Anabolic steroid users face accelerated brain ageing

Neurodegenerative disorders

By Michael Woodhead

13 Apr 2021

Long term users of anabolic androgenic steroids such as weighlifters face a risk of premature brain ageing, according to Scandinavian research.

The synthetic versions of testosterone have many known side effects such as acne, cardiovascular disorders and aggression, and a new study using brain MRI imaging suggests they also have deleterious effects on the brain, causing it to age more rapidly than normal.

Researchers led by Dr Astrid Bjørnebekk, of Oslo University Hospital, Norway, used brain MRI to assess regional brain volumes, cortical thickness, and surface area in 130 male weightlifters who had a history of prolonged anabolic steroid use and a control group of 99 weightlifters who had never used steroids.

Using machine learning and data from nearly 2,000 healthy males from age 18 to 92 years of age, the researchers determined the predicted brain age of each of their participants and then determined the brain age gap: the difference between each participant’s chronological age and their predicted brain age.

They found that long term anabolic steroid users had a bigger brain age gap compared to non-users. Those with dependence on steroids, or with a longer history of use, showed accelerated brain ageing. Differences in brain age gap could not be explained by other substance use, general cognitive abilities, or depression

Dr Bjørnebekk and colleagues said anabolic steroids would be expected to have significant effects on the brain since they readily enter the brain, and receptors for sex hormones are found throughout the brain.

In addition, the brains of athletes who use anabolic–androgenic steroids would be exposed to much higher doses of androgens than those naturally found in the body, and this could have a harmful impact on the brain, particularly over a long period of use.

They noted that previous studies have shown that anabolic steroid users performed worse on cognitive tests than non-users, and advanced brain age would be associated with impaired cognitive performance and increased risk for neurodegenerative diseases.

“Since anabolic steroids have only been in the public domain for about 35 years, we are still in the early phase of appreciating the full scope of effects after prolonged use. The least studied effects are those that relate to the brain,” they wrote

“This important study shows in a large sample that use is associated with deviant brain ageing, with a potential impact on quality of life in older age,” added Dr Bjørnebekk.

“The findings could be directly useful for health care professionals, and may potentially have preventive implications, where brain effects are also included into the risk assessment for young men wondering whether to use anabolic steroids,”.

The findings are published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging.

Dr Cameron Carter, editor of the journal, said of the study:

“The results of this brain imaging study should be of concern for athletes using anabolic steroids for performance enhancement and suggest that the adverse effects on behaviour and cognition previously shown to be associated with long-term use are the result of effects on the brain in the form of accelerated brain ageing.”

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