AAS – CNS Effects

[Michael Scally MD]

“A long habit of not thinking a thing wrong, gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom. But the tumult soon subsides. Time makes more converts than reason.”

― Thomas Paine, Common Sense

 

[Michael Scally MD]

[GMAFB] [Rat Cell Cultures] Toxic Impact of Anabolic Androgenic Steroids in Primary Rat Cortical Cell Cultures

Highlights
· Structurally diverse anabolic steroids cause cellular toxicity.
· Testosterone, nandrolone, and trenbolone induce apoptosis.
· Stanozolol causes cell death, probably through necrosis.
· The toxic steroid effects are primarily mediated by the androgen receptor.

The use of anabolic androgenic steroids (AASs) among non-athletes is a public health-problem, as abusers underestimate the negative effects associated with these drugs. The present study investigated the toxic effects of testosterone, nandrolone, stanozolol, and trenbolone, and aimed to understand how AAS abuse affects the brain.

Mixed cortical cultures from embryonic rats were grown in vitro for 7 days and thereafter treated with increasing concentrations of AASs for 24 h (single-dose) or 3 days (repeated exposure). Cells were co-treated with the androgen-receptor (AR) antagonist flutamide, to determine whether the potential adverse effects observed were mediated by the AR. Cellular toxicity was determined by measuring mitochondrial activity, lactate dehydrogenase (LDH) release, and caspase-3/7 activity.

Nandrolone, unlike the other AASs studied, indicated an effect on mitochondrial activity after 24 h. Furthermore, single-dose exposure with testosterone, nandrolone and trenbolone increased LDH release, while no effect was detected with stanozolol. However, all of the four steroids negatively affected mitochondrial function and resulted in LDH release after repeated exposure. Testosterone, nandrolone, and trenbolone caused their toxic effects by induction of apoptosis, unlike stanozolol that seemed to induce necrosis. Flutamide almost completely prevented AAS-induced toxicity by maintaining mitochondrial function, cellular integrity, and inhibition of apoptosis.

Overall, we found that supra-physiological concentrations of AASs induce cell death in mixed primary cortical cultures, but to different extents, and possibly through various mechanisms. The data presented herein suggest that the molecular interactions of the AASs with the AR are primarily responsible for the toxic outcomes observed.

Zelleroth S, Nylander E, Nyberg F, Grönbladh A, Hallberg M. Toxic Impact of Anabolic Androgenic Steroids in Primary Rat Cortical Cell Cultures. Neuroscience 2019;397:172-83. https://www.sciencedirect.com/science/article/pii/S0306452218307772

 

[eryximachus]

“A long habit of not thinking a thing wrong, gives it a superficial appearance of being right, and raises at first a formidable outcry in defense of custom. But the tumult soon subsides. Time makes more converts than reason.”

― Thomas Paine, Common Sense

Considering the comedy that is The United States of America, land of the free, home of the trannies, and the enforced state religion of equality and the tabula rasa myth, Thomas Paine did not possess common sense. More accurately, he possessed madness and was a harbinger of the madhouse we call the USA.

 

[Michael Scally MD]

Liao PW, Chen JT, Liu SP, Ho CH. The predictive value of serum testosterone level on the functional outcomes after acute ischemic stroke in males. The aging male: the official journal of the International Society for the Study of the Aging Male 2019:1-7. https://www.tandfonline.com/doi/abs/10.1080/13685538.2019.1582620?journalCode=itam20

INTRODUCTION: We aimed to evaluate the predictive value of sex hormone levels on 3-month functional outcomes after acute ischemic stroke (AIS) in males.

MATERIALS AND METHODS: A total of 110 male AIS patients were included in this prospective study. Serum levels of testosterone and estradiol were measured at admission. The National Institutes of Health Stroke Scale (NIHSS) and the modified Rankin Scale (mRS) were measured at admission and after 3 months. A mRS score >/=3 was considered as a poor functional outcome.

RESULTS: The median age of the 110 subjects was 62.0 [23.3] years (range 35-93 years). Univariate logistic regression revealed that bioavailable testosterone, free testosterone, age, NIHSS at admission, mRS at admission, and prior ischemic stroke were associated with a poor functional outcome (mRS score >/=3) at 3 months. In multivariate analysis, only age, NIHSS at admission, and mRS at admission were independent predictors.

