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Wood RI, Chen MY, Snow E. Chronic high-dose testosterone impairs economic decision making, but has no effect on memory in male rats. Behav Processes 2024; 218:105044. [PMID: 38679343 PMCID: PMC11111344 DOI: 10.1016/j.beproc.2024.105044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 03/22/2024] [Accepted: 04/25/2024] [Indexed: 05/01/2024]
Abstract
The goal is to understand consequences of anabolic-androgenic steroid (AAS) abuse on cognitive function, using rats as a model. Economic decision making was evaluated in an operant test of effort value discounting, where subjects choose between 2 levers that deliver large and small rewards differing in maximum value and reward contrast. The hypothesis is that chronic high-dose testosterone increases preference for large rewards. Male rats were treated chronically with testosterone (7.5 mg/kg) or vehicle. Initially, all rats preferred the large reward lever when large and small rewards remained fixed at 3 and 1 sugar pellets, respectively. When different reward values were introduced, and with increasing response requirements, testosterone-treated rats made fewer responses for the large reward, and increased omissions. They earned fewer rewards overall. To determine if testosterone impairs memory, rats were tested for recognition memory with the novel object recognition and social transmission of food preference tasks, and for spatial memory with the radial arm maze and Morris water maze. There was not effect of chronic high-dose testosterone on any memory task. These results suggest that testosterone shifts economic decision making towards larger rewards even when they are disadvantageous, but does not alter memory in rats.
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Affiliation(s)
- Ruth I Wood
- Department of Integrative Anatomical Sciences, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, United States.
| | - Michael Y Chen
- Department of Integrative Anatomical Sciences, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, United States
| | - Elizabeth Snow
- Department of Integrative Anatomical Sciences, Keck School of Medicine at the University of Southern California, Los Angeles, CA 90033, United States
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Zelleroth S, Stam F, Nylander E, Kjellgren E, Gising J, Larhed M, Grönbladh A, Hallberg M. The decanoate esters of nandrolone, testosterone, and trenbolone induce steroid specific memory impairment and somatic effects in the male rat. Horm Behav 2024; 161:105501. [PMID: 38368844 DOI: 10.1016/j.yhbeh.2024.105501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/26/2024] [Accepted: 02/05/2024] [Indexed: 02/20/2024]
Abstract
Long-term use of anabolic androgenic steroids (AAS) in supratherapeutic doses is associated with severe adverse effects, including physical, mental, and behavioral alterations. When used for recreational purposes several AAS are often combined, and in scientific studies of the physiological impact of AAS either a single compound or a cocktail of several steroids is often used. Because of this, steroid-specific effects have been difficult to define and are not fully elucidated. The present study used male Wistar rats to evaluate potential somatic and behavioral effects of three different AAS; the decanoate esters of nandrolone, testosterone, and trenbolone. The rats were exposed to 15 mg/kg of nandrolone decanoate, testosterone decanoate, or trenbolone decanoate every third day for 24 days. Body weight gain and organ weights (thymus, liver, kidney, testis, and heart) were measured together with the corticosterone plasma levels. Behavioral effects were studied in the novel object recognition-test (NOR-test) and the multivariate concentric square field-test (MCSF-test). The results conclude that nandrolone decanoate, but neither testosterone decanoate nor trenbolone decanoate, caused impaired recognition memory in the NOR-test, indicating an altered cognitive function. The behavioral profile and stress hormone level of the rats were not affected by the AAS treatments. Furthermore, the study revealed diverse AAS-induced somatic effects i.e., reduced body weight development and changes in organ weights. Of the three AAS included in the study, nandrolone decanoate was identified to cause the most prominent impact on the male rat, as it affected body weight development, the weights of multiple organs, and caused an impaired memory function.
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Affiliation(s)
- Sofia Zelleroth
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Frida Stam
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Erik Nylander
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Ellinor Kjellgren
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden
| | - Johan Gising
- The Beijer Laboratory, Science for Life Laboratory, Department of Medicinal Chemistry, SE-751 23, Uppsala University, Sweden.
| | - Mats Larhed
- The Beijer Laboratory, Science for Life Laboratory, Department of Medicinal Chemistry, SE-751 23, Uppsala University, Sweden.
| | - Alfhild Grönbladh
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
| | - Mathias Hallberg
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Neuropharmacology and Addiction Research, SE-751 24, Uppsala University, Sweden.
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Scarth M, Hauger LE, Thorsby PM, Leknes S, Hullstein IR, Westlye LT, Bjørnebekk A. Supraphysiological testosterone levels from anabolic steroid use and reduced sensitivity to negative facial expressions in men. Psychopharmacology (Berl) 2024; 241:701-715. [PMID: 37993638 DOI: 10.1007/s00213-023-06497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 11/03/2023] [Indexed: 11/24/2023]
Abstract
RATIONALE Anabolic-androgenic steroids (AAS) are used to improve physical performance and appearance, but have been associated with deficits in social cognitive functioning. Approximately 30% of people who use AAS develop a dependence, increasing the risk for undesired effects. OBJECTIVES To assess the relationship between AAS use (current/previous), AAS dependence, and the ability to recognize emotional facial expressions, and investigate the potential mediating role of hormone levels. METHODS In total 156 male weightlifters, including those with current (n = 45) or previous (n = 34) AAS use and never-using controls (n = 77), completed a facial Emotion Recognition Task (ERT). Participants were presented with faces expressing one out of six emotions (sadness, happiness, fear, anger, disgust, and surprise) and were instructed to indicate which of the six emotions each face displayed. ERT accuracy and response time were recorded and evaluated for association with AAS use status, AAS dependence, and serum reproductive hormone levels. Mediation models were used to evaluate the mediating role of androgens in the relationship between AAS use and ERT performance. RESULTS Compared to never-using controls, men currently using AAS exhibited lower recognition accuracy for facial emotional expressions, particularly anger (Cohen's d = -0.57, pFDR = 0.03) and disgust (d = -0.51, pFDR = 0.05). Those with AAS dependence (n = 47) demonstrated worse recognition of fear relative to men without dependence (d = 0.58, p = 0.03). Recognition of disgust was negatively correlated with serum free testosterone index (FTI); however, FTI did not significantly mediate the association between AAS use and recognition of disgust. CONCLUSIONS Our findings demonstrate impaired facial emotion recognition among men currently using AAS compared to controls. While further studies are needed to investigate potential mechanisms, our analysis did not support a simple mediation effect of serum FTI.
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Affiliation(s)
- Morgan Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Lisa Evju Hauger
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
| | - Per Medbøe Thorsby
- Hormone laboratory, Department of Medical Biochemistry and Biochemical endocrinology and metabolism research group, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine and University of Oslo, Oslo, Norway
| | - Siri Leknes
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Diagnostic Physics, Oslo University Hospital, Oslo, Norway
| | - Ingunn R Hullstein
- Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
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Carollo A, Corazza O, Mantovani M, Silvestrini N, Rabin O, Esposito G. Performance-enhancing substances in sport: A scientometric review of 75 years of research. Drug Test Anal 2024. [PMID: 38491903 DOI: 10.1002/dta.3677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 03/18/2024]
Abstract
The use of performance-enhancing substances not only undermines the core values of sports but also poses significant health risks to athletes. In a fast-evolving doping environment, where sport professionals are constantly seeking novel and illegal means to bypass doping tests, and new substances are regularly detected on the drug market, it is crucial to inform authorities with updated evidence emerging from scientific research. The current study aims to (i) outline the structure of knowledge in the literature on performance enhancers in sports (i.e., most active countries, main sources, most productive authors, and most frequently used keywords); (ii) identify the most impactful documents in the field; and (iii) uncover the main domains of research in the literature. To do so, we conducted a comprehensive scientometric analysis of the literature on doping, sourcing our data from Scopus. Our research involved a document co-citation analysis of 193,076 references, leading to the identification of the 51 most influential documents and seven key thematic areas within the doping literature. Our results indicate that the scientific community has extensively studied the most prevalent doping classes, such as anabolic agents and peptide hormones, and little is still known about the use of contaminated supplements or other types of enhancers identified as emergent trends. Concurrently, technological advancements contributed to the development of more sophisticated doping detection techniques, using blood or urine samples. More recently, the focus has shifted towards the athlete biological passport, with research efforts aimed at identifying biomarkers indicative of doping. The dynamic nature of doping methods underlines the necessity for more robust educational campaigns, aiming at raising awareness among sports professionals and their entourage about the dangers of doping and the intricacies of its control mechanisms.
