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1H-MRS study of hippocampus in advanced prostate cancer patients: Relationship between hippocampal secondary damage and cognitive disorder following combined androgen blockade therapy

  • 0Department of Urology, Neijiang First People's Hospital, Neijiang, Sichuan, China.
Plos One +

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May 7, 2025

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May 7, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Combined androgen blockade (CAB) treatment for advanced prostate cancer (PCa) caused hippocampal metabolic changes, leading to cognitive decline. Testosterone

Area Of Science

  • Neuroscience
  • Oncology
  • Metabolic Research

Background

  • Advanced prostate cancer (PCa) treatment often involves combined androgen blockade (CAB).
  • Potential side effects of CAB on cognitive function and brain metabolism are not fully understood.
  • The hippocampus plays a crucial role in memory and cognition.

Purpose Of The Study

  • To investigate metabolic changes in the hippocampus following 6 months of CAB treatment in advanced PCa patients.
  • To determine the correlation between hippocampal metabolic alterations and cognitive function changes.
  • To explore the role of testosterone in mediating these effects.

Main Methods

  • Observational study comparing advanced PCa patients undergoing CAB with a healthy control group.
  • Proton magnetic resonance spectroscopy (1H-MRS) measured hippocampal N-acetylaspartate/creatine (NAA/Cr) and choline-containing compounds/creatine (Cho/Cr) ratios.
  • Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA-BJ).

Main Results

  • After 6 months of CAB, patients showed significant cognitive decline (MoCA-BJ scores, delayed recall, visuospatial/executive, attention).
  • Hippocampal metabolic changes included reduced NAA/Cr and elevated left hippocampal Cho/Cr.
  • Left hippocampal NAA/Cr positively correlated with MoCA-BJ total score and delayed recall; testosterone mediated this relationship.

Conclusions

  • CAB treatment induces secondary hippocampal injury, contributing to cognitive dysfunction in advanced PCa patients.
  • The cognitive impact of advanced PCa itself may be minimal compared to treatment side effects.
  • Hippocampal metabolic changes, particularly NAA/Cr levels, are linked to cognitive performance during CAB therapy.