Structural Brain Imaging of Long-Term Anabolic-Androgenic Steroid Users and Nonusing Weightlifters

Bjørnebekk, Astrid; Walhovd, Kristine B.; Jørstad, Marie Lindvik; Due‐Tønnessen, Paulina; Hullstein, Ingunn; Fjell, Anders M.

doi:10.1016/j.biopsych.2016.06.017

Cited by 89 publications

(100 citation statements)

References 51 publications

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“…In an overlapping sample it was recently reported smaller neuroanatomical volumes in AAS-users compared to non-users, including overall cortical, total gray matter, corpus callosum and putamen volumes and thinner cortex in widespread regions, including the posterior cingulate cortices, which are key regions in the DMN (Bjørnebekk et al, 2016). Whereas DMN connectivity has been implicated in a range of psychiatric and neurological conditions (Buckner et al, 2008, Whitfield-Gabrieli and Ford, 2012), suggesting that DMN connectivity is a sensitive but not specific index of brain function, our findings of reduced DMN-amygdala connectivity are in line with extant evidence of emotional dysregulation in AAS users.…”

Section: Discussionmentioning

confidence: 99%

“…125 USD). The sample is partly overlapping with the one described in detail in Bjørnebekk et al (Bjørnebekk et al, 2016). Here, we were primarily interested in brain connectivity alterations related to AAS-induced hormonal fluctuations.…”

Section: Methodsmentioning

confidence: 99%

“…Of the 69 non-using controls one was excluded due to neuroradiological findings, one because he failed to match criteria for strength training (see Bjørnebekk et al, 2016 for details). In addition, three participants were excluded due to missing urine samples and five for having T/E ratios > 4 (range 4.3–8.4), which might indicate administration of testosterone, yielding 59 participants in this group.…”

Section: Methodsmentioning

confidence: 99%

“…In an overlapping sample, prolonged AAS use was associated with smaller gray matter, cortical and putamen volumes and thinner cortex, with stronger effects with increasing exposure, also in users without any other substance abuse (Bjørnebekk et al, 2016). Summarized, converging evidence suggests that prolonged AAS use with supraphysiological doses is associated with both structural and functional brain alterations.…”

Section: Introductionmentioning

confidence: 99%

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Brain connectivity aberrations in anabolic-androgenic steroid users

Westlye

Kaufmann

Alnæs

et al. 2017

NeuroImage: Clinical

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Sustained anabolic-androgenic steroid (AAS) use has adverse behavioral consequences, including aggression, violence and impulsivity. Candidate mechanisms include disruptions of brain networks with high concentrations of androgen receptors and critically involved in emotional and cognitive regulation. Here, we tested the effects of AAS on resting-state functional brain connectivity in the largest sample of AAS-users to date. We collected resting-state functional magnetic resonance imaging (fMRI) data from 151 males engaged in heavy resistance strength training. 50 users tested positive for AAS based on the testosterone to epitestosterone (T/E) ratio and doping substances in urine. 16 previous users and 59 controls tested negative. We estimated brain network nodes and their time-series using ICA and dual regression and defined connectivity matrices as the between-node partial correlations. In line with the emotional and behavioral consequences of AAS, current users exhibited reduced functional connectivity between key nodes involved in emotional and cognitive regulation, in particular reduced connectivity between the amygdala and default-mode network (DMN) and between the dorsal attention network (DAN) and a frontal node encompassing the superior and inferior frontal gyri (SFG/IFG) and the anterior cingulate cortex (ACC), with further reductions as a function of dependency, lifetime exposure, and cycle state (on/off).

