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Treating new-onset cognitive complaints after risk-reducing salpingo-oophorectomy: A randomized controlled crossover
Christina A Metcalf1, Chloe E Page1, Brianna O S Stocker2
1Department of Psychiatry, Anschutz Medical Campus, University of Colorado, Aurora, CO, United States.
Objective:
To determine whether the psychostimulant lisdexamfetamine improves subjective and objective measures of cognitive functioning among women genetically at-risk for cancer who have undergone risk-reducing salpingo-oophorectomy and report new-onset executive functioning difficulties.
Methods:
69 participants were assigned to a randomized controlled crossover trial with 6-week trials of active medication (lisdexamfetamine) and placebo, separated by a minimum 2-week washout in an intent-to-treat framework (clinical trial registration number: NCT03187353). At trial baseline, midpoint, and endpoint, participants completed a self-report measure of executive functioning (Brown Attention Deficit Disorder Scale). At study baseline and trial endpoint, participants completed sustained attention, attention/working memory, and verbal learning/memory cognitive tasks. Side effects were assessed at 2, 3, 4, and 6 weeks for each trial.
Results:
From trial baseline to trial endpoint, lisdexamfetamine - relative to placebo - significantly improved total scores on the self-report Brown Attention Deficit Disorder Scale (and scores on four of five subdomains) as well as attention and working memory performance. Significantly more participants endorsed side effects across the lisdexamfetamine trial versus placebo; however, trial completion rates were similar, indicating that lisdexamfetamine was nonetheless well-tolerated.
Conclusions:
Lisdexamfetamine improved both subjective and objective measures of attention and working memory and could offer women experiencing cognitive difficulties post-risk-reducing salpingo-oophorectomy an alternative therapeutic option.
Insights
Lisdexamfetamine improved cognitive function in women post-risk-reducing surgery. This psychostimulant medication enhanced attention and working memory, offering a potential treatment for executive functioning difficulties.
Area of Science:
- Neuroscience
- Oncology
- Pharmacology
Background:
- Women undergoing risk-reducing salpingo-oophorectomy (RRSO) may experience new-onset executive functioning difficulties.
- Genetic risk for cancer necessitates surgical intervention, impacting quality of life.
- Cognitive changes post-RRSO require effective therapeutic strategies.
Purpose of the Study:
- To evaluate the efficacy of lisdexamfetamine in improving cognitive function in women at genetic risk for cancer post-RRSO.
- To assess the impact of lisdexamfetamine on subjective and objective measures of executive functioning.
- To determine the safety and tolerability of lisdexamfetamine in this patient population.
Main Methods:
- A randomized controlled crossover trial involving 69 participants comparing lisdexamfetamine and placebo over 6-week periods with a 2-week washout.
- Utilized the Brown Attention Deficit Disorder Scale for self-reported executive functioning and objective cognitive tasks assessing attention, working memory, and verbal learning.
- Monitored side effects throughout the trial and assessed trial completion rates.
Main Results:
- Lisdexamfetamine significantly improved self-reported executive functioning scores (Brown Attention Deficit Disorder Scale) compared to placebo.
- Objective cognitive assessments showed significant improvements in attention and working memory performance with lisdexamfetamine.
- While side effects were more frequently reported with lisdexamfetamine, overall trial completion rates were similar, suggesting good tolerability.
Conclusions:
- Lisdexamfetamine effectively improved both subjective and objective measures of attention and working memory.
- This psychostimulant presents a viable therapeutic option for women experiencing cognitive difficulties after risk-reducing salpingo-oophorectomy.
- Further research may explore long-term efficacy and optimal dosing in this population.
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