Neurocognitive changes in cancer patients as a current challenge in psycho-oncology

Kovač, Aleksandra; Bugarski-Ignjatović, Vojislava; Tovilović, Snežana; Boban, Jasmina; Kozić, Duško

doi:10.2298/MPNS2012357K

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Medicinski pregled

2020, vol. 73, br. 11-12, str. 357-363

Neurokognitivne promene kod onkoloških pacijenata kao aktuelni izazov u psihoonkologiji

Kovač Aleksandra^a, Bugarski-Ignjatović Vojislava^b

, Tovilović Snežana^c, Boban Jasmina^d

, Kozić Duško^d

^aUniverzitet u Novom Sadu, Medicinski fakultet, Srbija + Institut za onkologiju Vojvodine, Sremska Kamenica, Srbija
^bUniverzitet u Novom Sadu, Medicinski fakultet, Srbija + Klinički centar Vojvodine, Klinika za neurologiju, Novi Sad, Srbija
^cUniverzitet u Novom Sadu, Filozofski fakultet, Odsek za psihologiju, Srbija
^dUniversity of Novi Sad, Faculty of Medicine Novi Sad, Department of Radiology, Novi Sad + Institut za onkologiju Vojvodine, Sremska Kamenica, Srbija

e-adresa: aleksandra.kovac@mf.uns.ac.rs

Ključne reči: neurokognitivni poremećaji; onkološki bolesnici; psiho-onkologija; neuropsihologija; neuroimidžing; kognitivni poremećaji; afektivni simptomi; kognitivni poremećaji uzrokovani hemoterapijom; psihološki poremećaj; ličnost

Sažetak

Uvod. Uz visok intenzitet emocionalnog distresa, onkološki pacijenti često se suočavaju sa neurokognitivnim promenama koje postaju naročito izražene nakon hemioterapije. Kliničke manifestacije neurokognitivnog deficita kod pacijenata koji nemaju tumor centralnog nervnog sistema. Dosadašnje studije su pokazale da se kognitivne smetnje najčešće javljaju u domenima egzekutivnih funkcija, pažnje i koncentracije, radne memorije, brzine procesiranja informacija i vizuospacijalnih sposobnosti, te za iste još uvek ne postoji krajnje definisan protokol dijagnostike i lečenja. Potencijalni etiološki mehanizmi i faktori rizika. Pored hemioterapije, važnu ulogu u nastanku i manifestaciji neurokognitivnog deficita kod onkoloških pacijenata imaju i drugi: genetski, biološki, psihološki i sociodemografski faktori. Metode procene neurokognitivnog deficita kod onkoloških pacijenata. Za procenu eventualnog neurokognitivnog oštećenja najbolje je koristiti kombinaciju koja uključuje neuropsihološku dijagnostiku i inventare za samoprocenu kognitivnog i afektivnog statusa, kao i savremene metode neuroimidžing dijagnostike koje će ukazati na neuralne (strukturalne i funkcionalne) promene koje leže u osnovi neurokognitivnog deficita. Uloga psihosocijalnih faktora - smernice za buduća istraživanja. Pored kognitivne rezerve i afektivnog statusa, potencijalnu ulogu u objašnjenju neurokognitivnog funkcionisanja i neurokognitivne adaptacije po završenom lečenju vrlo verovatno mogu imati i karakteristike ličnosti obolelih. Zaključak. Neophodne su nove studije koje će omogućiti dalje rasvetljavanje mehanizama koji leže u osnovi neurokognitivnih promena kod onkoloških pacijenata, sa posebnim akcentom na doprinos psihosocijalnih faktora, a na osnovu kojih će dalje biti omogućen i adekvatan i pravovremeni kognitivno-rehabilitacioni tretman obolelih od malignih bolesti.

Abstract

Introduction. Along with a high intensity emotional distress, cancer patients often face neurocognitive changes that are particularly pronounced after chemotherapy. Clinical features of neurocognitive deficits in non-central nervous system cancer patients. So far, studies have demonstrated that neurocognitive changes most often occur in domains of executive functions, attention and concentration, working memory, information processing speed and visuospatial abilities, but there is still no definite protocol for the diagnosis and management of this condition. Potential causal mechanisms and risk factors. Apart from chemotherapy, there are other factors associated with the development and manifestation of neurocognitive deficits in cancer patients: genetic, biological, psychological and socio-demographic. Assessment of cancer-related cognitive impairments. When assessing potential cognitive impairments, it is beneficial to combine neuropsychological test battery and self-report questionnaires for the assessment of cognitive and affective status, as well as modern neuroimaging methods that will indicate neural (structural and functional) changes underlying neurocognitive deficit. The role of psychosocial factors: implications for future research. In addition to cognitive reserve and emotional status, the patient's personal characteristics may very likely play an important role in explaining neurocognitive functioning and neurocognitive adaptation of cancer patients upon completion of treatment. Conclusion. Further studies are needed to elucidate the mechanisms underlying neurocognitive changes in cancer patients, with special emphasis on the contribution of psychosocial factors. Based on the novel findings, adequate and timely cognitive rehabilitation treatment will be provided for patients suffering from malignant diseases.

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O članku

jezik rada: engleski
vrsta rada: pregledni članak
DOI: 10.2298/MPNS2012357K
primljen: 18.12.2020.
revidiran: 31.12.2020.
prihvaćen: 01.02.2021.
objavljen u SCIndeksu: 06.08.2022.

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