Effects of Androgen Deprivation on Cerebral Morphometry in Prostate Cancer Patients - An Exploratory Study
Effects of Androgen Deprivation on Cerebral Morphometry in Prostate Cancer Patients - An Exploratory Study
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DOI：
10.1371/journal.pone.0072032
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发表时间：
2013-08-19
期刊：
影响因子：
3.7
通讯作者：
Li, Chiang-shan R.
中科院分区：
文献类型：
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作者：
Chao, Herta H.;Hu, Sien;Li, Chiang-shan R.
背景：雄激素剥夺疗法（ADT）是一种常见的治疗非转移性、低风险前列腺癌的方法，但ADT的潜在副作用是脑功能受损。先前使用功能性磁共振成像（MRI）的研究表明，认知控制中的前额皮质激活发生了改变，而行为表现则发生了不可检测的变化。鉴于脑成像在识别ADT对脑功能的潜在有害影响方面的效用，目前的研究使用高分辨率MRI和基于体素的形态测量（VBM）检查了ADT对脑结构的影响。方法：对12名前列腺癌患者和12名人口统计学匹配的非暴露对照组在同一时间点成像，获得基线和ADT后6个月的全脑高分辨率T1加权图像。使用统计参数映射8中实现的VBM工具箱将脑图像分割为灰质、白质和脑室。结果：与基线扫描相比，接受ADT的前列腺癌患者的额极皮层、背外侧前额叶皮层和初级运动皮层的灰质体积减少，而未接受ADT的对照组则没有这种变化。此外，初级运动皮层灰质体积的减少与工作记忆任务中对目标检测的反应时间延长有显著相关性。结论：ADT可影响前列腺癌患者的脑灰质体积。如果重复，这些结果可能有助于进一步研究接受ADT的男性的认知功能和生活质量，也可以帮助临床医生权衡激素治疗前列腺癌的益处和风险。
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.