CONCLUSIONS: After controlling the covariates, bioavailable and free testosterone levels are not associated with the 3-month mRS in male patients with AIS. Age, NIHSS at admission, and mRS at admission are robust predictors for the functional outcomes.

 

[Michael Scally MD]

Chegeni R, Sagoe D, Mentzoni RA, Pallesen S. Aggression and Anabolic–Androgenic Steroid Use Intent in Adolescents: A Longitudinal Study. Substance Use & Misuse 2019:1-10. https://doi.org/10.1080/10826084.2019.1589522

Background: There is a dearth of longitudinal studies on risk factors for anabolic–androgenic steroid (AAS) use and intent.

Objectives: We conducted a longitudinal investigation of factors associated with AAS use intent from age 18 to 19, examining particularly the role of physical and verbal aggression. A sample of Norwegians completed questionnaires containing demographic, AAS use and intent, other addictions, aggression, and health measures at ages 18 (N = 1333, females = 58.9%) and 19 (N = 1277, females = 61.7%). The data were analyzed using descriptive statistics, correlations, and hierarchical multiple regression.

Results: Results show that AAS use prevalence increased from 1 person at age 18 to 4 persons at age 19. Intent to use AAS, being male, living alone, and AAS use (all at 18 years) were associated with higher AAS use intent at 19 years. We found no associations between physical or verbal aggression and AAS use intent from ages 18 to 19.

Conclusions: Our findings indicate temporal stability in AAS use intent, as well as the influence of demographic and health factors on AAS use intent from ages 18 to 19. Implications of findings for practice and future research are discussed.

 

[Michael Scally MD]

Androgenic-Anabolic Steroids, Mental Health and Aggression: Does Mental Health Cause Changes in Aggression in Users
by Andy Sutherland

[A major project submitted to the School of Social Sciences, Humanities and Law, University of Teesside, in partial fulfilment of the degree of BSc (Hons) Psychology.]

The aim of this research was to assess the impact of Androgenic-Anabolic Steroids upon aggressive tendencies in users and to assess if indications of mental health issues were a factor that affected changes in behaviour. Measurements were taken via the Difficulties in Emotional regulation scale (Gratz & Roemer, 2003) in relation to mental health and the Buss-Perry (1992) aggression questionnaire, as a measure of aggressive tendencies. Consideration was also given to the impact of Trenbolone, a Testosterone derived compound, designed for use in cattle that anecdotal evidence indicates could be a contributory factor.

Results indicate non-significant findings in relation to both mental health and the use of Trenbolone. Although some factors within the research could be addressed to improve outcome. Further research into the impacts of Trenbolone and larger sample sizes may be beneficial in assessing the aims of this research, however application of the General Aggression Model suggests that no single factor is sufficient to accurately predict changes in behaviour in users.

 

[Michael Scally MD]

[GMAFB] Hauger LE, Sagoe D, Vaskinn A, et al. Anabolic androgenic steroid dependence is associated with impaired emotion recognition. Psychopharmacology 2019. Anabolic androgenic steroid dependence is associated with impaired emotion recognition

Rationale - Illicit use of anabolic androgenic steroids (AAS) has grown into a serious public health concern throughout the Western World. AAS use is associated with adverse medical, psychological, and social consequences.

Around 30% of AAS users develop a dependence syndrome with sustained use despite adverse side effects. AAS dependence is associated with a high frequency of intra- and interpersonal problems, and it is central to identify factors related to the development and maintenance of dependence.

Methods - The present study investigated the ability to recognize emotion from biological motion. The emotional biological motion task was administered to male AAS dependent users (AAS dependents; n = 45), AAS non-dependent users (AAS non-dependents; n = 38) and a comparison-group of non-using weightlifters (non-users; n = 69).

Results - Multivariate analysis of variance showed a general impairment in emotion recognition in AAS dependents, compared to the non-using weightlifters, whereas no significant impairment was observed in AAS non-dependents.

Furthermore, AAS dependents showed impaired recognition of fearful stimuli compared to both AAS non-dependents and non-using weightlifters. The between-group effect remained significant after controlling for Intelligence Quotient (IQ), past 6 months of non-AAS drug use, antisocial personality problems, anxiety, and depression.

