some pharmacological approaches (donepezil and memantine) showed (at least partial) benefits for cognitive problems in adults with brain cancer. The effects of other pharmacological and exercise interventions were inconclusive and/or preliminary.

Conclusion: Overall, drawing firm conclusions is complicated due to various methodological shortcomings, including the absence of a (placebo) control group and small sample sizes. Promising effects have been reported for cognitive rehabilitation and some pharmacological approaches. Suggestions for more thorough research with respect to the various approaches are provided.

Keywords: brain neoplasms; cognition; exercise therapy; neoplasm metastasis; pharmacology; rehabilitation.

Publication types

  • Review

MeSH terms

  • Brain Neoplasms / psychology
  • Brain Neoplasms / rehabilitation*
  • Central Nervous System Stimulants / therapeutic use*
  • Cholinesterase Inhibitors / therapeutic use*
  • Cognition
  • Cognitive Dysfunction / psychology
  • Cognitive Dysfunction / rehabilitation*
  • Cognitive Remediation*
  • Donepezil / therapeutic use
  • Dopamine Agents / therapeutic use*
  • Exercise*
  • Ginkgo biloba
  • Humans
  • Memantine / therapeutic use
  • Plant Extracts / therapeutic use

Substances

  • Central Nervous System Stimulants
  • Cholinesterase Inhibitors
  • Dopamine Agents
  • Plant Extracts
  • Ginkgo biloba extract
  • Donepezil
  • Memantine