Brain Training in Breast Cancer Survivors Combats Chemobrain

Cognitive function affects a variety of adults with certain diseases or neurological problems. In particular, women who previously underwent chemotherapy for their breast cancer diagnosis have an increased reporting of fogginess or forgetfulness. But now, there is a website that can help with just that.

In a recent pilot study, published in Breast Cancer Research and Treatment, researchers at the University of Alabama at Birmingham found that a brain training program — Brain HQ – helps breast cancer survivors improve their cognitive function.

Changes in cognitive function are common among patients who survive breast cancer. However, limited efforts have been put in to understanding or managing these cognitive changes in patients.

“Cognitive changes are distressing occurrence during and after treatment. Many cancer survivors who wish to return to work have difficulty with these changes and are not generally aware that there are ways to help improve cognition,” Karen Meneses Ph.D., RN, FAAN, Professor, Associate Dean for Research and co-Director of the Nursing Program at the University of Alabama at Birmingham, said in an interview with CURE.

Brain HQ training

Brain HQ, founded by Posit Science, is a computerized brain training program, designed to improve speed of processing information and accuracy in the brain.

Before its inception, most researchers looked to the brain as “a computer chip inside of your head that has this fixed set of wiring that processes your information,” said Henry Mahncke, Ph.D., CEO of Posit Science, said in an interview with CURE.

However, as more research was done in this field, many started to realize the brain is, in fact, not fixed in its wiring, but rather, is constantly reorganizing and rewiring itself in response to what is asked of it.

“So, Brain HQ, what it does is it builds on the scientific understanding of brain plasticity, on how the brain changes, and implements those principles in a set of specific brain exercises, in which, quite literally doing them rewires the brain to make information processing faster and more accurate, and in doing so, improves cognitive function,” explained Mahncke.

Although this technology is intended for a variety of people, its inception in to breast cancer survival seems to be an important one. “We have more and more people surviving cancer, surviving breast cancer in particular,” said Mahncke. “We think of it is now as a disease, that perhaps, to some extent can be managed over time and now we have to deal with issues like survivorship and quality of life and, in particular, cognitive function.”

The program of exercises is available on BrainHQ.com, where individuals can register for free to receive an exercise a day. After a free trial, they can then subscribe for $8 a month.

“Doing these exercises is like learning to play the piano,” said Mahncke. “It is something you do through practice and learn by doing it.”

For example, one exercise requires an individual to look at a computer screen where a car or truck will be centered on the screen. Simultaneously, a road sign appears within an individual’s peripheral vision on the same screen. The individual is then required to remember if the center image was a car or truck, and where the sign was located exactly in their peripheral vision. These images appear slow at first, and with success in identifying them, speed up, or slow down if not identified correctly. As time goes on, the exercises increase in challenge.

“It automatically adapts its speed and presentation to how fast your personal brain is working in that exact moment you are doing the training exercise. And what happens, as you practice this as days go on, your brain actually gets faster,” Mahncke explained. “In doing so, this actually directly improves the brain’s processing speed and it improves what is called the useful field of view — how well you can spread your attention over everything you see.”

SOAR Results

Meneses and colleagues conducted the randomized, controlled pilot study, which was designed to evaluate preliminary efficacy of speed-of-processing training using Brain HQ exercises in middle-aged and older breast cancer survivors.

Sixty breast cancer survivors with self-reported cognitive changes were randomized to either home-based speed-of-processing training or no-contact at all. The researchers primarily focused on investigating speed-of-processing and executive function — which was measured at study entry, six weeks later and six months later.

Those who underwent brain training were asked to complete 10 hours of training, or two hours per week, in a visual speed of processing exercise called “Double Decision” from the BrainHQ web application.

Breast cancer survivors reported significant improvements immediately and in the long-term. At six weeks, they reported improvements in standard measures of processing speed and episodic memory, and at six months overall improvements in objective measures of speed of processing and executive function were seen.

What’s Next

Now that this brain training has found success among breast cancer survivors, Mahncke hopes it can expand in to additional cancer survivorship populations. “I would like to think that the cognitive changes that people with different kinds of cancers experience, despite the fact that their cancers are different and their treatments are different, I would think that the end changes that happen in the brain that lead to chemobrain — fogginess and slowing – those are probably similar changes that happen in the brain.”

Considering Brain HQ exercises work for a variety of conditions such as aging, multiple sclerosis or mental illness, Mahncke is confident it can used in a variety of malignancies.

In addition to expanding to additional cancer types, the company would also like to see these exercises become a standard of care among survivorship plans for patients with breast cancer. For example, the Oncology Nursing Society has already written patient treatment guidelines for chemobrain, and for the first time they included speed of processing cognitive training.

“One of the main areas that we see ahead of us as collaborators is to make sure the results get translated from publication and academic journals in to true changes in treatment care,” said Mahncke. “And that means working with doctors, clinical societies, groups that provide cancer care, and so forth.”

Cancer has transitioned from an incurable disease 20 years ago, to what is now considered something manageable. With that, comes the responsibility of health care providers to think of long-term outcomes and management plans of survivors.

“It is really appropriate that patients, doctors and medical associations are turning their attention to make sure that [cancer] is not only survivable, but a person can turn to thrive afterwards in their family life, their home life and their leisure life,” Mahncke said. “And tackling these issues of brain health is important and we are really excited that our academic partners have been pushing this forward in this way.”