Changes in neuronal activation patterns in response to androgen deprivation therapy: a pilot study

<p>Abstract</p> <p>Background</p> <p>A common treatment option for men with prostate cancer is androgen deprivation therapy (ADT). However, men undergoing ADT may experience physical side effects, changes in quality of life and sometimes psychiatric and cognitive side effects.</p> <p>Methods</p> <p>In this study, hormone naïve patients without evidence of metastases with a rising PSA were treated with nine months of ADT. Functional magnetic resonance imaging (fMRI) of the brain during three visuospatial tasks was performed at baseline prior to treatment and after nine months of ADT in five subjects. Seven healthy control patients, underwent neuroimaging at the same time intervals.</p> <p>Results</p> <p>ADT patients showed reduced, task-related BOLD-fMRI activation during treatment that was not observed in control subjects. Reduction in activation in right parietal-occipital regions from baseline was observed during recall of the spatial location of objects and mental rotation.</p> <p>Conclusions</p> <p>Findings, while preliminary, suggest that ADT reduces task-related neural activation in brain regions that are involved in mental rotation and accurate recall of spatial information.</p

In brief, look sharp: short form assessment in the geriatric setting

Objective: Older adults are an increasing proportion of the population globally. They are also an underserved population with respect to psychological services generally, and neuropsychological services specifically, with both cognitive and psychological concerns going undetected and therefore untreated. Strategies to improve detection of cognitive and psychological concerns in this population, as well as means of obtaining data within limited time or service delivery constraints, include the use of relatively brief assessment protocols. This review of such tools aims to assist clinicians in understanding when best to use such approaches with older adults. Method: A review of the extant empirical literature on brief assessment tools for older adults was undertaken, with the aim of enumerating both advantages and drawbacks of the use of such tools. Results: Although short-form assessments in geriatric settings can indeed be advantageous and appropriate, if used incorrectly, they can potentially hamper accurate diagnosis and treatment. Measures, which hold particular promise with this population span, refer to both cognitive and affective measures, and include instruments designed for specific populations, for example specific cultural groups or disorders. Conclusion: Older adults present across a wide range of settings, often with complex presentations, impaired cognition, and frail health that can challenge both diagnostic and assessment efforts as well as actual health service provision. This review provides data to enable practitioners to sharpen their practice with brief assessments for greatest efficacy in serving geriatric populations. Consideration is also given to possible areas for future clinical and research developments with respect to brief assessment strategies