NCO-17: A BRAIN-PLASTICITY BASED COMPUTERIZED INTERVENTION TO TREAT ATTENTION AND MEMORY PROBLEMS IN ADULT BRAIN TUMOR (BT) SURVIVORS

BACKGROUND: BT survivors commonly have impairments in attention/memory that adversely impact independence, home, school and work roles, mood and quality of life. Adults produce new brain cells, replace dead brain cells, and adaptively recruit new brain regions to perform certain tasks. We sought to determine the feasibility, acceptability, and early efficacy signals of an at-home, internet accessible, adaptive, brain-plasticity based computerized intervention designed to enhance attention/memory processes (Plasticity-based Adaptive Cognitive Remediation, PACR). METHODS: Adult BT survivors with self-reported and tested attention/memory impairment, status post surgery and radiation were enrolled (n = 34) into a longitudinal, single-arm study. Patients completed neuropsychological testing before and after intervention. Patients were instructed to complete 40 PACR sessions (1 hour/day, 5 days/week for 8 weeks). A priori feasibility was defined as >80% of patients completing >10 sessions in the first month and not skipping >10 consecutive sessions thereafter. Secondary objectives were to assess improvement on trained tasks (near transfer), unrelated cognitive tests (far transfer), and acceptability. RESULTS: PACR was considered feasible in 40% of patients; 77% reported being "somewhat" or "very satisfied" with PACRs "usefulness in helping to minimize the impact of cognitive symptoms on ability to function effectively in daily activities"; and 100% of subjects would recommend PACR to others. Near transfer of training effects were significant (P < 0.05) on most trained tasks with effect sizes ranging from 0.32 to 1.29. Far transfer of training effects were only seen on the COWA (p = 0.02). CONCLUSIONS: Only 40% of BT survivors completed the PACR intervention as it was prescribed in this study. Near transfer of training but not far transfer of training was observed. Most participants found the intervention useful and all would recommend it to other patients. Consideration of dose-response curves, alternative treatment delivery, and patient selection appears warranted if PACR is to be a viable intervention.