Abstract
ObjectiveAlthough cancer patients frequently report cognitive disturbances, it is commonly asserted a lack of association between cognitive complaints and neuropsychological test performances. Our goal was to better understand the relationships between subjective and objective cognitive scores through a metamemory monitoring assessment.MethodsSixty cancer patients currently treated by chemotherapy and/or targeted therapy, and 30 healthy controls (HC) were included. Cognitive complaint was assessed by FACT‐cog, QAM and DEX questionnaires. One or more z‐scores ≤−1.65 among these three questionnaires defined the presence of cognitive complaints. Objective cognitive performances assessed episodic memory, processing speed and executive functions/working memory (ESR paradigm, TMT, Stroop, n‐back). Metamemory was assessed with a Judgment of Learning (JOL) task.ResultsPatients with cognitive complaints had significantly more depressive and anxiety symptoms (ps < .004), and lower performances on several cognitive tests (ps < .05) than both patients without complaints and HC. More specifically, analyses of the metamemory scores revealed that HC gave significantly more overestimations (“Yes” judgment and incorrect recall) than patients with cognitive complaints (p = .036). For these patients, JOL scores correlated positively with executive functioning (ps < .01).ConclusionMetamemory monitoring seems to be well‐preserved during cancer. What is more, patients make less overestimation than HC, and they do not underestimate their memory. An accurate self‐estimation of memory abilities in cancer patients, particularly those with mild cognitive deficits, may play an adaptive function. Our results suggest that the discrepancy frequently reported between cognitive complaints and objective cognitive scores may not be related to metamemory monitoring dysfunction.
Highlights
Some non-central nervous system cancer patients report mild cognitive disturbances such as memory problems (Hodgson, Hutchinson, & Wilson, 2013; Root, Andreotti, & Tsu, 2016)
Due to the significant impact on the patient's quality of life (Boykoff, Moieni, & Subramanian, 2009; Hutchinson, Hosking, & Kichenadasse, 2012; Lange & Joly, 2017), a growing body of neuropsychological and neuroimaging studies focuses on cognitive impairment in cancer patients (Joly et al, 2015)
Results from this study showed that breast cancer patients had no significantly different performances on Feeling of Knowing (FOK) index than healthy controls (HC)
Summary
Some non-central nervous system (non-CNS) cancer patients report mild cognitive disturbances such as memory problems (Hodgson, Hutchinson, & Wilson, 2013; Root, Andreotti, & Tsu, 2016). Considering the frequent discrepancies between subjective reports of cognitive difficulties and objective measures from neuropsychological tests (Bray, Dhillon, & Vardy, 2018; Hutchinson et al, 2012; Pullens, De Vries, & Roukema, 2010), overall cancer patients' cognitive complaints do not seem to be good predictors of their objective performances. One study has focused on metamemory monitoring abilities in cancer patients (Collins, Paquet, & Dominelli, 2017) This one was based on the Feeling of Knowing (FOK) procedure which assess, during a memory task, the prediction to recognize nonrecalled items during the recall phase. We hypothesized that patients with cognitive complaints would have a metamemory dysfunction in the sense of an underestimation of their performances, contrary to patients without cognitive complaints and HC
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