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Affiliation(s)
- Alessandro Carollo
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Ornella Corazza
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Maria Mantovani
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Nicolò Silvestrini
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
| | - Olivier Rabin
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
- World Anti-Doping Agency, Montreal, Québec, Canada
| | - Gianluca Esposito
- Department of Psychology and Cognitive Science, University of Trento, Rovereto, Italy
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Scarth M, Westlye LT, Havnes IA, Bjørnebekk A. Investigating anabolic-androgenic steroid dependence and muscle dysmorphia with network analysis among male weightlifters. BMC Psychiatry 2023; 23:342. [PMID: 37193971 DOI: 10.1186/s12888-023-04781-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 04/13/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Anabolic-androgenic steroid (AAS) dependence has numerous adverse health consequences, and may be driven in part by body image concerns, primarily muscle dysmorphia. This study aims to further understand and identify potential clinical targets using network analyses of AAS dependence and muscle dysmorphia symptoms in males who used AAS and weightlifting controls. METHODS A sample of 153 men who currently or previously used AAS and 88 weight-lifting controls were recruited through social media and relevant online forums, and via posters and flyers distributed in select gyms in Oslo, Norway. Symptoms of AAS dependence and muscle dysmorphia were assessed using clinical interviews and standardized questionnaires. Severity of muscle dysmorphia symptoms were compared between the groups using independent samples t-tests. The following symptom networks were computed using Gaussian graphical modeling or mixed graphical modeling: (1) AAS dependence symptoms among men with AAS use (2) muscle dysmorphia symptoms among men with AAS use and weight-lifting controls in two separate networks, which were compared using a network comparison test, and (3) AAS dependence and muscle dysmorphia symptoms among men with AAS use. RESULTS In a network of AAS dependence symptoms, continuing use despite physical and mental side effects, using longer than planned, tolerance, and work/life interference were the most central symptoms. When comparing symptom structures of muscle dysmorphia between those who used AAS and controls, the most central symptoms in each group were exercise dependence and size/symmetry concerns, respectively. Men with AAS use demonstrated elevated muscle dysmorphia symptoms compared to controls, indicating that both the severity and structure of symptoms differ between these groups. In a network including both AAS dependence and muscle dysmorphia symptoms, no significant connections between symptom groups were identified. CONCLUSIONS AAS dependence is complex, with correlated somatic and psychological challenges driving the symptom network, indicating that alleviating physical and mental health concerns during both AAS use and cessation is an important clinical target. Muscle dysmorphia symptoms related to taking action (diet, exercise, and supplement use) appear to cluster together more for those who use AAS than those who do not.
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Affiliation(s)
- Morgan Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Oslo, 0424, Norway.
- Department of Psychology, University of Oslo, Oslo, Norway.
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Institute of Clinical Medicine, NORMENT, Oslo University Hospital, University of Oslo, Oslo, Norway
- KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ingrid A Havnes
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Oslo, 0424, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Oslo, 0424, Norway
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Jørstad ML, Scarth M, Torgersen S, Pope HG, Bjørnebekk A. Clustering psychopathology in male anabolic-androgenic steroid users and nonusing weightlifters. Brain Behav 2023:e3040. [PMID: 37150843 DOI: 10.1002/brb3.3040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/14/2023] [Accepted: 04/20/2023] [Indexed: 05/09/2023] Open
Abstract
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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Affiliation(s)
- Marie Lindvik Jørstad
- Anabolic Androgenic Steroid Research Group, National Advisory Unit on SUD Treatment, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Morgan Scarth
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | | | - Harrison Graham Pope
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts, USA
- Harvard Medical School, Department of Psychiatry, Boston, Massachusetts, USA
| | - Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Substance availability and use in ex-professional ice hockey enforcers. Sci Rep 2022; 12:22204. [PMID: 36564454 PMCID: PMC9789070 DOI: 10.1038/s41598-022-26806-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Some ex-professional ice hockey enforcers (players whose primary role was fighting) have experienced negative health outcomes following their careers including substance use. Some have suggested that negative post-career outcomes following a career in contact sport relate specifically to neurotrauma. The purpose of this study was to determine whether ex-professional ice hockey enforcers were negatively impacted by substance use during and/or following their careers. It was hypothesised that given their role in the sport, significant exposure to injury (including concussions) occurred, leading to challenges post-career including substance use. This study utilises a mixed methods quantitative and qualitative approach with one-on-one semi-structured interviews and questions related to substance use. This hypothesis for this study was not supported. Participants in this study reported low levels of substance use post-career. Patterns of substance use during career varied by era with a change in use from alcohol and over-the-counter stimulants to opioids, sleep aids, and anabolic androgenic steroids (AAS) estimated to occur near the mid to late 1990s. Four participants described patterns of excessive alcohol use during their careers. Stimulant use was prevalent in ice hockey pre-mid-1990s. The use of prescription opioids and sleep aids was reportedly rare before the mid to late 1990s, but eventually became easily attainable via team medical staff and prescription sharing. Two participants from the later era also reported use of AAS. This sample of ex-professional hockey enforcers experienced a significant number of concussions, continue to have challenges with chronic pain, and were exposed to several unique stressors during their careers, the effects of which may have varied based upon how the role was viewed. A combination of these factors may have resulted in substance use in some of these athletes during, but not following their careers.
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Doping and sports endocrinology: anabolic-androgenic steroids. Rev Clin Esp 2022; 222:612-620. [PMID: 36400345 DOI: 10.1016/j.rceng.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/16/2022] [Indexed: 11/17/2022]
Abstract
The use of anabolic steroids affects not only professional athletes but also the general population (bodybuilders, gym clients, and adolescents). In the first case, its use is prohibited and sanctioned by the World Anti-Doping Agency and Olympic committees. For the other users, it is difficult to establish its prevalence since many obtain the products via the internet. The reasons for its use are varied and different forms of use and other types of users have been described. Among the side effects of steroid use, hypogonadism is the most frequent cause for endocrinological consultation. After a general introduction to doping, this review describes the historical background of anabolic-androgenic steroids, their classification, forms of use, physiological effects, adverse effects on different organs and systems, treatment of hypogonadism, as well as detection methods.
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Hearne E, Atkinson A, Boardley I, McVeigh J, Van Hout MC. ‘Sustaining masculinity’: a scoping review of anabolic androgenic steroid use by older males. DRUGS: EDUCATION, PREVENTION AND POLICY 2022. [DOI: 10.1080/09687637.2022.2132135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Evelyn Hearne
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Amanda Atkinson
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
| | - Ian Boardley
- Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Jim McVeigh
- School of Sport Exercise & Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Marie Claire Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, UK
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García-Arnés J, García-Casares N. Endocrinología del dopaje y los deportes: andrógenos anabolizantes. Rev Clin Esp 2022. [DOI: 10.1016/j.rce.2022.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Donovan A, Källström M, Wood RI. Effort-based decision making in response to high-dose androgens: role of dopamine receptors. Behav Pharmacol 2022; 33:435-441. [PMID: 36148834 PMCID: PMC9512319 DOI: 10.1097/fbp.0000000000000687] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Anabolic-androgenic steroids (AAS) are performance-enhancing drugs used by both world-class and rank-and-file athletes. AAS abuse has been linked with risky decision-making, ranging from drunk driving to abusing multiple drugs. Our lab uses operant behavior in rats to test the effects of AAS (testosterone) on decision making. In our previous study, testosterone caused rats to work harder for food reward during an effort discounting (ED) task. ED is sensitive to dopamine in the nucleus accumbens, and AAS alter accumbens dopamine receptor expression. Accordingly, we determined if testosterone increases response to dopamine receptor antagonists during ED. METHODS Rats were treated chronically with high-dose testosterone (7.5 mg/kg; n = 9) or vehicle (n = 9). We measured baseline preference for the large reward in an ED task, where rats choose between a small easy reward (one lever press for one sugar pellet) and a large difficult reward (2, 5, 10, or 15 presses for three pellets). Preference for the large reward was measured after administration of D1-like (SCH23390, 0.01 mg/kg) or D2-like (eticlopride, 0.06 mg/kg) receptor antagonists. RESULTS At baseline, testosterone- and vehicle-treated rats showed similar preference for the large reward lever (FR5, testosterone: 68.6 ± 9.7% and vehicle: 85.7 ± 2.5%). SCH23390 reduced large reward preference significantly in both groups (FR5, testosterone: 41.3 ± 9.2%; vehicle: 49.1 ± 8.2%; F(1,16) = 17.7; P < 0.05). Eticlopride decreased large reward preference in both groups, but more strongly in testosterone-treated rats (FR5: testosterone: 37.0 ± 9.7%; vehicle: 56.3 ± 7.8%; F(1,16) = 35.3; P < 0.05). CONCLUSION Testosterone increases response to dopamine D2-like receptor blockade, and this contributes to previously observed changes in decision-making behaviors.
