Uwarunkowania zaburzeń poznawczych powstających wskutek leczenia onkologicznego i wybrane sposoby terapii kognitywnej

• Authors: Magdalena Bury

Title variants

EN

Determinants of cognitive impairments resulting from oncological treatment and selected methods of cognitive therapy

• Languages of publication: EN PL

Abstracts

EN

In the light of the current empirical data, the situation of a patient suffering from a cancer can be additionally burdened by the co-occurrence of cognitive impairments, which are referred to as chemobrain, appearing as a result of oncological treatment. However, research findings are extremely diversified both with respect to the occurrence of cognitive impairments, their exacerbation, duration, and with respect to the factors determining as well as modifying the symptoms of the deterioration of cognitive processes. The mechanisms which directly influence the occurrence of cognitive impairments include neurotoxic factors, oxidative stress, DNA damage, hormonal changes, immunological dysregulation, central nervous system vascular changes, and genetic predispositions. Genetic mutations, proinflammatory cytokines, paraneoplastic diseases, type of treatment, genetic polymorphism, immunological reactivity, diet, the level of hormones as well as the previous cognitive resources of patients have also an indirect, yet significant, influence on the occurrence of cognitive impairments. Therefore, the aim of this article is to analyze the test results explaining the diversified cognitive outcomes of oncological treatment, with particular reference to the factor of the dysregulation of cytokines level, which seems to have a major influence on the occurrence of chemobrain symptoms. A number of exemplary therapeutical approaches, which improve the daily cognitive functioning of patients suffering from oncological diseases, have been described: MAAT training (Memory and Attention Adaptation Training), the Cognitive-Behavioral Model of Everyday Memory method (CBMEM), the C-Car exercises and Strategy Training, the Mindfulness-Based Stress Reduction (MBSR) – a strategy reducing stress – or the Polish RehaCom system. All of the mentioned therapeutic options aim to improve selected functions, that is attention or memory, the increase of self-awareness of the experienced deficits or self-control abilities.

PL

Jak wynika z aktualnych danych empirycznych, sytuację pacjenta cierpiącego na nowotwór mogą dodatkowo utrudniać współwystępujące zaburzenia poznawcze pojawiające się wskutek leczenia onkologicznego; zaburzenia te określa się jako chemobrain. Rezultaty badań są bardzo zróżnicowane – zarówno w zakresie powszechności zaburzeń poznawczych, ich nasilenia czy czasu trwania, jak i w zakresie czynników determinujących lub modyfikujących objawy dotyczące procesów poznawczych. Do mechanizmów bezpośrednio wpływających na wystąpienie zaburzeń poznawczych zalicza się czynniki neurotoksyczne, stres oksydacyjny, uszkodzenie DNA, zmiany hormonalne, dysregulację immunologiczną, zmiany naczyniowe ośrodkowego układu nerwowego, predyspozycje genetyczne. Pośrednio na powstawanie zaburzeń oddziałują natomiast mutacje genetyczne, cytokiny prozapalne, zespoły paranowotworowe, rodzaj leczenia, polimorfizm genetyczny, reaktywność immunologiczna, dieta, poziom hormonów i wcześniejsze zasoby poznawcze chorego. Celem artykułu jest analiza wyników badań wyjaśniających zróżnicowane skutki poznawcze leczenia onkologicznego, ze szczególnym uwzględnieniem dysregulacji poziomu cytokin – mającej, jak się wydaje, istotny udział w patogenezie objawów chemobrain. Omówiono także kilka podejść terapeutycznych wspomagających codzienne funkcjonowanie poznawcze pacjentów onkologicznych: trening MAAT (Memory and Attention Adaptation Training), metodę CBMEM (Cognitive-Behavioral Model of Everyday Memory), ćwiczenia C-Car and Strategy Training, metodę redukcji stresu MSBR (Mindfulness-Based Stress Reduction) i polski system RehaCom. Wszystkie wymienione propozycje mają na celu usprawnianie wybranych funkcji, takich jak uwaga albo pamięć, wzrost samoświadomości deficytów i poprawę samokontroli.

Keywords

EN

cancer; chemioterapia; chemotherapy; cognitive impairments; nowotwór; zaburzenia poznawcze

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Psychiatria i Psychologia Kliniczna
• Year: 2015
• Volume: 15
• Issue: 1
• Pages: 26-32

Contributors

author

Magdalena Bury

• Zakład Psychologii Klinicznej i Neuropsychologii, Instytut Psychologii, Uniwersytet Marii Curie-Skłodowskiej, pl. Litewski 5, 20-080 Lublin, tel.: [phone]

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• Document Type: review