Conclusion - AAS dependents show impaired emotion recognition from body movement, fear in particular, which could potentially contribute to higher frequency of interpersonal problems and antisocial behaviors in this population.

 

[Michael Scally MD]

Hauger LE, Westlye LT, Fjell AM, Walhovd KB, Bjornebekk A. Structural brain characteristics of anabolic-androgenic steroid dependence in men. Addiction (Abingdon, England) 2019. https://onlinelibrary.wiley.com/doi/abs/10.1111/add.14629

AIM: To identify differences in brain morphology between dependent and non-dependent male anabolic-androgenic steroid (AAS) users.

DESIGN: Cross-sectional data from a longitudinal study on male weightlifters.

SETTING: Oslo University Hospital, Norway.

PARTICIPANTS: 81 AAS users were divided into two groups; AAS-dependent (n=43) and AAS-non-dependent (n=38).

MEASUREMENTS: Neuroanatomical volumes and cerebral cortical thickness were estimated based on magnetic resonance imaging (MRI) using FreeSurfer. Background and health information were obtained using a semi-structured interview. AAS-dependence was evaluated in a standardized clinical interview using a version of the Structured Clinical Interview for DSM-IV, adapted to apply to AAS-dependence.

FINDINGS: Compared with non-dependent users, dependent users had significantly thinner cortex in three clusters of the right hemisphere and in five clusters of the left hemisphere, including frontal, temporal, parietal and occipital regions.

Profound differences were seen in frontal regions (left pars orbitalis, cluster wise p < .001, right superiorfrontal, cluster wise p < .001), as has been observed in other dependencies. Group differences were also seen when excluding participants with previous or current non-AAS drug abuse (left precentral, cluster wise p < .001, left pars orbitalis, cluster wise p = .010).

CONCLUSION: Male dependent anabolic-androgenic steroid (AAS) users appear to have thinner cortex in widespread regions, specifically in prefrontal areas involved in inhibitory control and emotional regulation, compared with non-dependent AAS users.

 

[Michael Scally MD]

[OA] [WTF] [GMAFB] [POS] Steroids A Boon or Bane in Sports

Steroid is a drug which is one of blessing and banes. Next to dope, it is almost the most misused drug. In sports, it is being used so much to take away the spirit of sports. This article investigates in depth of steroids.

Steroids are used for medicinal purposes only, but its use has been misunderstood by the teenagers and athletes leading to use them for illegal purposes. Athletes take these drugs to gain body bulk and muscular strength. Several countries banned steroid use and the sportsmen are checked before athletic games such as Olympic to know whether they take steroids, if so, they are disqualified to play.
Teenagers of these days use these drugs to attract opposite sex, thereby decreasing their self-confidence. However, these people are unaware about the side effects that these drugs cause. Most of them lost their life due to drug overdose. Steroids are also used in dentistry to treat infection and pain, but the only thing is that it only reduces the symptoms but does not treat the cause of disease.

Steroids using people are more aggressive than normal individuals, and on long run, it leads to infertility. It causes premature puberty in men when has taken in small age and the primary and secondary sexual characters start to develop earlier than the ideal age in such persons. These effects are due to the factor that anabolic steroids are derived from testosterone which, in turn, is a male hormone responsible for the development of sexual hormones in men.

Samuel DS, Priyadarshoni SP. Steroids a boon or bane in sports. Drug Invention Today. 2019;11. http://jprsolutions.info/article_detail.php?article_id=3201

 

[Old]

Teenagers of these days use these drugs to attract opposite sex, thereby decreasing their self-confidence. However, these people are unaware about the side effects that these drugs cause. Most of them lost their life due to drug overdose.

Most teenagers die from AAS? Love to see the statistics on that. Perhaps a little bias here??? Maybe this happens in India

Infertility is a blessing in a world that is seriously overpopulated. WHO recommends using T shots for men just for this very purpose. Due to poverty and food supply limitations, the Indian government might do well consider this.