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Affiliation(s)
- Alexandra Donovan
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA
| | - Malin Källström
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Ruth I. Wood
- Department of Integrative Anatomical Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA
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Layman HM, Keirns NG, Hawkins MA, Nagata JM. Does seeking the brawns impact the brain?: An investigation of muscularity-oriented disordered behaviors and cognitive function. Body Image 2022; 42:307-314. [PMID: 35908297 PMCID: PMC9812210 DOI: 10.1016/j.bodyim.2022.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 01/07/2023]
Abstract
Shifts in body-image ideals over the past 30 years towards leaner, muscular bodies have revealed new health behaviors that may be related to cognitive function. This study objective was to investigate prospective associations between a drive for muscularity and/or muscularity-oriented disordered behaviors (MODBs) with cognition. Data were drawn from Add Health, a nationally representative longitudinal cohort dataset. Drive for muscularity and MODB engagement were assessed in emerging adulthood (ages 18-26). Cognition was measured via immediate word recall, delayed-word recall, and number recall at 7-years later (ages 24-32). Analyzes were conducted in 1976 participants with available data. A one-way ANCOVA revealed that those with a drive for muscularity had lower immediate word recall (F(3, 12,819) = 3.845, p = .009) and delayed word recall (F(3, 12,807) = 5.933, p < .001) scores than other weight goal groups adjusting for covariates. Hierarchical linear regressions between individual MODBs and cognitive outcomes showed that legal performance-enhancing substance use (βs = 0.06-0.07, p < .05) and exercise (β = 0.06, p < .05) were positively associated with some cognition scores. Conversely, lifting weights (β = - 0.06, p < .05) and eating different foods than usual (β = - 0.05, p < .05) exhibited negative associations with some of the cognitive outcomes. Future research should be conducted to examine other potential outcomes related to the drive for muscularity and associated MODBs.
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Affiliation(s)
- Harley M. Layman
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74074, the United States of America,Corresponding author. (H.M. Layman)
| | - Natalie G. Keirns
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74074, the United States of America
| | - Misty A.W. Hawkins
- Department of Psychology, Oklahoma State University, 116 Psychology Building, Stillwater, OK 74074, the United States of America
| | - Jason M. Nagata
- Department of Pediatrics, University of California, 550 16th St., San Francisco, CA 94158, the United States of America
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The effects of resistance training and spirulina on the performance of the antioxidant system with emphasis on mir125b, mir146a and cognitive function in stanazolol-induced neurotoxicity in rats. Chem Biol Interact 2022; 366:110112. [PMID: 36029803 DOI: 10.1016/j.cbi.2022.110112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 11/23/2022]
Abstract
Abuse of anabolic-androgenic steroids (AAS) is associated with neurological and cognitive problems in athletes. The Purpose of this study was to investigate the simultaneous effect of resistance training (RT) and spirulina supplementation (Sp) on the function of the antioxidant system with emphasis on mir125b, mir146a and cognitive function in Stanazolol (S)-induced neurotoxicity in rats. This experimental animal model study was performed with a post-test design with a control group. 45 male Sprague-Dawley rats were divided into six groups of 9 animals including (Althobaiti et al., 2022) [1]: sham (Sh/normal saline intake) (Havnes et al., 2019) [2], 25 mg/kg/wk of stanazolol (S) (Albano et al., 2021) [3], S + 100 mg/kg of Sp + (S + Sp) (Bjørnebekk et al., 2021) [4], RT (six weeks with an intensity of 50-100% of body weight) + S (S + RT) (Kanayama et al., 2013) [5] S + Sp + RT. Levels of superoxide dismutase (SOD), glutathione peroxidase (GPx), total antioxidant capacity (TAC), malondialdehyde (MDA), percentage of healthy cells in the C1 and C3 regions of hippocampus, miR125b, miR146a, step-through latency (STL), time spent in dark compartment (TDC), repeated entry in dark compartment (RDC) and percentage of alternation (PA%) were measured in the post-test. Results showed that the Sp, RT and SP + RT increased levels of SOD, GPx and percentage of healthy cells in C1 region, decreased MDA, mir125b, mir146a in hippocampal tissue and decreased TDC levels in S-exposed rats (P ≤ 0.05). Sp + RT decreased RDC and increased SOD levels; on the other hand, RT decreased RDC levels in S-exposed rats (P ≤ 0.05). Levels of TAC in the Sp groups were significantly higher than the S group (P ≤ 0.05). Also, the effect of Sp + RT in reducing miR125b, miR146a, and STL levels was much higher than the effect of Sp and RT alone (P ≤ 0.05). It seems that applying resistance training and spirulina supplementation both separately and interactively is effective in improving the antioxidant system as well as memory and learning in cognitive impairment caused by stanazolol. However, more studies on microRNAs are needed.
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Kildal E, Hassel B, Bjørnebekk A. ADHD symptoms and use of anabolic androgenic steroids among male weightlifters. Sci Rep 2022; 12:9479. [PMID: 35676515 PMCID: PMC9178025 DOI: 10.1038/s41598-022-12977-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/19/2022] [Indexed: 11/09/2022] Open
Abstract
Use of anabolic androgenic steroids (AAS) is associated with adverse health effects. The factors that predispose to AAS use among athletes are poorly understood, but attention deficit/hyperactivity disorder (ADHD), which is known to occur among athletes more often than in the general population, is associated with risk behaviors, including substance abuse. We aimed to see if AAS use in male weightlifters was associated with ADHD symptoms, and test the link between ADHD symptoms and cognitive performance. Hundred and forty male weightlifters, 72 AAS users and 68 weightlifting controls (WLC), completed the Achenbach system of empirically based assessment (ASEBA) for ADHD symptoms and underwent cognitive examination. Self-reported ADHD symptom scores were significantly higher among AAS users compared to WLC, and scores in the range indicating clinically important ADHD was significantly more common in the AAS-using group. Age of onset of AAS use correlated inversely with ADHD scale score (r = - 0.35; p = 0.003). ADHD score correlated inversely with cognitive scores for working memory (r = - 0.25, p < 0.001), processing speed (r = - 0.24, p < 0.001), verbal learning and memory (r = - 0.19, p = 0.03), and problem solving (r = - 0.20, p = 0.02). AAS use among weightlifters is associated with ADHD symptoms and corresponding lower cognitive performance. Recognising a relationship between ADHD symptoms and AAS use may guide drug prevention strategies in sports.
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Affiliation(s)
- Emilie Kildal
- Department of Neurohabilitation, Oslo University Hospital, Kirkeveien 166, 0450, Oslo, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Bjørnar Hassel
- Department of Neurohabilitation, Oslo University Hospital, Kirkeveien 166, 0450, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway
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15
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Anabolic-androgenic steroid use is associated with psychopathy, risk-taking, anger, and physical problems. Sci Rep 2022; 12:9133. [PMID: 35650220 PMCID: PMC9160254 DOI: 10.1038/s41598-022-13048-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 04/25/2022] [Indexed: 11/09/2022] Open
Abstract
Previous research has uncovered medical and psychological effects of anabolic-androgenic steroid (AAS) use, but the specific relationship between AAS use and risk-taking behaviors as well as between AAS use and psychopathic tendencies remains understudied. To explore these potential relationships, we anonymously recruited 492 biologically male, self-identified bodybuilders (median age 22; range 18-47 years) from online bodybuilding fora to complete an online survey on Appearance and Performance Enhancing Drug (APED) use, psychological traits, lifestyle choices, and health behaviors. We computed odds ratios and 95% confidence intervals using logistic regression, adjusting for age, race, education, exercise frequency, caloric intake, and lean BMI. Bodybuilders with a prior history of AAS use exhibited heightened odds of psychopathic traits, sexual and substance use risk-taking behaviors, anger problems, and physical problems compared to those with no prior history of AAS use. This study is among the first to directly assess psychopathy within AAS users. Our results on risk-taking, anger problems, and physical problems are consistent with prior AAS research as well as with existing frameworks of AAS use as a risk behavior. Future research should focus on ascertaining causality, specifically whether psychopathy is a risk associated with or a result of AAS use.
