Androgen deprivation therapy and cognitive decline—associations with brain connectomes, endocrine status, and risk genotypes

Author(s):  
Cecilie R. Buskbjerg ◽  
Ali Amidi ◽  
Simon Buus ◽  
Claus H. Gravholt ◽  
S. M. Hadi Hosseini ◽  
...  
BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e043844
Author(s):  
Natalia Araujo ◽  
Samantha Morais ◽  
Ana Rute Costa ◽  
Raquel Braga ◽  
Ana Filipa Carneiro ◽  
...  

IntroductionProstate cancer is the most prevalent oncological disease among men in industrialised countries. Despite the high survival rates, treatments are often associated with adverse effects, including metabolic and cardiovascular complications, sexual dysfunction and, to a lesser extent, cognitive decline. This study was primarily designed to evaluate the trajectories of cognitive performance in patients with prostate cancer, and to quantify the impact of the disease and its treatments on the occurrence of cognitive decline.MethodsParticipants will be recruited from two main hospitals providing care to approximately half of the patients with prostate cancer in Northern Portugal (Portuguese Institute of Oncology of Porto and São João Hospital Centre), and will comprise a cohort of recently diagnosed patients with prostate cancer proposed for different treatment plans, including: (1) radical prostatectomy; (2) brachytherapy and/or radiotherapy; (3) radiotherapy in combination with androgen deprivation therapy and (4) androgen deprivation therapy (with or without chemotherapy). Recruitment began in February 2018 and is expected to continue until the first semester of 2021. Follow-up evaluations will be conducted at 1, 3, 5, 7 and 10 years. Sociodemographic, behavioural and clinical characteristics, anxiety and depression, health literacy, health status, quality of life, and sleep quality will be assessed. Blood pressure and anthropometrics will be measured, and a fasting blood sample will be collected. Participants’ cognitive performance will be evaluated before treatments and throughout follow-up (Montreal Cognitive Assessment and Cube Test as well as Brain on Track for remote monitoring). All participants suspected of cognitive impairment will undergo neuropsychological tests and clinical observation by a neurologist.Ethics and disseminationThe study was approved by the Ethics Committee of the hospitals involved. All participants will provide written informed consent, and study procedures will be developed to ensure data protection and confidentiality. Results will be disseminated through publication in peer-reviewed journals and presentation in scientific meetings.


2020 ◽  
Vol 14 (4) ◽  
pp. 169-177
Author(s):  
Konstantina G. Yiannopoulou ◽  
Aikaterini I. Anastasiou ◽  
Konstantinos Kontoangelos ◽  
Charalambos Papageorgiou ◽  
Ioannis P. Anastasiou

<b><i>Objectives: </i></b>Psychological morbidity as well as cognitive impairment are increasingly reported in prostate cancer (PCa) patients. However, despite growing numbers of PCa survivors and the well estimated negative impact of cognitive decline and emotional distress on survivors' quality of life, no study has assessed the whole range of cognitive and psychological sequelae as a response to treatment options for PCa. The objective of the present review was to systematically characterize the types and estimate the prevalence of the cognitive impairment and emotional burdens that were found in PCa survivors secondary to different treatment options. <b><i>Methods: </i></b>Systematic, general reviews, meta-analysis, and overviews of review studies in English, that were published in PubMed during the last 10 years until l August 2019 and that reported psychological distress, anxiety, depression, cognitive decline, or dementia among individuals with PCa exposed to a particular treatment option were analyzed. <b><i>Results: </i></b>A total of 21 articles were reviewed. Some of the studies described one or more cognitive or psychological consequences of only one therapeutic strategy while others compared the psychological impacts among different strategies. Most of these studies suggested that either radical prostatectomy or active surveillance and radiotherapy were well-tolerated treatments in terms of psychological modifications. However, many of these patients may require additional emotional support. There is also increasing evidence that androgen deprivation therapy may be associated with depression, while controversy surrounding the association between cognitive dysfunction, dementia, and androgen deprivation therapy remains ambivalent. <b><i>Conclusion: </i></b>Emotional distress and cognitive decline may accompany every PCa treatment option to different degrees. Accurate information on the short- and long-term effect of treatments on cognitive and psychological aspects should be provided to patients during treatment decision-making. There is also a need to develop well-targeted psychological and neurological interventions that could help those experiencing ongoing post-treatment difficulties.


2007 ◽  
Vol 177 (4S) ◽  
pp. 200-200 ◽  
Author(s):  
Andrea Gallina ◽  
Pierre I. Karakiewicz ◽  
Jochen Walz ◽  
Claudio Jeldres ◽  
Quoc-Dien Trinh ◽  
...  

2007 ◽  
Vol 177 (4S) ◽  
pp. 200-200
Author(s):  
John B. Malcolm ◽  
Christopher J. DiBlasio ◽  
Jamie H. Womack ◽  
Matthew C. Kincade ◽  
Mitch Ogles ◽  
...  

2006 ◽  
Vol 175 (4S) ◽  
pp. 65-65
Author(s):  
Tracey L. Krupski ◽  
Kathleen A. Foley ◽  
Onur Baser ◽  
Stacey R. Long ◽  
David Macarios ◽  
...  

2006 ◽  
Vol 175 (4S) ◽  
pp. 41-41
Author(s):  
Matt C. Kincade ◽  
Ithaar H. Derweesh ◽  
John Malcolm ◽  
Kimberly D. Lamar ◽  
Anthony L. Patterson ◽  
...  

2006 ◽  
Vol 175 (4S) ◽  
pp. 41-42
Author(s):  
Anna Orsola ◽  
Jacques Planas ◽  
Carlos Salvador ◽  
José M. Abascal ◽  
Enrique Trilla ◽  
...  

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