A most curious article from a guy working for Dentistry. India has more serious concerns than AAS

 

[Old]

"Athletes use steroids to give them muscle bulk and strength, while teenagers use it to develop the so-called biceps, broad shoulders, and narrow hip to make them look handsome, while women use steroids to enhance female features in every way, making them look attractive and voluptuous"

This article just gets better and better!

 

[MisterSuperGod]

Most teenagers die from AAS? Love to see the statistics on that. Perhaps a little bias here??? Maybe this happens in India

Infertility is a blessing in a world that is seriously overpopulated. WHO recommends using T shots for men just for this very purpose. Due to poverty and food supply limitations, the Indian government might do well consider this.

A most curious article from a guy working for Dentistry. India has more serious concerns than AAS

Oh sweet Jesus. No wonder they still have outbreaks of the plague over there!

 

[Michael Scally MD]

Hart A. Making a difference? Applying Vitellone’s Social Science of the Syringe to performance and image enhancing drug injecting. International Journal of Drug Policy 2018;61:69-73. http://www.sciencedirect.com/science/article/pii/S0955395918300999

Vitellone’s Social Science of the Syringe investigates epistemologies of injecting drug use. She argues for a methodology that can be simultaneously sensitive to biopolitical power regimes; the trajectories of social stratification; and the resistance, creativity and dignity of human agency. She proposes a methodological focus on the syringe-in-use as an active participant in these dynamics. Harm reduction policy and service provision frameworks have paid little attention to the phenomena of performance and image enhancing drug (PIEDs) injection. One way of assessing the merit of Vitellone’s proposal is to use it to investigate these phenomena. I argue that Vitellone’s method can be used to articulate a range of significant differences between people who inject PIEDs and other people who inject drugs, and that these differences can inform harm reduction initiatives. When compared to the heroin syringe, the PIED syringe participates in different socio-economic and material contexts, gendered identities, and biopolitical governance regimes. These differences materialise in different rates of syringe sharing and blood-borne virus transmission; and different experiences of needle exchange services. I offer a thought experiment demonstrating how a different syringe might alter the structural dynamics, biopolitical governance, and the agentic choices of people who inject PIEDs. Judging by the productive effects of diffracting Vitellone’s analysis through an empirical concern with PIED injecting, I concur with Vitellone’s proposition that ‘something objective may be gained from an empirical investigation of the syringe-in-use’ (p. 33).


Bates G, Tod D, Leavey C, McVeigh J. An evidence-based socioecological framework to understand men’s use of anabolic androgenic steroids and inform interventions in this area. Drugs: Education, Prevention and Policy 2018:1-9. https://doi.org/10.1080/09687637.2018.1488947

Research into men’s use of anabolic androgenic steroids (AAS) over the past three decades has identified many factors that contribute to decision-making in this area. However, there are limited theoretical frameworks to synthesise this research and guide practice, such as interventions to prevent use or reduce health risks. To address this gap, a socioecological framework is presented based upon the international literature examining AAS use. Socioecological models recognise that individuals and behaviours exist within complex physical and social systems and are useful tools for guiding interventions to ensure consideration is given to multiple influential factors. This framework proposes that use of AAS is the result of the interaction of a range of factors at the individual, social network, institutional, community, and societal levels that are likely to change over time and with experience. Viewed through this framework, it becomes clear that AAS use can be a complex behaviour with many influential environments and relationships impacting on a diverse population in different ways and at different times. The implications of findings for engaging with people who use AAS and delivering interventions are discussed, such as the identification of important transition times and influencing norms within social groups and communities.


Hutchinson B, Moston S, Engelberg T. Social validation: a motivational theory of doping in an online bodybuilding community. Sport in Society 2018;21:260-82. https://doi.org/10.1080/17430437.2015.1096245

Doping research has predominantly been framed through an ethical lens, implicitly restricted to the realms of elite sport. Despite increasing anecdotal evidence of growing prevalence rates amongst recreational athletes, such as bodybuilders, these populations have largely been neglected within psychological research. This study aims to develop a theoretical framework relevant to these athletes. Data were collected over a five-month period from an online community forum dedicated to recreational bodybuilders. Purposive sampling was used to gather 118 webpages of doping-related discussion, which were qualitatively analysed using grounded theory applying Strauss’s coding paradigm. Inductive categories were integrated into a motivational framework that related recreational doping to social validation. Categories included the online community’s rite of passage, normative-inferences that facilitated doping, and deterrence factors related to fear of perceived health risks. Findings demonstrate that, for recreational bodybuilders, psychosocial processes are significantly related to doping motives, and that health factors are primary doping deterrents.

