title: A pilot study of the effects of gonadotropin-releasing hormone agonist therapy on brain activation pattern in a man with pedophilia.
abstract: Gonadotropin-releasing hormone (GnRH) agonists, such as leuprorelin, are recommended in the patients with pedophilia at highest risk of offending. However, the cerebral mechanisms of the effects of these testosterone-decreasing drugs are poorly known. This study aimed to identify changes caused by leuprorelin in a pedophilic patient's brain responses to pictures representing children. Clinical, endocrine, and fMRI investigations were done of a man with pedophilia before leuprorelin therapy and 5 months into leuprorelin therapy. Patient was compared with an age-matched healthy control also assessed 5 months apart. Before therapy, pictures of boys elicited activation in the left calcarine fissure, left insula, anterior cingulate cortex, and left cerebellar vermis. Five months into therapy, all the above-mentioned activations had disappeared. No such activations and, consequently, no such decreases occurred in the healthy control. The results of this pilot study suggest that leuprorelin decreased activity in regions known to mediate the perceptual, motivational, and affective responses to visual sexual stimuli.
authors.affiliation: Inserm, U669, Paris, France.
authors.forename: Virginie
authors.initials: V
authors.lastname: Moulier
authors.forename: Véronique
authors.initials: V
authors.lastname: Fonteille
authors.forename: Mélanie
authors.initials: M
authors.lastname: Pélégrini-Issac
authors.forename: Bernard
authors.initials: B
authors.lastname: Cordier
authors.forename: Sophie
authors.initials: S
authors.lastname: Baron-Laforêt
authors.forename: Emeline
authors.initials: E
authors.lastname: Boriasse
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Durand
authors.forename: Serge
authors.initials: S
authors.lastname: Stoléru
mesh_terms: D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D001143:Arousal / Q000187:drug effects*; D001921:Brain / Q000187:drug effects*; D001931:Brain Mapping; D002648:Child; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000819:agonists*; D006801:Humans; D016729:Leuprolide / Q000627:therapeutic use*; D007989:Libido / Q000187:drug effects; D008279:Magnetic Resonance Imaging; D008297:Male; D008803:Mianserin / Q000627:therapeutic use; D008875:Middle Aged; D010101:Oxygen Consumption / Q000187:drug effects; D010378:Pedophilia / Q000188:drug therapy*; D010865:Pilot Projects; D011613:Psychotherapy; D012016:Reference Values
chemical_list: D018687:Antidepressive Agents, Second-Generation; D008803:Mianserin; D007987:Gonadotropin-Releasing Hormone; D016729:Leuprolide