Mental time travel in patients “cured” from primary central nervous system lymphoma

ABSTRACT

Introduction: Significant advances in neuro-oncological treatment led to considering neurocognitive functioning and everyday functional needs in patients with long-term survival. Since a potentially lethal disease interrupts normal life and represents a threat to physical and psychological integrity, patients have to cope with the new challenges. Long-term survival and even “cure” is possible in primary central nervous system lymphoma (PCNSL), however, suffering from a life-threatening disease may affect patients´ cognitive processing of past and future (i.e., the generation of personal past memories and generation of personal future events). Therefore, the present study aimed to assess how PCNSL long-term survivors remember their past and anticipate their future.

Methods: Recall of past and anticipation of future events (i.e., mental time travel), both positive and negative, was assessed in 39 PCNSL patients with ongoing complete remission to therapy for at least 1 year in an adapted verbal fluency paradigm. A group of 39 healthy controls matched for age, gender and education was assessed with the same paradigm evaluating retrospective and prospective cognitions.

Results: Concerning the generation of personal future events PCNSL patients anticipated significantly fewer negative events for the distant future as compared to healthy controls. At trend level, patients also reported fewer negative events regarding their recent past.

Conclusions: The results provide support for an altered generation of personal future events (i.e., future-directed assumptions) in PCNSL patients with ongoing complete remission. Being “cured” after experiencing a threat to life might induce cognitive reappraisal processes and lead people to reexamine their priorities and principles in life, resulting in a less negative evaluation of (future) life (i.e., “optimism bias”) after facing death. Clinicians should be aware of these possible cognitive and affective processes and of chronic psychological disturbances in cancer survivors. Possible adaptive strategies ought to be promoted in supportive (neuro)psychological therapy.

KEYWORDS:

• Mental time travel
• future thinking
• psychological adjustment
• brain tumor
• primary central nervous system lymphoma

Disclosure statement

Uwe Schlegel received speech honoraria from medac, GSK, and Novartis. The other authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (local ethics board of the medical faculty, Ruhr University Bochum, reference number 18-6386) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all individual participants included in the study.

Data availability statement

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Supplementary material

Supplemental data for this article can be accessed here.