Abstract
People often experience high level of distress during invasive interventions, which may exceed their coping abilities. This may be in particular evident when confronted with the suspicion of cancer. Taking the example of prostate biopsy sampling, we aimed at investigating the impact of an MRI guided prostate biopsy on the acute stress response and its mechanistic basis. We recruited 20 men with a clinical suspicion of prostate cancer. Immediately before an MRI guided biopsy procedure, we conducted fMRI in the same scanner to assess resting-state brain connectivity. Physiological and hormonal stress measures were taken during the procedure and associated with questionnaires, hair cortisol levels and brain measures to elucidate mechanistic factors for elevated stress. As expected, patients reported a stress-related change in affect. Decreased positive affect was associated with higher hair but not saliva cortisol concentration. Stronger use of maladaptive emotion regulation techniques, elevated depression scores and higher within-salience-network connectivity was associated with stronger increase in negative affect and/or decrease of positive affect during the procedure. While being limited in its generalization due to age, sample size and gender, our proof of concept study demonstrates the utility of real-life stressors and large-scale brain network measures in stress regulation research with potential impact in clinical practice.
Highlights
People often experience high level of distress during invasive interventions, which may exceed their coping abilities
In order to explore the peri-interventional stress during prostate biopsy we investigated a physiological stress response and a subjective stress response
We included possible mediating factors such as physiological indicators of long term stress, large-scale brain network connectivity related to stress and emotion regulation strategies
Summary
People often experience high level of distress during invasive interventions, which may exceed their coping abilities. Medical disciplines like radiology have tried to develop minimally-invasive diagnostic tools Despite these technical advantages, in particular elderly patients often experience a high level of distress during an intervention which may exceed their coping m echanisms[1]. We could show in a recent study comparing healthy young and elderly men that healthy older adults display elevated activity in brain regions involved in emotion processing during a mild stressor induction procedure[5] These findings suggest that increased reactivity in emotion processing brain regions during acute stress in an otherwise healthy older individual may constitute one mechanism by which leads into heightened vulnerability for affective disorders. Despite an optimization in prostate cancer screening with multi-parametric magnetic resonance imaging (MRI), MRI in itself may be a potentially stressful e xperience[12], which may add to the stress burden of biopsy and cancer threat
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