Pilot randomized study of adaptive cognitive training’s effect on breast cancer survivors assessed through eye tracking

This is the authors' abstract. We don't add key points for this paper.

PURPOSE: Cancer-related cognitive impairment (CRCI) is a prevalent comorbidity among breast cancer survivors, yet evidence supporting the efficacy of adaptive cognitive training remains limited. This pilot study seeks to examine participants' adherence and preliminary effect of tablet-based cognitive training as an intervention for CRCI and apply eye tracking technology as an innovative approach to evaluate cognitive training outcomes. METHODS: Fifty-two eligible participants were randomly assigned to either the biofeedback therapy group (BF) or the combined biofeedback therapy and cognitive training group (BF + COG). Participants completed a 30-session intervention lasting 6 weeks and eye tracking assessments at two timepoints: baseline and immediately after the intervention completion. RESULTS: Retention rates were 68% in the BF group and 70.4% in the BF + COG group. At the 6-week follow-up, the BF + COG group demonstrated significantly improved fixation stability. Under non-interfering conditions, they maintained fixation 307.76 ms longer (p = 0.022, Cohen's d = 0.307) and had a 32.4% reduction in saccadic distance (p = 0.019, Cohen's d = -0.677) compared to BF. This advantage persisted under interference conditions with a 28.2% shorter saccadic distance (p = 0.034, Cohen's d = -0.579). While within-group changes were not significant, the BF+COG group consistently showed reduced saccade distances across conditions, whereas the BF group exhibited increases. CONCLUSION: Adaptive cognitive training may enhance attentional engagement and inhibitory control in breast cancer survivors. Large-scale study is needed to confirm these effects and refine eye-tracking applications for CRCI assessment. IMPLICATIONS FOR CANCER SURVIVORS: Tablet-based cognitive training targeting cognitive control with adaptive difficulty levels may ameliorate CRCI among breast cancer survivors.