The Physical Activity and Memory (PAM) study

Physical exercise is a promising intervention to improve cognition and white matter integrity. Therefore, we investigate whether an exercise intervention can improve cognitive functioning and white matter integrity in breast cancer patients, 2-4 years after diagnosis.

The PAM study is a randomized controlled trial in which chemotherapy-exposed breast cancer patients with self-reported and tested cognitive problems were randomized to an exercise or wait-list control group. The 6-month exercise intervention consisted of supervised aerobic and strength training for 2x1 hour/week and Nordic/power walking sessions for 2x1 hour/week. Face-to-face tested cognitive functioning (learning and memory functioning; HVLT-R), online neuropsychological tests (ACS) and self-reported cognitive functioning (MDASI-MM) are measured. Two indices for white matter microstructure are derived from magnetic resonance diffusion tensor imaging. Additionally, physical fitness, fatigue, QoL, depression and anxiety are assessed.  Data collection is finished and we randomized 181 patients to the exercise (n=91) or control group (n=90). No beneficial effects of the intervention were found on tested cognitive functioning, but self-reported cognition did improve significantly in the exercise group compared to controls. DTI data showed no significant differences in FA and MD values for the intervention compared to the control group. Significant improvements following the intervention were found for physical fitness, fatigue, QoL, and depression. A subgroup analysis indicated a positive effect of exercise on tested cognitive functioning in highly-fatigued patients, which is a hopeful new avenue for research.