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Published on: March 6, 2018
Effects of androgen deprivation on cerebral morphometry in prostate cancer patients--an exploratory study
Herta H Chao1, Sien Hu, Jaime S Ide
1Department of Internal Medicine & Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, Connecticut, United States of America ; Medical Service, VA Connecticut Healthcare System, West Haven, Connecticut, United States of America.
Background:
Androgen deprivation therapy (ADT) is a common treatment for non-metastatic, low-risk prostate cancer, but a potential side effect of ADT is impaired brain functioning. Previous work with functional magnetic resonance imaging (MRI) demonstrated altered prefrontal cortical activations in cognitive control, with undetectable changes in behavioral performance. Given the utility of brain imaging in identifying the potentially deleterious effects of ADT on brain functions, the current study examined the effects of ADT on cerebral structures using high resolution MRI and voxel-based morphometry (VBM).
Methods:
High resolution T1 weighted image of the whole brain were acquired at baseline and six months after ADT for 12 prostate cancer patients and 12 demographically matched non-exposed control participants imaged at the same time points. Brain images were segmented into gray matter, white matter and cerebral ventricles using the VBM toolbox as implemented in Statistical Parametric Mapping 8.
Results:
Compared to baseline scan, prostate cancer patients undergoing ADT showed decreased gray matter volume in frontopolar cortex, dorsolateral prefrontal cortex and primary motor cortex, whereas the non-exposed control participants did not show such changes. In addition, the decrease in gray matter volume of the primary motor cortex showed a significant correlation with longer reaction time to target detection in a working memory task.
Conclusions:
ADT can affect cerebral gray matter volumes in prostate cancer patients. If replicated, these results may facilitate future studies of cognitive function and quality of life in men receiving ADT, and can also help clinicians weigh the benefits and risks of hormonal therapy in the treatment of prostate cancer.
Insights
Androgen deprivation therapy (ADT) in prostate cancer patients reduced gray matter volume in key brain regions. This structural change may impact cognitive function and quality of life.
Area of Science:
- Neuroimaging
- Oncology
- Neurology
Background:
- Androgen deprivation therapy (ADT) is a standard prostate cancer treatment.
- ADT may impair cognitive functions, particularly in the prefrontal cortex.
- Previous studies showed altered brain activity without behavioral changes.
Purpose of the Study:
- To investigate the effects of ADT on cerebral structures.
- To utilize high-resolution MRI and VBM for detailed analysis.
- To correlate structural changes with cognitive performance.
Main Methods:
- Acquired high-resolution T1-weighted MRI scans at baseline and 6 months.
- Included 12 prostate cancer patients on ADT and 12 controls.
- Segmented brain images into gray matter, white matter, and ventricles using VBM.
Main Results:
- ADT patients showed decreased gray matter volume in frontopolar, dorsolateral prefrontal, and primary motor cortex.
- Control participants exhibited no significant structural changes.
- Reduced gray matter in the primary motor cortex correlated with slower reaction times in a working memory task.
Conclusions:
- ADT significantly affects cerebral gray matter volumes in prostate cancer patients.
- Findings may guide future research on cognitive function and quality of life.
- Results can aid clinicians in balancing ADT benefits and risks.
