Navigating a 30-year career as an insurance salesman requires Mike Johnson to constantly track his activities on a series of to-do lists. Now 66, Johnson could blame his need for memory-boosters on his age, but he doesn’t do that.
“I’ve been making lists for a long time,” he says. “To me, it’s just a way of life.”
Johnson’s cognitive challenges may also stem from his cancer battle as a teen in 1968. As one of the first 1,000 patients treated at St. Jude Children’s Research Hospital, he was cured of acute lymphoblastic leukemia (ALL). But he and other survivors often face problems with working memory and executive function — the ability to retain information and solve problems — due to the disease and its treatment.
In an effort to address this issue, Johnson is helping St. Jude researchers by participating in a study. He is one of the first adult leukemia survivors to help test a combination of low-voltage brain stimulation with “brain training” games to boost thinking skills. Although the therapy has been used in other types of patients, this study is the first of its kind in childhood cancer survivors.
Early results are extremely promising, increasing brain function and potentially smoothing the futures of survivors and families, says Kevin Krull, PhD, of the St. Jude departments of Psychology and Epidemiology and Cancer Control.
“With successful treatment, typical childhood leukemia survivors are going to outlive their parents,” Krull says. “If survivors have significant executive-function deficits and can’t live independently, what happens when their parents are 70 or 80 and are more dependent on them? How does that affect the family dynamics?
“We know those with higher executive function do better in getting higher-paying jobs and pursuing higher education, so they can attain a higher level of social independence and success,” he adds.
Fun for a purpose
Krull and his colleagues paired a technique called transcranial direct-current stimulation — delivering a low dose of electrical current to the brain — with brain-training games in adult survivors of childhood leukemia. All participants had shown problems with executive function, a skill that usually develops during childhood and adolescence.
Scientists placed electrodes on the forehead to stimulate the brain’s frontal lobes, which are responsible for executive function. Survivors continued the 15-minute process at home for 10 sessions. Participants followed each session with 20 minutes of cognitive-training games.
“The notion was if they could do the cognitive training during the two-hour window of increased brain sensitivity after stimulation, they would learn the skill faster and it would help engage them more in the task,” Krull explains.
Johnson usually enjoyed the games, which had him virtually whizzing around racetracks, tracking the direction of flying birds or matching numbers on objects at the top and bottom of the screen. The games are meant to test skills such as working memory, processing speed and pattern recognition.
“Some were more intense or complex than others, and on some I was just trying to do the best I could,” he says. “I even continue to do some of them today. It was fun.”
After the brain-training regimen, Johnson and fellow survivors completed the same cognitive tests they’d taken before the study. Results proved encouraging.
“After just 10 sessions, they improved both in their self-report of cognitive function as well as in our tests,” Krull says. “Participants said they could concentrate better, they got less distracted and could hold information in their heads better. I’m quite excited about it.”
The study’s findings will propel a much larger effort to determine whether this program can produce lasting improvements.
“Can we maintain this effect and magnify the effect over time?” Krull asks. “If so, we hope to begin treating children who are younger, who just begin to show problems, to hopefully prevent a lot of hardship down the road.”
From Promise, Autumn 2018