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Shelli Kesler, PhD
ShelliKeslerPhD (Researcher (Verified) )| Communities: All Cancers | Answers: 8 |
| Member Since: Jun. 2012 |
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Professional Statement
Dr. Kesler is an Assistant Professor of Psychiatry and Behavioral Sciences, a licensed neuropsychologist, a Member of the Cancer Center and a Member of the Bio-X Program at Stanford University. She is the Director of the Neuropsychology and Neuroimaging Lab. Her research focuses on the neurobiologic effects of cancer as well as the development of practical methods for cognitive assessment and rehabilitation. She has received the NIH Director's New Innovator Award and an NCI Career Development Award for her work in cancer-related cognitive impairment. Dr. Kesler has published several studies utlizing neuroimaging techniques that demonstrate neurobiologic effects of cancer and its treatments as well as studies describing the implementation of computerized cognitive training and rehabilitation methods. Dr. Kesler is also an attending neuropsychologist in the Child Psychiatry and Behavioral Medicine outpatient clinics at Stanford University Medical Center. She treats children and adults who have cancer-related cognitive disorders.
Professional Info
Credential: PhD
School / University: Brigham Young University
Areas of expertise: Psychology, Psychiatry
Research interests: Assessment and treatment of cognitive deficits related to medical problems, particularly cancer. Multi-level research involving neuropsychology, neuroimaging and genetics. Measurement and enhancement of neuroplasticity mechanisms through targeted interventions.
Hospital or other affiliation: Stanford School of Medicine
City: Stanford
State: CA
Zip: 94305
ShelliKeslerPhD Activities
Currently there is not a specific treatment or solution for chemobrain. For patients with persistent cognitive difficulties that negatively impact social, occupational, home and/or other areas of function should start by getting a neuropsychological evaluation. This evaluation can provide an individualized treatment plan and can also be useful if disability or workplace accommodations need to be considered. Regular and consistent mental and physical (aerobic) activity can improve brain function. Addressing any psychiatric issues such as depression or anxiety are also very important as these symptoms can worsen cognitive problems. Some patients show improvement with certain stimulant medications such as those used to treat ADHD.
New answer by ShelliKeslerPhD (Researcher (Verified))
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11 months ago
These mechanisms remain largely unclear but strong candidates include neurotoxic effects of chemotherapy, elevated inflammation (from treatments and/or the cancer itself), interactions of treatments with genetic variations and hormonal deficiencies. All of these factors may negatively affect brain structure and function in various ways leading to cognitive changes.
New answer by ShelliKeslerPhD (Researcher (Verified))
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11 months ago
These are known as cognitive training methods and there are many options available. Most involve computerized or online software that is commercially available. Thus far, the research suggests that these may be helpful for improving certain skills. There also are some studies that suggest cognitive training might help prevent further cognitive decline. Regular mental and physical activity is very important for keeping your brain healthy. Home based cognitive training programs are just one way that individuals can stay mentally active. They provide a structured, inexpensive and entertaining option for staying including some mental activity in one's daily routine. Regardless of what mental activity is chosen, it is critical to be regular and consistent with it in order to have benefit.
New answer by ShelliKeslerPhD (Researcher (Verified))
1
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11 months ago
My lab uses neuroimaging methods, neuropsychological testing, genotyping and immunologic assays. Neuroimaging involves measurement of brain structure, function and metabolism, among others. Our lab uses magnetic resonance imaging (MRI) to obtain images of the brain that are then quantified. Neuropsychological testing involves standardized measures of cognitive skills such as executive function, memory and attention. Genotyping involves obtaining DNA from a blood or saliva sample. Immune assays include measurement of cytokines from blood samples.
New answer by ShelliKeslerPhD (Researcher (Verified))
1
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11 months ago
Neurobiologic impairments typically refer to deficits or abnormalities in the brain while cognitive impairments refer to behavioral or performance difficulties. For example, a neurobiologic impairment might include hippocampal atrophy. A cognitive impairment might include memory loss. Cognitive impairments tend to stem from neurobiologic impairments because cognition and behavior arise from brain structure and function. Therefore, someone with hippocampal atrophy (neurobiologic impairment) might be expected to have memory difficulties (cognitive impairment) although it is not always directly correlated due to the brain's high degree of complexity and individual difference.
New answer by ShelliKeslerPhD (Researcher (Verified))
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11 months ago
What process do you follow when performing a cognitive assessment of a cancer survivor (chemobrain)?
This is typically referred to as a neuropsychological evaluation. This evaluation usually involves a clinical interview with the patient (and sometimes a significant other and/or family members familiar with the patient's functioning). During this interview, detailed information is gathered regarding the patient's background including early developmental, family, medical, social, educational, occupational and psychiatric histories. Medical records are reviewed. The patient then spends several hours (4-6 or more) with the clinician completing various tests. These tests measure executive function, intellectual function, memory and learning, sensorimotor skills, visual-spatial processing, attention and emotional status, among others. Testing can be broken up into several sessions to reduce fatigue. The clinician then formulates a diagnosis and a treatment plan based on the combined information from interviews, records and testing.
New answer by ShelliKeslerPhD (Researcher (Verified))
1
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11 months ago
Cognitive rehabilitation generally refers to a clinic based treatment that is provided by a trained professional. Neuropsychologists, speech and language therapists and occupational therapists are typically trained in these methods. The strategies involved in the treatment plan depend on the individual's specific cognitive strengths and weaknesses. These strategies can include a range of methods including the use of assistive technology, cognitive exercises, compensatory strategies and relaxation training, among others.
New answer by ShelliKeslerPhD (Researcher (Verified))
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11 months ago
The most common areas of difficulty including processing speed, attention, memory and executive function. Specific difficulties will vary among survivors depending on many factors. These factors include age, pre-cancer cognitive ability (i.e. cognitive reserve), level of physical and mental activity, psychiatric status (is the patient depression/anxious?) treatment history (e.g. chemotherapy, hormonal blockade, radiation) and certain genetic variants. However, we don't yet know all the mediating and moderating factors that might be involved.
New answer by ShelliKeslerPhD (Researcher (Verified))
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11 months ago
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