Department of Medicine and Biomedical Research Institute, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA.
Department of Psychiatry, NYU Grossman Long Island School of Medicine, Mineola, NY 11501, USA.
Medicina (Kaunas). 2023 Dec 30;60(1):77. doi: 10.3390/medicina60010077.
Prostate cancer is the second leading cause of cancer death in men in the United States. Androgen deprivation therapy (ADT) is currently the primary treatment for metastatic prostate cancer, and some studies have shown that the use of anti-androgen drugs is related to a reduction in cognitive function, mood changes, diminished quality of life, dementia, and possibly Alzheimer's disease. ADT has potential physiological effects such as a reduction in white matter integrity and a negative impact on hypothalamic functions due to the lowering of testosterone levels or the blockade of downstream androgen receptor signaling by first- and second-generation anti-androgen drugs. A comparative analysis of prostate cancer patients undergoing ADT and Alzheimer patients identified over 30 shared genes, illustrating common ground for the mechanistic underpinning of the symptomatology. The purpose of this review was to investigate the effects of ADT on cognitive function, mood, and quality of life, as well as to analyze the relationship between ADT and Alzheimer's disease. The evaluation of prostate cancer patient cognitive ability via neurocognitive testing is described. Future studies should further explore the connection among cognitive deficits, mood disturbances, and the physiological changes that occur when hormonal balance is altered.
在美国，前列腺癌是男性癌症死亡的第二大主要原因。去势治疗（ADT）是目前治疗转移性前列腺癌的主要方法，一些研究表明，使用抗雄激素药物与认知功能下降、情绪变化、生活质量下降、痴呆症，甚至阿尔茨海默病有关。ADT 具有潜在的生理效应，如降低睾酮水平或第一代和第二代抗雄激素药物阻断下游雄激素受体信号，导致白质完整性降低，对下丘脑功能产生负面影响。对接受 ADT 的前列腺癌患者和阿尔茨海默病患者进行的比较分析发现了 30 多个共同基因，这表明两种疾病的症状有共同的潜在机制。本综述的目的是探讨 ADT 对认知功能、情绪和生活质量的影响，并分析 ADT 与阿尔茨海默病的关系。通过神经认知测试来评估前列腺癌患者的认知能力。未来的研究应进一步探讨认知缺陷、情绪障碍以及激素平衡改变时发生的生理变化之间的联系。