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Severity of anabolic steroid dependence, executive function, and personality traits in substance use disorder patients in Norway. Drug Alcohol Depend 2022; 231:109275. [PMID: 35030506 DOI: 10.1016/j.drugalcdep.2022.109275] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 12/21/2021] [Accepted: 12/21/2021] [Indexed: 01/16/2023]
Abstract
INTRODUCTION Anabolic androgenic steroids (AAS), including testosterone and synthetic derivatives, are typically used to increase muscle mass. Many users develop a dependence on these substances, contributing to worsened physical and mental health outcomes. Aspects of personality and executive dysfunction may represent underlying vulnerabilities for developing dependence. OBJECTIVE To identify levels of AAS dependence within substance use disorder (SUD) treatment patients and assess the relationship between dependence severity and personality traits and executive function (EF). METHODS Data were collected from patients at 38 SUD treatment facilities in Norway. Questionnaires were completed for measures of personality and EF. Measures of symptoms of AAS dependence were used in latent class analysis to identify sub-groups of patients, which were evaluated for association with EF and personality traits, and compared with a group of non-AAS using SUD patients. RESULTS Three classes were identified; largely reflecting low, moderate, and high symptoms of dependence. Multinomial regression analyses indicated that moderate and high symptoms were associated with several measures of EF and personality traits, particularly self-monitoring, antagonism, disinhibition, and rigid perfectionism while users with low symptoms exhibited higher capacities for emotional control and shift, and lower negative affectivity, relative to non-AAS using SUD patients. Backward stepwise regressions indicated antagonism, and decreased self-monitoring as key personality and cognitive characteristics of SUD patients with severe AAS dependence. CONCLUSION Our findings indicate that specific executive dysfunctions and personality features, particularly those associated with poor emotional control, reduced empathy, and impulsivity are associated with more severe AAS dependence in the SUD population.
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Anabolic-Androgenic Steroid Misuse: Mechanisms, Patterns of Misuse, User Typology, and Adverse Effects. JOURNAL OF SPORTS MEDICINE 2021; 2021:7497346. [PMID: 34926695 PMCID: PMC8683244 DOI: 10.1155/2021/7497346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/16/2021] [Indexed: 11/17/2022]
Abstract
Anabolic-androgenic steroids (AAS) encompass a broad group of natural and synthetic androgens. AAS misuse is highly prevalent on a global scale, with the lifetime prevalence of AAS misuse in males being estimated to be around 6%, with 15 to 25% of male gym attendees using it at any one time. AAS are associated with sudden cardiac death, neuropsychiatric manifestations, and infertility. The average AAS user is unlikely to voluntarily declare their usage to a physician, with around 1 in 10 actively engaging in unsafe injection techniques. The aim of this paper is to review the current evidence base on AAS with emphasis on mechanisms of action, adverse effects, and user profiles that are most likely to engage in AAS misuse. This paper also reviews terminologies and uses methods specific to the AAS user community.
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18
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Abstract
Androgens are potent drugs requiring prescription for valid medical indications but are misused for invalid, unproven, or off-label reasons as well as being abused without prescription for illicit nonmedical application for performance or image enhancement. Following discovery and first clinical application of testosterone in the 1930s, commercialization of testosterone and synthetic androgens proliferated in the decades after World War II. It remains among the oldest marketed drugs in therapeutic use, yet after 8 decades of clinical use, the sole unequivocal indication for testosterone remains in replacement therapy for pathological hypogonadism, organic disorders of the male reproductive system. Nevertheless, wider claims assert unproven, unsafe, or implausible benefits for testosterone, mostly representing wishful thinking about rejuvenation. Over recent decades, this created an epidemic of testosterone misuse involving prescription as a revitalizing tonic for anti-aging, sexual dysfunction and/or obesity, where efficacy and safety remains unproven and doubtful. Androgen abuse originated during the Cold War as an epidemic of androgen doping among elite athletes for performance enhancement before the 1980s when it crossed over into the general community to become an endemic variant of drug abuse in sufficiently affluent communities that support an illicit drug industry geared to bodybuilding and aiming to create a hypermasculine body physique and image. This review focuses on the misuse of testosterone, defined as prescribing without valid clinical indications, and abuse of testosterone or synthetic androgens (androgen abuse), defined as the illicit use of androgens without prescription or valid indications, typically by athletes, bodybuilders and others for image-oriented, cosmetic, or occupational reasons.
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Affiliation(s)
- David J Handelsman
- ANZAC Research Institute, University of Sydney, Sydney, Australia.,Andrology Department, Concord Hospital, Sydney, Australia
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19
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Bjørnebekk A, Kaufmann T, Hauger LE, Klonteig S, Hullstein IR, Westlye LT. Long-term Anabolic-Androgenic Steroid Use Is Associated With Deviant Brain Aging. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2021; 6:579-589. [PMID: 33811018 DOI: 10.1016/j.bpsc.2021.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 12/02/2020] [Accepted: 01/04/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND High-dose long-term use of anabolic-androgenic steroids (AASs) may cause a range of adverse effects, including brain and cognitive abnormalities. We performed age prediction based on brain scans to test whether prolonged AAS use is associated with accentuated brain aging. METHODS T1-weighted magnetic resonance imaging (3D MPRAGE [magnetization-prepared rapid acquisition gradient-echo]) scans were obtained from male weightlifters with a history of prolonged AAS use (n = 130) or no AAS use (n = 99). We trained machine learning models on combinations of regional brain volumes, cortical thickness, and surface area in an independent training set of 1838 healthy male subjects (18-92 years of age) and predicted brain age for each participant in our study. Including cross-sectional and longitudinal (mean interval = 3.5 years, n = 76) magnetic resonance imaging data, we used linear mixed-effects models to compare the gap between chronological age and predicted brain age (the brain age gap [BAG]) for the two groups and tested for group differences in the rate of change in BAG. We tested for associations between apparent brain aging and AAS use duration, pattern of administration, and dependence. RESULTS AAS users had higher BAG compared with weightlifting control subjects, which was associated with dependency and longer history of use. Group differences in BAG could not be explained by other substance use, general cognitive abilities, or depression. While longitudinal analysis revealed no evidence of increased brain aging in the overall AAS group, accelerated brain aging was seen with longer AAS exposure. CONCLUSIONS The findings suggest that long-term high-dose AAS use may have adverse effects on brain aging, potentially linked to dependency and exaggerated use of AASs.
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Affiliation(s)
- Astrid Bjørnebekk
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
| | - Tobias Kaufmann
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Lisa E Hauger
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Sandra Klonteig
- Anabolic Androgenic Steroid Research Group, Section for Clinical Addiction Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingunn R Hullstein
- Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway
| | - Lars T Westlye
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway; K.G. Jebsen Center for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
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20
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Adverse Effects of Anabolic-Androgenic Steroids: A Literature Review. Healthcare (Basel) 2021; 9:healthcare9010097. [PMID: 33477800 PMCID: PMC7832337 DOI: 10.3390/healthcare9010097] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/03/2021] [Accepted: 01/11/2021] [Indexed: 12/19/2022] Open
Abstract
Anabolic-androgenic steroids (AASs) are a large group of molecules including endogenously produced androgens, such as testosterone, as well as synthetically manufactured derivatives. AAS use is widespread due to their ability to improve muscle growth for aesthetic purposes and athletes’ performance, minimizing androgenic effects. AAS use is very popular and 1–3% of US inhabitants have been estimated to be AAS users. However, AASs have side effects, involving all organs, tissues and body functions, especially long-term toxicity involving the cardiovascular system and the reproductive system, thereby, their abuse is considered a public health issue. The aim of the proposed review is to highlight the most recent evidence regarding the mechanisms of action of AASs and their unwanted effects on organs and lifestyle, as well as suggesting that AAS misuse and abuse lead to adverse effects in all body tissues and organs. Oxidative stress, apoptosis, and protein synthesis alteration are common mechanisms involved in AAS-related damage in the whole body. The cardiovascular system and the reproductive system are the most frequently involved apparatuses. Epidemiology as well as the molecular and pathological mechanisms involved in the neuropsychiatric side-effects of AAS abuse are still unclear, further research is needed in this field. In addition, diagnostically reliable tests for AAS abuse should be standardized. In this regard, to prevent the use of AASs, public health measures in all settings are crucial. These measures consist of improved knowledge among healthcare workers, proper doping screening tests, educational interventions, and updated legislation.