 

[Michael Scally MD]

[Rats] Nandrolone Use During Adolescence Increases Cocaine Sensitization and Impairs Reproductive Function
https://www.fasebj.org/doi/10.1096/fasebj.2019.33.1_supplement.738.5

Anabolic androgenic steroids (AAS) are known to affect mood and motivational behaviors. One of the AAS most commonly used by young adults is nandrolone. In 2017, prevalence of cocaine use in this population was approximately 33% compared to 4.9% in the rest of this population.

Cocaine and AAS increase risk taking behaviors. However, the link between the use of AAS during adolescence and propensity to use other drugs of abuse has not been clearly established.

In this study, adolescent female rats were administered nandrolone decanoate (20mg/kg/sc) or vehicle for 10 successive days starting on day 28, the rats were then divided into 4 groups;
Oil-Saline,
ND-Saline,
Oil-cocaine and
ND-cocaine.

Beginning on day 40, they were tested for locomotor sensitization to cocaine. From days 1–5 and at days 13 and 23 rats received an injection of cocaine (15 mg/kg/ip). Their locomotor response to cocaine was measured at days 1, 5, 13 and 23.

Our data show that nandrolone enhances cocaine sensitization in female rats. In ovarian tissue, it reduced weight and induced cysts formation.

These data show that exposure to supra-physiological levels of androgens during adolescence modifies the brain circuitry that regulates addictive behaviors increasing the psychoactive properties of cocaine. AAS also have detrimental effects on the female reproductive system and on fertility.

 

[Michael Scally MD]

Testosterone May Hold Therapeutic Promise for the Treatment of Ischemic Stroke in Aging: A Closer Look at Laboratory Findings

Male sex is more prone to cerebrovascular disorders, yet the exact role of androgens in cerebral ischemia remains unclear. Here we reviewed current understanding of testosterone (TES) neuroprotective activity against ischemic stroke and mechanisms underlying these effects in aging.

TES may exert a neuroprotective effect in aging through pathways including inhibition of oxidant molecules production, enhancing the enzymatic antioxidant capacity of the brain and modulation of apoptotic cell death.

Given this, a better understanding of the neuroprotective roles of TES may propose an effective therapeutic strategy to improve the quality of life and decrease androgen-related cerebrovascular problems in the aging men.

Farajdokht F, Farhoudi M, Majdi A, et al. Testosterone May Hold Therapeutic Promise for the Treatment of Ischemic Stroke in Aging: A Closer Look at Laboratory Findings. Adv Pharm Bull 2019;9:48-55. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6468219/

 

[Michael Scally MD]

[OA] [Rats] Neurotoxic Effects of Stanozolol on Male Rats‘ Hippocampi: Does Stanozolol Cause Apoptosis?

[Subcutaneous Injections of Stanozolol (5mg/Kg/Day) For Consecutive 28 Days]

Stanozolol is an anabolic-androgenic steroid which is commonly abused by athletes for improved energy, appearance, and physical size. It has been previously shown to cause changes in behaviour and has various physical effects. Studies have previously been conducted on its neurotoxic effect on the central nervous system (CNS), which are typically psychological in nature. This study was performed to investigate the apoptotic effect of stanozolol on different parts of the rat hippocampus.

Sixteen male Wistar rats were divided randomly into two groups (experimental and control). The experimental group received subcutaneous injections of stanozolol (5mg/kg/day) for consecutive 28 days, whereas the control group received saline using the same dosing schedule and administration route.

After routine procedures, coronal sections of rat brain were stained with Toluidine blue and TUNEL for pre-apoptotic and apoptotic cell detection, respectively. In order to compare groups, the mean number of TUNEL-positive and pre-apoptotic neurons per unit area were calculated and analysed.

Histopathological examination revealed that the mean number of pre-apoptotic and apoptotic neurons in the CA1, CA2, CA3 and DG areas of the hippocampus were significantly increased in the stanozolol treated group. In conclusion, stanozolol abuse may induce pre-apoptotic and apoptotic cell formation in different regions of the hippocampus.

