264P - Neuropsychological and morphological effects of simultaneous exercise during neo-/adjuvant chemotherapy in breast cancer patients: The Exercise Cancer and Cognition (ECCO) study

Background

Cancer-related cognitive impairment (CRCI), affecting up to 80% of breast cancer (BC) patients, manifests in various cognitive domains such as learning, memory, and concentration. The hippocampus, crucial for these cognitive processes and known to retain its neurogenesis capacity throughout adulthood, is susceptible to morphological alterations due to BC treatment. Recent research highlights the link between physical exercise and neurogenesis. This study aims to investigate CRCI and the potential effects of high-intensity interval training (HIIT) on learning, memory, and concentration function, as well as brain morphology in BC patients undergoing treatment.

Methods

This randomized (1:1) controlled trial allocated early-stage BC patients to either a HIIT intervention group (IG) or a control group (CG). The intervention involved a 12-month supervised HIIT program tailored through cardio-pulmonary exercise testing. Learning, memory, and concentration function were assessed using the California Verbal Learning Test (CVLT) alongside the Wechsler Memory Scale (WMS). Hippocampal volume was evaluated with MRI-based free surfer analysis. Assessments were conducted at baseline and after 12 months.

Results

A total of 69 patients (mean age 50.67 years, SD 10.55; 98.5% female) were recruited. The analysis showed no statistically significant changes in total hippocampal volume in either group (IG: p = 0.25 and p = 0.39; CG: p = 0.25 and p = 0.33). Similarly, no significant changes were observed in the CVLT scores for both groups (IG: p = 0.102; CG: p = 0.059). However, compared to the CG, the IG exhibited significant improvements in the WMS (p < 0.05).

Conclusions

Assessing CRCI in BC patients is challenging. Despite a multimodal approach, we couldn't objectify structural or functional adverse effects on specific cognitive subdomains. Although HIIT exercise during chemotherapy didn't notably impact learning and memory, it did enhance concentration over time. This might suggest that cognitive function in BC patients benefits from exercising.

Clinical trial identification

NCT04789187. Registered on 09 March 2021.

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Verein zur Forschungsförderung der Krebshilfe OÖ.

Disclosure

All authors have declared no conflicts of interest.