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21
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Anabolic-androgenic steroid administration increases self-reported aggression in healthy males: a systematic review and meta-analysis of experimental studies. Psychopharmacology (Berl) 2021; 238:1911-1922. [PMID: 33745011 PMCID: PMC8233285 DOI: 10.1007/s00213-021-05818-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/03/2021] [Indexed: 12/31/2022]
Abstract
RATIONALE Aggression and irritability are notable psychiatric side effects of anabolic-androgenic steroid (AAS) use. However, no previous study has systematically reviewed and quantitatively synthesized effects reported by experimental studies on this topic. OBJECTIVE We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) investigating the effect of AAS administration on self-reported and observer-reported aggression. METHODS Twelve RCTs comprising a total of 562 healthy males were identified through systematic searches of MEDLINE, PsycInfo, ISI Web of Science, ProQuest, Google Scholar, and the Cochrane Library. RESULTS After excluding one outlier, AAS administration was associated with an increase in self-reported aggression under a random-effects model, albeit small (Hedges' g = 0.171, 95% CI: 0.029-0.312, k = 11, p = .018), and when restricting the analysis to the effect of acute AAS administration on self-reported aggression under a fixed-effect model (g = 0.291, 95% CI: 0.014-0.524, p = .014). However, the above effects were neither replicated in the analysis of observer-reported aggression nor after restricting the analysis to the effects of the administration of higher (over 500 mg) and long-term (3 days to 14 weeks) doses. CONCLUSIONS The present meta-analysis provides evidence of an increase, although small, in self-reported aggression in healthy males following AAS administration in RCTs. Ecologically rational RCTs are warranted to better explore the effect of AAS administration on aggression in humans.
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Sessa F, Salerno M, Cipolloni L, Bertozzi G, Messina G, Mizio GD, Asmundo A, Pomara C. Anabolic-androgenic steroids and brain injury: miRNA evaluation in users compared to cocaine abusers and elderly people. Aging (Albany NY) 2020; 12:15314-15327. [PMID: 32756006 PMCID: PMC7467388 DOI: 10.18632/aging.103512] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/04/2020] [Indexed: 12/14/2022]
Abstract
Anabolic-androgenic steroids (AASs) can be used to treat both hormonal diseases and other pathologies characterized by muscle loss (aging, cancer, and AIDS). Even if the adverse effects related to the misuse of AASs have been well studied in different systems and apparatuses, knowledge about brain damage is poor.In this scenario, this experimental study aimed to analyze the role of several microRNAs (miRNAs) in brain damage after AAS misuse, to better comprehend the underlying mechanisms. The research hypothesis at the base of this experimental study is that the chronic use of AASs may be associated to brain damage with a dysregulation of these miRNAs. Moreover, miRNA expression values were compared among three different groups, "AAS" group, "Cocaine" group and "Aging" group, in order to define if AAS brain damage can be compared with the brain impairment linked to aging and/or cocaine assumption.This experimental study revealed that the tested miRNAs (hsa-miR-21-5p, hsa-miR-34a-5p, hsa-miR-124-5p, hsa-miR-132-3p, and hsa-miR-144-3p) were overexpressed in all enrolled groups. In the light of the presented results, the identification of specific circulating and/or tissue biomarkers is challenging for the scientific community. Further studies with larger samples are needed to confirm these interesting findings.
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Affiliation(s)
- Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71122, Italy
| | - Monica Salerno
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Catania 95121, Italy
| | - Luigi Cipolloni
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71122, Italy
| | - Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71122, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71122, Italy
| | - Giulio Di Mizio
- Department of Legal, Historical, Economic and Social Sciences, University of Catanzaro, Catanzaro 88100, Italy
| | - Alessio Asmundo
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, Section of Legal Medicine, University of Messina, Messina 98121, Italy
| | - Cristoforo Pomara
- Department of Medical, Surgical and Advanced Technologies “G.F. Ingrassia”, University of Catania, Catania 95121, Italy
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Shankara-Narayana N, Yu C, Savkovic S, Desai R, Fennell C, Turner L, Jayadev V, Conway AJ, Kockx M, Ridley L, Kritharides L, Handelsman DJ. Rate and Extent of Recovery from Reproductive and Cardiac Dysfunction Due to Androgen Abuse in Men. J Clin Endocrinol Metab 2020; 105:5729047. [PMID: 32030409 DOI: 10.1210/clinem/dgz324] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/17/2020] [Indexed: 02/04/2023]
Abstract
CONTEXT Androgen abuse impairs male reproductive and cardiac function, but the rate, extent, and determinants of recovery are not understood. OBJECTIVE To investigate recovery of male reproductive and cardiac function after ceasing androgen intake in current and past androgen abusers compared with healthy non-users. METHODS Cross-sectional, observational study recruited via social media 41 current and 31 past users (≥3 months since last use, median 300 days since last use) with 21 healthy, eugonadal non-users. Each provided a history, examination, and serum and semen sample and underwent testicular ultrasound, body composition analysis, and cardiac function evaluation. RESULTS Current abusers had suppressed reproductive function and impaired cardiac systolic function and lipoprotein parameters compared with non- or past users. Past users did not differ from non-users, suggesting full recovery of suppressed reproductive and cardiac functions after ceasing androgen abuse, other than residual reduced testicular volume. Mean time to recovery was faster for reproductive hormones (anti-Mullerian hormone [AMH], 7.3 months; luteinizing hormone [LH], 10.7 months) than for sperm variables (output, 14.1 months) whereas spermatogenesis (serum follicle-stimulating hormone [FSH], inhibin B, inhibin) took longer. The duration of androgen abuse was the only other variable associated with slower recovery of sperm output (but not hormones). CONCLUSION Suppressed testicular and cardiac function due to androgen abuse is effectively fully reversible (apart from testis volume and serum sex hormone binding globulin) with recovery taking between 6 to 18 months after ceasing androgen intake with possible cumulative effects on spermatogenesis. Suppressed serum AMH, LH, and FSH represent convenient, useful, and underutilized markers of recovery from androgen abuse.
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Affiliation(s)
- Nandini Shankara-Narayana
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Christopher Yu
- Department of Cardiology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Sasha Savkovic
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Reena Desai
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Carolyn Fennell
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Leo Turner
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Veena Jayadev
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Ann J Conway
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Maaike Kockx
- Department of Cardiology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Lloyd Ridley
- Department of Radiology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - Len Kritharides
- Department of Cardiology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
| | - David J Handelsman
- Department of Andrology, Concord Repatriation General Hospital and ANZAC Research Institute, University of Sydney, Concord Hospital, NSW, Australia
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Abstract
The sport of competitive bodybuilding requires an intense regimen of weightlifting and dieting, often aided with muscle-building or fat-burning drugs, and culminating in an on-stage posing competition. Despite these rigorous demands, competitive bodybuilding is popular, with thousands of competitions performed annually around the world. Although many studies have addressed the psychological features of various sports and the athletes who compete in them, few have examined the psychological aspects of bodybuilding. Even fewer studies have specifically examined competitive bodybuilders, as opposed to the much larger group of "recreational" bodybuilders who do not compete. The limited available literature suggests that competitive bodybuilders may show an increased risk for four categories of psychopathology: muscle dysmorphia, eating disorders, abuse of appearance- and performance-enhancing drugs, and exercise dependence. However, in each of these categories, one must carefully distinguish between the planned and dedicated behaviors required for success in the sport, as opposed to frankly pathological behaviors that impair social or occupational function, cause subjective distress, or lead to adverse health consequences. Future work should attempt to better assess the nature and prevalence of these conditions among competitive bodybuilders, with perhaps greatest attention to the issue of drug use.
