Memory and Thinking Skills Workshop in Improving Cognitive Rehabilitation in Ovarian Cancer Survivors

• Changes in cognitive performance and QOL pre and post participation in a cognitive rehabilitation intervention [ Time Frame: Baseline to 7 weeks ] [ Designated as safety issue: No ]
  The behavioral data (tests and questionnaires) will be entered into SPSS statistical software and analyzed. A mixed model (group by time) multivariate analysis of variance (MANOVA) will be used to determine if an interaction occurs between the treatment group and control (CL) over time, which will be further confirmed with post-hoc analyses.
• Changes in neural function measured by fMRI BOLD signal and corresponding behavioral responses while performing cognitive tasks [ Time Frame: Baseline to 7 weeks ] [ Designated as safety issue: No ]
  Software from the fMRI for the Brain (FMRIB) Software Library will be used to analyze fMRI data and a paired T-test will be used to compare resting state images with paired associate recall images. Prior to automated procedures each functional series will be manually reviewed and aberrant volumes or extreme motion artifacts will be removed. Both a whole brain and region of interest (ROI) analysis will be conducted for cognitive task scans.

The purpose of this study is to examine thinking abilities, mood, and quality of life in cancer survivors before and after an 8-week group-based memory and thinking skills workshop. Research participants will include people treated for cancer in the past. Researchers would like to know if there is a relationship between baseline performance on timed attention and memory tasks before receiving memory and thinking skills workshop, and performance on such tasks after the workshop

PRIMARY OBJECTIVES:

I. To objectively assess changes in cognitive performance and quality of life (QOL) pre and post participation in a cognitive rehabilitation intervention in ovarian cancer survivors who have undergone chemotherapy.

II. To measure changes in neural function as measured by functional magnetic resonance imaging (fMRI) blood oxygenation level dependent (BOLD) signal and corresponding behavioral responses while performing cognitive tasks.

OUTLINE: Patients are randomized to 1 of 2 treatment arms.

ARM I: Patients participate in a memory and thinking skills workshop once weekly for 8 weeks. Patients complete cognitive tests and questionnaires at baseline and 7 weeks.

ARM II: Patients complete cognitive tests and questionnaires at baseline and 7 weeks. Patients are then scheduled to participate in a later memory and thinking skills workshop.

• Cancer Survivor
• Cognitive/Functional Effects
• Ovarian Neoplasm

• Other: cognitive intervention
  Participate in memory and thinking skills workshop
• Other: questionnaire administration
  Ancillary studies
• Procedure: quality-of-life assessment
  Ancillary studies
  Other Name: quality of life assessment
• Procedure: blood-oxygen-level-dependent functional magnetic resonance imaging
  Undergo BOLD-fMRI
  Other Name: BOLD fMRI
• Other: memory intervention
  Participate in memory and thinking skills workshop

• Experimental: Arm I (memory and thinking skills workshop)
  Patients participate in a memory and thinking skills workshop once weekly for 8 weeks. Patients complete cognitive tests and questionnaires at baseline and 7 weeks.
  Interventions:

  • Other: cognitive intervention
  • Other: questionnaire administration
  • Procedure: quality-of-life assessment
  • Procedure: blood-oxygen-level-dependent functional magnetic resonance imaging
  • Other: memory intervention
• Active Comparator: Arm II (control)
  Patients complete cognitive tests and questionnaires at baseline and 7 weeks. Patients are then scheduled to participate in a later memory and thinking skills workshop.
  Interventions:

  • Other: questionnaire administration
  • Procedure: quality-of-life assessment
  • Procedure: blood-oxygen-level-dependent functional magnetic resonance imaging

Inclusion Criteria:

• Subjective concern about declines in cognitive functioning related to a diagnosis of cancer and/or cancer related treatment
• Prior treatment of ovarian cancer with chemotherapy
• Completion of treatment (e.g., chemotherapy, radiation therapy, surgery, etc.) for ovarian cancer 6 months or greater in the past
• Able to comprehend and speak English
• For the subset of participants who will undergo magnetic resonance imaging (MRI), ability to withstand lying down in small area (MRI scanner) for 50 minutes
• Completion of successful fMRI safety screening
• Able to give informed consent
• Able to undergo informed consent procedures and 3 hours of testing, plus 8 1-hour cognitive rehabilitation sessions with breaks

Exclusion Criteria:

• Ongoing treatment for ovarian or other cancer (e.g., chemotherapy, radiation, surgery, etc.)
• Cancer onset before the age of 21
• Unstable medical problems (such as unstable heart disease, unstable hypertension, diabetes in poor control, respiratory disease complicated by hypoxia or hypercapnia, infectious illnesses, unstable thyroid dysfunction, currently hospitalized)
• History of, or current symptoms of, serious psychiatric disorder requiring antipsychotic medications or hospitalization; mild depression or stable anti-depressants, and anti-seizure medications are acceptable; anti-anxiety medications are not
• Current alcohol over-use as defined by currently consuming 4 drinks or more per day or binge drinking (6 or more drinks in one night) within the past week
• Current substance use or abuse as defined by any recreational drug use (e.g. cocaine, methamphetamine, crack, hashish, heroin, acid, mushrooms and others that may not be listed here but are determined to be adverse according to PI) as well as any use of marijuana regardless of medical prescription
• History of or current neurological illness that significantly impacts cognition (e.g. stroke, multiple sclerosis, Parkinson's disease, Alzheimer's disease, head injury, epilepsy, etc)
• History of brain injury that significantly impacted cognition; as indicated responses on the Ohio State University Traumatic Brain Injury Identification Method (OSU TBI-ID) greater or equal to any of the following: 30 minutes or more of LOC, two or more mild cases within two weeks of each other, or any injury with loss of consciousness before the age of 15
• History of central nervous system (CNS) tumor
• A score of 25 or more on the Patient Health Questionnaire (PHQ-9) on the first visit
• A score of 26 or below on the Mini Mental Status Exam (MMSE)
• A score above 45 on the Wender Utah Rating Scale for ADD (WURS)

• For the subset of participants undergoing neuroimaging:

  • Medical history or devices which make an MRI unsafe or uncomfortable (e.g., magnetic rods or pins, metal plates or screws, pacemaker)