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Background <p>Cognitive impairment is a recognized challenge for cancer survivors, often linked to chemotherapy’s neurotoxic effects. In colorectal cancer (CRC), this impact remains less understood despite emerging evidence. This study aims to evaluate cognitive flexibility, memory, and attention in colorectal cancer patients compared to healthy controls.</p> Methods <p>This prospective study assessed cognitive function in 58 colorectal cancer patients and 32 healthy, age- and education-matched controls. Cognitive testing was conducted within four weeks of chemotherapy completion. Exclusion criteria included pre-existing cognitive issues, brain metastases, and medications affecting cognition. Tests included Sensory Perception, Total Learning Score, Long-Term Memory Score, Stroop Test, and Trail Making Test.</p> Results <p>The median age of the cancer group was 56.5 years (range: 29–70), while the median age for the control group was 52 years (range: 28–66). Cancer patients demonstrated significantly poorer performance across several cognitive domains. Total Learning Scores were notably lower in the cancer group (mean rank 40.23 vs. 55.05, <i>p</i> = 0.01), indicating reduced learning capacity. Trail Making Test A and B times were significantly longer for cancer patients (<i>p</i> = 0.004), reflecting deficits in visual attention and cognitive flexibility. Stroop Test performance also showed significant delays across all time points (<i>p</i> = 0.002 to <i>p</i> = 0.02), suggesting impaired processing speed and executive control. Subgroup analysis of stage IV patients revealed even greater deficits, with significantly lower Total Learning Scores (<i>p</i> = 0.001) and slower Trail Making Test completion times (<i>p</i> &lt; 0.001). No significant differences emerged in sensory perception or long-term memory.</p> Conclusion <p>The research revealed significant cognitive difficulties in colorectal cancer patients after undergoing chemotherapy, especially in areas such as learning, attention, and executive function, with the most severe impairments observed in those with stage IV cancer.</p>

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Cognitive flexibility, memory, and attention in colorectal cancer: findings from a comprehensive neuropsychological assessment

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月30日

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  • Sabin Goktas Aydin,
  • Bahar Ozguzel,
  • Bahar Bayramova,
  • Ersin Budak,
  • Erkan Aydin,
  • Ahmet Aydin,
  • Muge Ustuner,
  • Eda Nur Duran,
  • Fatma Bengu Aydin

摘要

Background

Cognitive impairment is a recognized challenge for cancer survivors, often linked to chemotherapy’s neurotoxic effects. In colorectal cancer (CRC), this impact remains less understood despite emerging evidence. This study aims to evaluate cognitive flexibility, memory, and attention in colorectal cancer patients compared to healthy controls.

Methods

This prospective study assessed cognitive function in 58 colorectal cancer patients and 32 healthy, age- and education-matched controls. Cognitive testing was conducted within four weeks of chemotherapy completion. Exclusion criteria included pre-existing cognitive issues, brain metastases, and medications affecting cognition. Tests included Sensory Perception, Total Learning Score, Long-Term Memory Score, Stroop Test, and Trail Making Test.

Results

The median age of the cancer group was 56.5 years (range: 29–70), while the median age for the control group was 52 years (range: 28–66). Cancer patients demonstrated significantly poorer performance across several cognitive domains. Total Learning Scores were notably lower in the cancer group (mean rank 40.23 vs. 55.05, p = 0.01), indicating reduced learning capacity. Trail Making Test A and B times were significantly longer for cancer patients (p = 0.004), reflecting deficits in visual attention and cognitive flexibility. Stroop Test performance also showed significant delays across all time points (p = 0.002 to p = 0.02), suggesting impaired processing speed and executive control. Subgroup analysis of stage IV patients revealed even greater deficits, with significantly lower Total Learning Scores (p = 0.001) and slower Trail Making Test completion times (p < 0.001). No significant differences emerged in sensory perception or long-term memory.

Conclusion

The research revealed significant cognitive difficulties in colorectal cancer patients after undergoing chemotherapy, especially in areas such as learning, attention, and executive function, with the most severe impairments observed in those with stage IV cancer.