Cherrier et al. BMC Cancer 2010, 10:1 http://www.biomedcentral.com/1471-2407/10/1 R E S E A R C H A R T I C L E Open Access Changes in neuronal activation patterns in response to androgen deprivation therapy: a pilot study Monique M Cherrier1,3*, Paul R Borghesani1, Amy L Shelton4, Celestia S Higano2 Abstract Background: 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. Methods: 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. Results: 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. Conclusions: 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. Background Prostate cancer is the most common form of non-skin cancer diagnosed in U.S. men with over 218,000 newly diagnosed cases each year estimated per year [1]. While androgen deprivation therapy (ADT) used to be reserved for those with metastatic disease and resulted in a med- ian survival of 2-5 years [2,3], ADT is now commonly prescribed in the setting of localized disease (e.g. in combination with radiation therapy) or for the 22% of patients who fail primary therapy and have a rising PSA without evidence of metastases [4]. In contrast to those with metastatic disease the latter patients often have no disease related symptoms and may live for many years. Physiological consequences of androgen deprivation include obesity, anemia, loss of bone mineral density, muscle atrophy, gynecomastia and mood changes [2,5,6]. A recent population based study showed that ADT was associated with an increased risk of diabetes, * Correspondence: cherrier@u.washington.edu 1Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA; 98195; USA myocardial infarction, and hypertension [7]. Psychiatric changes can include depression and anxiety [8] and cog- nitive problems can include impairments in verbal memory [9,10], spatial reasoning [11] and attention [12]. Given these cognitive and medical side effects of ADT understanding the immediate and long-term conse- quence of treatment is essential. Based on findings from our previous study demon- strating a decline in spatial reasoning abilities in healthy men undergoing ADT [11], the aim of this study was to examine if neural activation changes were evident in response to androgen deprivation while performing spa- tial reasoning and spatial memory tasks using functional magnetic resonance imaging (fMRI). Spatial reasoning and spatial memory were specifically chosen to examine the effects of ADT on brain function because task- related brain activation has been clearly identified, parti- cularly in regions of the parietal cortex [13-16] along with evidence of hormone influences on these brain regions [17-19]. The aim of the present study was to assess changes in neural activation in response to andro- gen deprivation using functional magnetic resonance © 2010 Cherrier et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.