Karimooy, FN, Bideskan AE, Pour AM, et al. Neurotoxic Effects of Stanozolol on Male Rats‘ Hippocampi: Does Stanozolol cause apoptosis?. Biomolecular Concepts. 2019;10(1):73-81. Neurotoxic Effects of Stanozolol on Male Rats‘ Hippocampi: Does Stanozolol cause apoptosis? : Biomolecular Concepts

 

[Michael Scally MD]

[OA] Anabolic-Androgenic Steroid Users Receiving Health-Related Information; Health Problems, Motivations to Quit and Treatment Desires

BACKGROUND: Anabolic-androgenic steroids (AAS) are used to increase muscle strength and improve appearance, but users also carry the risk of developing physical and mental health problems. In Norway, the substance use disorder treatment system provides health care to this patient group, but few AAS users have sought such treatment. Therefore, a service was created to inform AAS users and next of kin of potential negative consequences and their treatment options. This study describes health problems, motivations for AAS cessation, and treatment desires among AAS users.

METHODS: Over four years, 232 AAS users and 60 next of kin contacted the information service and received an hour-long information session with healthcare personnel. Information about AAS use, physical and mental health problems, substance use, motivation for cessation, and whether the information seeker desired treatment were registered. Qualitative interviews were conducted among seven individuals and analyzed thematically to explore information service experiences.

RESULTS: Of the 232 AAS users, 179 (77.2%) desired treatment after completing the information session and 53 (22.9%) were unsure or did not want treatment. Those who desired treatment were significantly older, had used AAS longer, reported more physical and mental health side effects, and a higher proportion reported having children than those who did not desire treatment. Although 181 (78.0%) reported co-occuring physical and mental health problems, mental health problems were the most common motivation for AAS cessation (n = 108, 47.8%), followed by a combination of mental and physical health problems (52, 23.0%). Findings from qualitative interviews suggest that barriers to treatment may be overcome with an easily accessible service that informs about addiction treatment and facilitates the treatment entry process.

CONCLUSIONS: Healthcare professionals who encounter users of AAS should have knowledge about AAS use and adverse effects. The desire for health care reveals extensive health problems and the user group is so non-homogeneous that examination and treatment must be adapted individually with focus on physical, mental and social factors as well as possible dependence of AAS and/or psychoactive substances.

Havnes IA, Jorstad ML, Wisloff C. Anabolic-androgenic steroid users receiving health-related information; health problems, motivations to quit and treatment desires. Substance abuse treatment, prevention, and policy 2019;14:20. Anabolic-androgenic steroid users receiving health-related information; health problems, motivations to quit and treatment desires

 

[Michael Scally MD]

The antidepressant effect of testosterone: An effect of neuroplasticity?

Highlights
· Testosterone has antidepressant effects whereby the underlying mechanisms are still unknown.
· Promoted neuroplasticity and the activation of the serotonin system may underlie the antidepressant effect of testosterone.
· Studies suggest that a combination of testosterone and current antidepressants enhance antidepressant-induced neurogenesis.
· Testosterone actions within the HPA axis and during inflammation may additionally contribute to the mood enhancing effects.
· Not only testosterone alone, but also its conversion to estradiol may contribute to the observed antidepressant effects.

Background Rodent and human studies indicate that testosterone has an antidepressant effect. The mechanisms via which testosterone exerts its antidepressant effect, however, remain to be elucidated. Some studies assume downstream effects of testosterone on sexual function and vitality followed by improvement of mood. Emerging evidence suggests that testosterone may be acting in the brain within depression-relevant areas, whereby eliciting direct antidepressant effects, potentially via neuroplasticity.

Methods Literature was searched focusing on testosterone treatment and depression and depression-like behavior. Due to the unilateral clinical use of testosterone in men and the different modes of action of sex hormones in the central nervous system in men and women, predominantly studies on male populations were identified.

Results The two proposed mechanisms via which testosterone might act as antidepressant in the central nervous system are the support of neuroplasticity as well as the activation of the serotonin system. Additionally, testosterone downregulates glucocorticoid output and reduces levels of pro-inflammatory markers, thereby acting as important counter regulatory agent reducing levels of neurotoxic factors in the central nervous system.