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Brain connectivity aberrations in anabolic-androgenic steroid users

Westlye

Kaufmann

Alnæs

et al. 2017

NeuroImage: Clinical

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“…Androgens especially anabolic androgen steroids (AAS) are not always neurobehaviorally beneficial, and their short-term use results in aggressive and manic behaviors, whereas their long-term use is associated with impairment of decision making, behavioral flexibility, cognitive control and spatial memory [61,62].…”

Section: Androgen Actions In Normal Cognitionmentioning

confidence: 99%

Sex Hormones and Alzheimer’s Disease

Bahnasy¹,

El-Heneedy²,

El-Seidy³

2018

Sex Hormones in Neurodegenerative Processes and Diseases

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Alzheimer's disease (AD) is the most common type of dementia and the most common neurodegenerative disorder of elderly. It is not an accelerated form of aging but it is characterized by distinct temporospatial brain pathological changes, including amyloid plaques accumulation, neurofibrillary tangles deposition, synaptic loss and neuronal death with gross brain atrophy. These changes result in persistent progressive memory and cognitive decline interfering with the usual daily activities. AD is a multifactorial disorder results from the interaction of genetic, epigenetic, environmental and lifestyle factors. Estrogen, progesterone and androgen effects are important building stones in AD pathogenesis, and their effect in brain modulation and development results in different gender susceptibility to the disease. These sex hormones whether gonadal or neurosteroids (synthesized locally in the brain) play important neuroprotective roles influencing the individual's vulnerability to AD development, rate of mild cognitive impairment (MCI)/AD conversion and speed of AD progression. Despite the little therapeutic implications of hormonal replacement therapy in AD treatment, yet this topic still represents a challenging hopeful way to construct a strategy for the development of personalized, gender-specific AD management.

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Clustering psychopathology in male anabolic–androgenic steroid users and nonusing weightlifters

et al. 2023

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Introduction Prior research has demonstrated that personality disorders and clinical psychiatric syndromes are common among users of anabolic–androgenic steroids (AAS). However, the prevalence, expression, and severity of psychopathology differ among AAS users and remain poorly understood. In this study, we examine the existence of potential clinically coherent psychopathology subgroups, using cluster procedures. Methods A sample of 118 male AAS users and 97 weightlifting nonusers was assessed using the Millon Clinical Multiaxial Inventory‐III (MCMI‐III), measuring personality disorders and clinical syndromes. Group differences in MCMI‐III scales were assessed using Wilcoxon‐Mann–Whitney tests and Fisher's exact test. Agglomerative hierarchical clustering was used to identify clusters based on MCMI‐III scale scores from the whole sample. Results AAS users displayed significantly higher scores on all personality disorder (except narcissistic) and clinical syndrome scales compared to nonusing weightlifters. The clustering analysis found four separate clusters with different levels and patterns of psychopathology. The “no psychopathology” cluster was most common among nonusing weightlifters, while the three other clusters were more common among AAS users: “severe multipathology,” “low multipathology,” and “mild externalizing.” The “severe multipathology” cluster was found almost exclusively among AAS users. AAS users also displayed the highest scores on drug and alcohol dependence syndromes. Conclusions AAS users in our sample demonstrated greater psychopathology than the nonusing weightlifters, with many exhibiting multipathology. This may pose a significant challenge to clinical care for AAS users, particularly as there appears to be significant variation in psychopathology in this population. Individual psychiatric profiles should be taken into consideration when providing treatment to this group. Significant Outcomes As a group, AAS users displayed markedly greater psychopathology than nonusing weightlifters. Multipathology was common among AAS users. Four different subgroups of personality profiles were identified with distinct patterns of pathology and severity. Limitations The cross‐sectional nature of the study precludes inferences about causality. The study is limited by possible selection bias, as participants choosing to be involved in research may not be entirely representative for the group as a whole. The study is vulnerable to information bias, as the results are based on self‐report measures and interviews.

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Structural Brain Imaging of Long-Term Anabolic-Androgenic Steroid Users and Nonusing Weightlifters

Cited by 89 publications

References 51 publications

Brain connectivity aberrations in anabolic-androgenic steroid users

Brain connectivity aberrations in anabolic-androgenic steroid users

Sex Hormones and Alzheimer’s Disease

Clustering psychopathology in male anabolic–androgenic steroid users and nonusing weightlifters

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