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Changes in cognitive functioning in the year after hematopoietic stem cell transplantation
Sheri R Jacobs1, Brent J Small, Margaret Booth-Jones
1Health Outcomes and Behavior Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida 33612, USA.
Insights
Hematopoietic stem cell transplantation (HSCT) candidates experience cognitive deficits pre-transplant. Cognitive functioning, except attention, significantly improves and returns to normal within one year post-HSCT.
Area of Science:
- Neuroscience
- Hematology
- Psychology
Background:
- Hematopoietic stem cell transplantation (HSCT) can impact cognitive functions.
- Cognitive deficits are often observed in HSCT candidates before the procedure.
Purpose of the Study:
- To examine changes in cognitive functioning domains in HSCT candidates.
- To assess cognitive performance at pre-transplantation, 6 months, and 12 months post-transplantation.
Main Methods:
- A sequential longitudinal design with 476 randomized patients.
- Comprehensive neuropsychological testing of memory, psychomotor speed, attention, and executive functioning.
- Calculation of a total neuropsychological performance score (TNP).
Main Results:
- Cognitive abilities, excluding attention, showed significant improvement 1 year after HSCT.
- Total neuropsychological performance and most cognitive domains met or exceeded population norms by 12 months.
- Repeated testing improved motor speed and TNP; attrition impacted TNP, favoring those remaining in the study.
Conclusions:
- HSCT candidates experience pre-transplant cognitive deficits.
- Cognitive functioning generally recovers to normative levels within one year following HSCT.
- Longitudinal improvements are observed, though influenced by sample attrition.
Background:
The current study examined changes in multiple domains of cognitive functioning of hematopoietic stem cell transplantation (HSCT) candidates tested pretransplantation, 6 months posttransplantation, and 12 months posttransplantation.
Methods:
Using a sequential longitudinal design, 476 patients were randomized to be tested at all 3 time points, at 6 and 12 months posttransplantation, or at only 12 months posttransplantation. Participants completed a comprehensive battery of neuropsychologic tests that indexed memory, psychomotor speed, attention, and executive functioning, and provided a total neuropsychologic performance score (TNP).
Results:
The results indicate that performance on cognitive abilities, except for attention, significantly improved across the 1-year follow-up period after HSCT. Performance on the TNP and all cognitive domains was superior or equal to population normative values by the 12-month measurement point. The results also indicate that repeated exposure to tests led to better performance on motor speed and the TNP and that attrition influenced the TNP, such that those who remained in the longitudinal sample exhibited greater longitudinal improvement in scores as compared with patients who left the sample.
Conclusions:
The findings of the current study suggest that although patients undergoing HSCT experience cognitive deficits during the period just before transplantation, cognitive functioning returns to normative values within a year after transplantation.
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