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Mullen C, Whalley BJ, Schifano F, Baker JS. Anabolic androgenic steroid abuse in the United Kingdom: An update. Br J Pharmacol 2020; 177:2180-2198. [PMID: 31989581 PMCID: PMC7174889 DOI: 10.1111/bph.14995] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 12/03/2019] [Accepted: 01/07/2020] [Indexed: 12/11/2022] Open
Abstract
Anabolic androgenic steroids (AASs) are prescribed for medical conditions related to low testosterone. Abuse of AASs has surged as they become recognised as potent image enhancement drugs. The primary goal of most abusers is to obtain a more attractive outward appearance. Abuse is complex. There are a vast range of AAS substances illegally available, the nature of their true composition is difficult to evaluate. Users follow dosing patterns which incorporate a number of different AASs, in addition to other pharmaceutical substances believed to complement the desired physical effects or manage unwanted effects. Animal work and medical case reports suggest potential to cause serious hepatotoxicity, plus possible neurotoxicity, nephrotoxicity and damage to the cardiovascular and reproductive systems. As the long-term AASs users reach maturity, further controlled experimentation, with larger sample sizes, is required. Data gathering should be directed towards the most vulnerable group of AAS users, females and adolescent boys.
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Affiliation(s)
- Carrie Mullen
- School of Computing, Engineering and Physical SciencesUniversity of the West of ScotlandPaisleyUK
| | - Benjamin J. Whalley
- School of Chemistry, Food and Nutritional Sciences, and PharmacyThe University of ReadingReadingUK
| | - Fabrizio Schifano
- School of Life and Medical SciencesUniversity of HertfordshireHatfieldUK
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Department of Sport, Physical Education and HealthHong Kong Baptist UniversityKowloon TongHong Kong
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Havnes IA, Jørstad ML, McVeigh J, Van Hout MC, Bjørnebekk A. The Anabolic Androgenic Steroid Treatment Gap: A National Study of Substance Use Disorder Treatment. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2020; 14:1178221820904150. [PMID: 32127749 PMCID: PMC7031794 DOI: 10.1177/1178221820904150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 11/23/2022]
Abstract
Background: Anabolic androgenic steroid (AAS) use is associated with serious mental and physical health problems. Evidence indicates that AAS use among people who use psychoactive substances is higher than in the general population. This study aims to estimate lifetime AAS use among patients in substance use disorder (SUD) treatment, compare characteristics of AAS and non-AAS users and identify whether AAS use was addressed during treatment. Methods: This cross-sectional survey included 563 (142 women, 24.2%) patients in 38 SUD treatment facilities in Norway. Respondents reported on AAS and substance use, and treatment experiences. Results: Lifetime AAS use was reported by 156 (28.3%) SUD patients, thereof 35.6% of the men and 8.0% of the women. Lifetime AAS use was highest among men with stimulants (55.8%) as preferred substance, and lowest among men who preferred alcohol (14.6%). Initiation of AAS use due to getting thinner following substance use was reported by 44.5% of the AAS using men. AAS users reported more severe substance use than non-AAS users. More than half (58%) of all patients had not been asked about AAS use, and 42.4% of those who were asked, experienced that treatment providers lacked expertise about AAS. Conclusion: Lifetime AAS use in this sample of SUD patients is common practice and comprise an underrecognized problem in SUD treatment. Given the deleterious implications to the individual and society that concomitant use of AAS may cause, it would be essential to raise the awareness about AAS use among SUD patients, and the level of competence among health professionals.
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Affiliation(s)
- Ingrid Amalia Havnes
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Marie Lindvik Jørstad
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Jim McVeigh
- Substance Use and Associated Behaviours, Department of Sociology, Manchester Metropolitan University, Manchester, UK
| | - Marie-Claire Van Hout
- Public Health Institute, Faculty of Education, Health & Community, Liverpool John Moores University, Liverpool, UK
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Hauger LE, Westlye LT, Bjørnebekk A. Anabolic androgenic steroid dependence is associated with executive dysfunction. Drug Alcohol Depend 2020; 208:107874. [PMID: 31972519 DOI: 10.1016/j.drugalcdep.2020.107874] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/07/2020] [Accepted: 01/11/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Anabolic androgenic steroid (AAS) dependence is associated with a high prevalence of intra- and interpersonal problems, hence it is central to identify cognitive factors related to the development and maintenance of dependence. METHODS The study explores executive functions (EFs) in a sample of 174 male weightlifters, divided into three groups; 1) AAS dependents; n = 58, 2) AAS non-dependents; n = 38 and 3) AAS non-users; n = 78, using a targeted battery of neuropsychological (NP) tests, and self-report questionnaires assessing EFs in everyday life, ADHD symptoms and psychological distress. RESULTS Multivariate analysis of variance showed significant between-group differences on several EFs, including working memory [F (2, 169) = 13.79, p < .001, ηp² = 0.14], mental flexibility [F (2, 169) = 4.82, p = .009, ηp² = 0.05], problem-solving [F (2, 169) = 4.77 p = .010, ηp² = 0.05] and inhibition [F (2, 163) = 4.15, p = .017, ηp² = 0.05]. Additionally, significant between-group differences were seen for self-reported problems with EFs [F (2, 124) = 4.38 p = .015, ηp² = 0.07], ADHD symptoms [F (2, 124) = 7.02 p = .001, ηp² = 0.10], and psychological distress [F (2, 124) = 4.11 p = .019, ηp² = 0.06]. Post hoc tests showed that AAS dependents exhibited poorer EFs and reported more psychological distress compared to non-users. CONCLUSION AAS dependence is associated with executive dysfunction, which might be related to continued abuse despite adverse side-effects and social consequences. Increased awareness of executive dysfunction could have important implications for treatment and rehabilitation.
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Affiliation(s)
- Lisa E Hauger
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Norway.
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Postbox 1094, Blindern, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4956, Nydalen, Norway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, Norway
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Anabolic-Androgenic Steroid Use in the Eastern Mediterranean Region: a Scoping Review of Extant Empirical Literature. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-019-00217-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
AbstractThe use of image- and performance-enhancing drugs particularly anabolic-androgenic steroids (AAS) is not a new phenomenon. AAS use is not limited to athletes, with mainstream populations using these drugs for aesthetic purposes. Prevalence has been predominantly in Western countries, with some recent studies indicating a rise in popularity in the Eastern Mediterranean region. A scoping review of extant empirical literature from the Eastern Mediterranean region described and mapped what is known about the extent of AAS in the region. Four themes emerged from the review: (1) profile of AAS users; (2) AAS within gymnasium practice; (3) AAS regimes of use; and (4) knowledge and understanding of the AAS concept and related adverse effects. The review highlights a relatively new phenomenon of AAS use in the Eastern Mediterranean. The review underscores the need to carry out further research, particularly qualitative and quantitative studies with both genders, and cognisant of the complexities of culture and religiosity.
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Vaskinn A, Hauger LE, Bjørnebekk A. Theory of mind in users of anabolic androgenic steroids. Psychopharmacology (Berl) 2020; 237:3191-3199. [PMID: 32623552 PMCID: PMC7524704 DOI: 10.1007/s00213-020-05603-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/26/2020] [Indexed: 02/02/2023]
Abstract
RATIONALE Anabolic androgenic steroids are used to improve physical performance or increase lean muscle mass. About one-third of users develop a dependency syndrome, which is characterized by elevated rates of psychopathology, cognitive impairments, and aggressive and antisocial behaviors. The mechanisms behind these intra- and interpersonal problems are not known. OBJECTIVE To examine theory of mind (ToM), i.e., the ability to infer the mental state of others, in users of anabolic androgenic steroids. Reduced ToM may be one factor underlying the interpersonal problems that have been reported with prolonged use of anabolic androgenic steroids. METHODS The Movie for the Assessment of Social Cognition (MASC) was used to assess ToM. Study participants were male/female weightlifters who used anabolic androgenic steroids (AAS, n = 34/9), who were dependent on anabolic androgenic steroids (AASdep, n = 44/7), and a non-using weightlifting comparison group (WLC, n = 69/16). RESULTS Analyses of variance showed that the AASdep group performed significantly worse than the WLC group, for all MASC measures (total ToM, cognitive ToM, affective ToM, overmentalizing/undermentalizing errors). Sex and sex x group interaction effects were non-significant. CONCLUSIONS Male and female weightlifters who were dependent on anabolic androgenic steroids had impaired ToM. Their reduced social cognition may be one contributing factor to the elevated rates of antisocial behavior reported in this population.