Conclusion Although it is possible that testosterone acts via the serotonin system or the downregulation of the immune or hyperactive stress physiological systems, recent evidence supports the hypothesis that testosterone also elicits anti-depressant effects via directly promoting neuroplasticity. Potential implementations of testosterone treatment in mood disorders are discussed.

Walther A, Wasielewska JM, Leiter O. The antidepressant effect of testosterone: An effect of neuroplasticity? Neurology, Psychiatry and Brain Research 2019;32:104-10. The antidepressant effect of testosterone: An effect of neuroplasticity? - ScienceDirect

 

[Michael Scally MD]

[OA] [Rats]Neuroendocrine Whiplash: Slamming the Breaks on Anabolic-Androgenic Steroids Following Repetitive Mild Traumatic Brain Injury in Rats May Worsen Outcomes

Sport-related concussion is an increasingly common injury among adolescents, with repetitive mild traumatic brain injuries (RmTBI) being a significant risk factor for long-term neurobiological and psychological consequences. It is not uncommon for younger professional athletes to consume anabolic-androgenic steroids (AAS) in an attempt to enhance their performance, subjecting their hormonally sensitive brains to potential impairment during neurodevelopment.

Furthermore, RmTBI produces acute neuroendocrine dysfunction, specifically in the anterior pituitary, disrupting the hypothalamic-pituitary adrenal axis, lowering cortisol secretion that is needed to appropriately respond to injury. Some AAS users exhibit worse symptoms post-RmTBI if they quit their steroid regime.

We sought to examine the pathophysiological outcomes associated with the abrupt cessation of the commonly abused AAS, Metandienone (Met) on RmTBI outcomes in rats. Prior to injury, adolescent male rats received either Met or placebo, and exercise. Rats were then administered RmTBIs or sham injuries, followed by steroid and exercise cessation (SEC) or continued treatment.

A behavioral battery was conducted to measure outcomes consistent with clinical representations of post-concussion syndrome and chronic AAS exposure, followed by analysis of serum hormone levels, and qRT-PCR for mRNA expression and telomere length.

RmTBI increased loss of consciousness and anxiety-like behavior, while also impairing balance and short-term working memory. SEC induced hyperactivity while Met treatment alone increased depressive-like behavior. There were cumulative effects whereby RmTBI and SEC exacerbated anxiety and short-term memory outcomes. mRNA expression in the prefrontal cortex, amygdala, hippocampus, and pituitary were modified in response to Met and SEC.

Analysis of telomere length revealed the negative impact of SEC while Met and SEC produced changes in serum levels of testosterone and corticosterone. We identified robust changes in mRNA to serotonergic circuitry, neuroinflammation, and an enhanced stress response.

Interestingly, Met treatment promoted glucocorticoid secretion after injury, suggesting that maintained AAS may be more beneficial than abstaining after mTBI.

Tabor J, Collins R, Debert CT, Shultz SR, Mychasiuk R. Neuroendocrine Whiplash: Slamming the Breaks on Anabolic-Androgenic Steroids Following Repetitive Mild Traumatic Brain Injury in Rats May Worsen Outcomes. Frontiers in neurology 2019;10:481. Neuroendocrine Whiplash: Slamming the Breaks on Anabolic-Androgenic Steroids Following Repetitive Mild Traumatic Brain Injury in Rats May Worsen Outcomes

 

[Michael Scally MD]

Long N, Bassi S, Pepito D, et al Gerstmann syndrome complicating polycythemia secondary to anabolic steroid use. BMJ Case Reports CP 2019;12:e229004. https://casereports.bmj.com/content/12/6/e229004

Anabolic steroid use is prevalent among athletes and bodybuilders. There are known cardiovascular, reproductive, musculoskeletal and neuropsychiatric risks associated with their prolonged use.

Although there have been very few documented cases of strokes associated with anabolic steroid use, cardiomyopathy and secondary erythropoiesis can increase the risk of strokes in users with no other risk factors.

We present a 49-year-old man with left parietal ischaemic stroke with haemorrhagic conversion resulting in Gerstmann syndrome secondary to a hypercoagulable state from chronic anabolic steroid use.