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Affiliation(s)
- Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Division Mental Health and Addiction, Oslo University Hospital, PO Box 4956, Nydalen, 0424, Oslo, Norway. .,Institute of Clinical Medicine, University of Oslo, PO Box 1171, Blindern, 0318, Oslo, Norway.
| | - Lisa E. Hauger
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, Division Mental Health and Addiction, Oslo University Hospital, PO Box 4959, Nydalen, 0424 Oslo, Norway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, Division Mental Health and Addiction, Oslo University Hospital, PO Box 4959, Nydalen, 0424 Oslo, Norway
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Wood RI, Serpa RO. Anabolic-androgenic steroid abuse and cognitive impairment: Testosterone IMPAIRS biconditional task performance in male rats. Behav Brain Res 2019; 379:112339. [PMID: 31697985 DOI: 10.1016/j.bbr.2019.112339] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 10/30/2019] [Accepted: 10/31/2019] [Indexed: 01/01/2023]
Abstract
Our goal is to understand the consequences of anabolic-androgenic steroid (AAS) abuse on cognitive function, using rats as a model. There is relatively little research on how AAS abuse impacts cognition. In the present study, rats were tested for their ability to use contextual information to guide decision-making in biconditional discrimination. The Stroop task is a classic human test for contextual decision-making. In rodents, biconditional discrimination challenges subjects to use contextual cues in the operant chamber to resolve the correct lever response when auditory and visual cues are incongruent. The hypothesis is that chronic high-dose testosterone impairs biconditional discrimination. Rats were trained in 24 trials/day over 14 days, in alternating sessions with each environment. On a flat floor with houselight illuminated, auditory cues (clicker vs tone) signified the active lever. On a barred floor with no light, visual cues from 2 stimulus lights (constant vs blinking) identified the active lever. Rats treated chronically with testosterone (7.5 mg/kg) were unimpaired in task acquisition, and all rats learned to select the correct lever in response to auditory or visual cues. During extinction, controls made significantly more correct than incorrect responses in congruent trials (p < 0.05 by paired t-test), but testosterone-treated rats failed to show a similar preference. This was reflected by significant interactions of drug x cue agreement (F1,18 = 5.21, p < 0.05) and drug x cue agreement x response accuracy (F1,18 = 8.95, p < 0.05). These results suggest that testosterone impairs cognitive flexibility, and demonstrates potential for AAS abuse to impair cognitive function in humans.
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Affiliation(s)
- Ruth I Wood
- Department of Integrative Anatomical Sciences, Keck School of Medicine at the University of Southern California, Los Angeles, CA, 90033, United States.
| | - Rebecka O Serpa
- Department of Integrative Anatomical Sciences, Keck School of Medicine at the University of Southern California, Los Angeles, CA, 90033, United States
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Perez-Laso C, Cerdan S, Junque C, Gómez Á, Ortega E, Mora M, Avendaño C, Gómez-Gil E, Del Cerro MCR, Guillamon A. Effects of Adult Female Rat Androgenization on Brain Morphology and Metabolomic Profile. Cereb Cortex 2019; 28:2846-2853. [PMID: 29106544 DOI: 10.1093/cercor/bhx163] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Indexed: 11/14/2022] Open
Abstract
Androgenization in adult natal women, as in transsexual men (TM), affects brain cortical thickness and the volume of subcortical structures. In order to understand the mechanism underlying these changes we have developed an adult female rat model of androgenization. Magnetic resonance imaging and spectroscopy were used to monitor brain volume changes, white matter microstructure and ex vivo metabolic profiles over 32 days in androgenized and control subjects. Supraphysiological doses of testosterone prevents aging decrease of fractional anisotropy values, decreased general cortical volume and the relative concentrations of glutamine (Gln) and myo-Inositol (mI). An increase in the N-acetylaspartate (NAA)/mI ratio was detected d. Since mI and Gln are astrocyte markers and osmolytes, we suspect that the anabolic effects of testosterone change astrocyte osmolarity so as to extrude Mi and Gln from these cells in order to maintain osmotic homeostasis. This mechanism could explain the brain changes observed in TM and other individuals receiving androgenic anabolic steroids.
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Affiliation(s)
- Carmen Perez-Laso
- Departamento de Psicobiología, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Sebastián Cerdan
- Instituto de Investigaciones Biomédicas Alberto Sols, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Carme Junque
- Departamento de Medicina, Facultad de Medicina, Universidad de Barcelona, Barcelona, Spain
| | - Ángel Gómez
- Departamento de Psicología Social y de las Organizaciones, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
| | - Esperanza Ortega
- Departamento de Bioquímica y Biología Molecular, Facultad de Medicina, Universidad de Granada, Granada, Spain
| | - Mireia Mora
- Departamento de Endocrinología, Hospital Clínic, Barcelona, Spain
| | - Carlos Avendaño
- Departamento de Anatomía y Neurociencia, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Esther Gómez-Gil
- Unidad de Identidad de Género, Departamento de Psiquiatría, Hospital Clìnic, Barcelona, Spain
| | | | - Antonio Guillamon
- Departamento de Psicobiología, Facultad de Psicología, Universidad Nacional de Educación a Distancia, Madrid, Spain
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Owens SJ, Purves-Tyson TD, Webster MJ, Shannon Weickert C. Evidence for enhanced androgen action in the prefrontal cortex of people with bipolar disorder but not schizophrenia or major depressive disorder. Psychiatry Res 2019; 280:112503. [PMID: 31446215 DOI: 10.1016/j.psychres.2019.112503] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 01/24/2023]
Abstract
Anxiety and depressive disorders are more prevalent in hypogonadal men. Low testosterone levels are associated with greater negative symptoms and impaired cognition in men with schizophrenia. Thus, androgens may contribute to brain pathophysiology in psychiatric disorders. We investigated androgen-related mRNAs in post-mortem dorsolateral prefrontal cortex of psychiatric disorders. We also assessed androgen receptor (AR) CAG trinucleotide repeat length, a functional AR gene variant associated with AR gene expression, receptor activity, and circulating testosterone. AR CAG repeat length was determined from genomic DNA and AR and 5α-reductase mRNAs measured using quantitative PCR in schizophrenia, bipolar disorder and control cases [n = 35/group; Stanley Medical Research Institute (SMRI) Array collection]. Layer-specific AR gene expression was determined using in situ hybridisation in schizophrenia, bipolar disorder, major depressive disorder and control cases (n = 15/group; SMRI Neuropathology Consortium). AR mRNA was increased in bipolar disorder, but was unchanged in schizophrenia, relative to controls. AR and 5α-reductase mRNAs were significantly positively correlated in bipolar disorder. AR CAG repeat length was significantly shorter in bipolar disorder relative to schizophrenia. AR mRNA expression was highest in cortical layers IV and V, but no layer-specific diagnostic differences were detected. Together, our results suggest enhanced cortical androgen action in people with bipolar disorder.
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Affiliation(s)
- Samantha J Owens
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick NSW 2031, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia.
| | - Tertia D Purves-Tyson
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick NSW 2031, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia
| | - Maree J Webster
- Laboratory of Brain Research, Stanley Medical Research Institute, MD 20815, USA
| | - Cynthia Shannon Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick NSW 2031, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney NSW 2052, Australia; Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, NY 13210, USA.
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Hauger LE, Sagoe D, Vaskinn A, Arnevik EA, Leknes S, Jørstad ML, Bjørnebekk A. Anabolic androgenic steroid dependence is associated with impaired emotion recognition. Psychopharmacology (Berl) 2019; 236:2667-2676. [PMID: 30941469 DOI: 10.1007/s00213-019-05239-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 03/22/2019] [Indexed: 01/22/2023]
Abstract
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.
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Affiliation(s)
- Lisa E Hauger
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway.
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Espen A Arnevik
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
| | - Siri Leknes
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Marie L Jørstad
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and Addiction, Oslo University Hospital, Postbox 4959, Nydalen, 0424, Oslo, Norway
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Hauger LE, Westlye LT, Fjell AM, Walhovd KB, Bjørnebekk A. Structural brain characteristics of anabolic-androgenic steroid dependence in men. Addiction 2019; 114:1405-1415. [PMID: 30955206 PMCID: PMC6767448 DOI: 10.1111/add.14629] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/15/2018] [Accepted: 03/29/2019] [Indexed: 12/31/2022]
Abstract
AIM To identify differences in brain morphology between dependent and non-dependent male anabolic-androgenic steroid (AAS) users. DESIGN This study used cross-sectional data from a longitudinal study on male weightlifters. PARTICIPANTS Oslo University Hospital, Norway. SETTING Eighty-one 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 < 0.001, right superior frontal, cluster-wise P < 0.001), as has been observed in other dependencies. Group differences were also seen when excluding participants with previous or current non-AAS drug abuse (left pre-central, cluster-wise P < 0.001, left pars orbitalis, cluster-wise P = 0.010). CONCLUSION Male dependent anabolic-androgenic steroid users appear to have thinner cortex in widespread regions, specifically in pre-frontal areas involved in inhibitory control and emotional regulation, compared with non-dependent anabolic-androgenic steroid users.
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Affiliation(s)
- Lisa E. Hauger
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and AddictionOslo University HospitalOsloNorway
| | - Lars T. Westlye
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical MedicineUniversity of OsloNorway,Department of PsychologyUniversity of OsloOsloNorway
| | - Anders M. Fjell
- Research Group for Lifespan Changes in Brain and Cognition, Department of PsychologyUniversity of OsloOsloNorway,Department of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
| | - Kristine B. Walhovd
- Research Group for Lifespan Changes in Brain and Cognition, Department of PsychologyUniversity of OsloOsloNorway,Department of Radiology and Nuclear MedicineOslo University HospitalOsloNorway
| | - Astrid Bjørnebekk
- The Anabolic Androgenic Steroid Research Group, National Advisory Unit on Substance Use Disorder Treatment, the Division of Mental Health and AddictionOslo University HospitalOsloNorway
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Dokovna LB, Li G, Wood RI. Anabolic-androgenic steroids and cognitive effort discounting in male rats. Horm Behav 2019; 113:13-20. [PMID: 31054274 PMCID: PMC6589107 DOI: 10.1016/j.yhbeh.2019.04.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/10/2019] [Accepted: 04/27/2019] [Indexed: 01/19/2023]
Abstract
Anabolic-androgenic steroids (AAS) are drugs of abuse that impair behavior and cognition. In a rodent model of AAS abuse, testosterone-treated male rats expend more physical effort, by repeatedly pressing a lever for a large reward in an operant discounting task. However, since modern society prioritizes cognitive over physical effort, it is important to determine if AAS limit cognitive effort. Here we tested the effects of AAS on a novel cognitive-effort discounting task. Each operant chamber had 3 nose-pokes, opposite 2 levers and a pellet dispenser. Rats pressed a lever to illuminate 1 nose-poke; they responded in the illuminated nose-poke to receive sugar pellets. For the 'easy' lever, the light remained on for 1 s, and a correct response earned 1 pellet. For the 'hard' lever, the light duration decreased from 1 s to 0.1 s across 5 blocks of trials, and a correct response earned 4 pellets. As the duration of the nose-poke light decreased, all rats decreased their choice of the hard lever in a modest discounting curve. Task accuracy also decreased significantly across the 5 blocks of trials. However, there was no effect of testosterone on choice of the hard lever or task accuracy. Antagonism of dopamine D1 or D2 receptors had no effect on lever choice or task accuracy. However, serotonin depletion significantly decreased preference for the hard lever, and impaired task accuracy. Thus, physical effort discounting depends on dopamine activity, while cognitive effort discounting task is sensitive to serotonin. AAS impair physical effort discounting, but not cognitive effort discounting.
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Affiliation(s)
- Lisa B Dokovna
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA 90033, United States of America
| | - Grace Li
- Department of Integrative Anatomical Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, United States of America
| | - Ruth I Wood
- Department of Integrative Anatomical Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA 90033, United States of America.
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Koundourakis NE, Margioris AN. The complex and bidirectional interaction between sex hormones and exercise performance in team sports with emphasis on soccer. Hormones (Athens) 2019; 18:151-172. [PMID: 31256350 DOI: 10.1007/s42000-019-00115-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Accepted: 01/07/2019] [Indexed: 10/26/2022]
Abstract
A constant topic reported in the lay press is the effect of sex hormones on athletic performance and their abuse by athletes in their effort to enhance their performance or to either boost or sidestep their hard, protracted, and demanding training regimens. However, an issue that it is almost never mentioned is that the athletic training itself affects the endogenous production of androgens and estrogens, while also being affected by them. Among sports, soccer is a particularly demanding activity, soccer players needing to possess high levels of endurance, strength, and both aerobic and anaerobic capacity, with the very great physiological, metabolic, physical, and psychological exertion required of the players being both influenced by sex steroids and, reciprocally, affecting sex steroid levels. This review focuses on the currently available knowledge regarding the complex relationship between athletic training and competition and sex steroid hormone adaptation to the demands of the exercise effort. In the first part of the review, we will examine the effects of endogenous testosterone, estrogen, and adrenal androgens on athletic performance both during training and in competition. In the second part, we will explore the reciprocal effects of exercise on the endogenous sex hormones while briefly discussing the recent data on anabolic androgenic steroid abuse.
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Affiliation(s)
- Nikolaos E Koundourakis
- Lab of Clinical Chemistry-Biochemistry, Department of Laboratory Medicine, School of Medicine, University of Crete, Heraklion, Crete, Greece.
| | - Andrew N Margioris
- Department of Clinical Chemistry, School of Medicine, University of Crete, Heraklion, Crete, Greece
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McDuff D, Stull T, Castaldelli-Maia JM, Hitchcock ME, Hainline B, Reardon CL. Recreational and ergogenic substance use and substance use disorders in elite athletes: a narrative review. Br J Sports Med 2019; 53:754-760. [PMID: 31097457 DOI: 10.1136/bjsports-2019-100669] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Substances from various classes may be used for recreational purposes, self-treatment or to boost performance. When substance use shifts from occasional to regular, heavy or hazardous use, positive and negative effects can develop that vary by substance class and athlete. Regular use of recreational or performance enhancing substances can lead to misuse, sanctions or use disorders. OBJECTIVE To review the prevalence, patterns of use, risk factors, performance effects and types of intervention for all classes of recreational and performance enhancing substances in elite athletes by sport, ethnicity, country and gender. METHODS A comprehensive search was conducted to identify studies that compared the prevalence and patterns of substance use, misuse and use disorders in elite athletes with those of non-athletes and provided detailed demographic and sport variations in reasons for use, risk factors and performance effects for each main substance class. RESULTS Alcohol, cannabis, tobacco (nicotine) and prescribed opioids and stimulants are the most commonly used substances in elite athletes, but generally used at lower rates than in non-athletes. In contrast, use/misuse rates for binge alcohol, oral tobacco, non-prescription opioids and anabolic-androgenic steroids are higher among athletes than non-athletes, especially in power and collision sports. Cannabis/cannabinoids seem to have replaced nicotine as the second most commonly used substance. CONCLUSIONS Substance use in elite athletes varies by country, ethnicity, gender, sport and competitive level. There are no studies on substance use disorder prevalence in elite male and female athletes and few studies with direct comparison groups.
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Affiliation(s)
- David McDuff
- Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA .,MD Sports Performance, Ellicott, Maryland, USA
| | - Todd Stull
- Athletics, University of Nebraska-Lincoln University Health Center, Lincoln, Nebraska, USA
| | - João Mauricio Castaldelli-Maia
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, Brazil.,Department of Neuroscience, Medical School, Fundação do ABC, Santo André, Brazil
| | - Mary E Hitchcock
- Ebling Library for the Health Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Brian Hainline
- National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
| | - Claudia L Reardon
- Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
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Havnes IA, Jørstad ML, Wisløff 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. [PMID: 31096999 PMCID: PMC6524231 DOI: 10.1186/s13011-019-0206-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 04/15/2019] [Indexed: 12/22/2022]
Abstract
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.
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Affiliation(s)
- Ingrid Amalia Havnes
- National Advisory Unit on Substance Use Disorder Treatment, Division of Mental Health and Addiction, Oslo University Hospital, PO Box 4959, Nydalen, 0424, Oslo, Norway.
| | - Marie Lindvik Jørstad
- National Advisory Unit on Substance Use Disorder Treatment, Division of Mental Health and Addiction, Oslo University Hospital, PO Box 4959, Nydalen, 0424, Oslo, Norway
| | - Christine Wisløff
- National Advisory Unit on Substance Use Disorder Treatment, Division of Mental Health and Addiction, Oslo University Hospital, PO Box 4959, Nydalen, 0424, Oslo, Norway
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Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med 2019; 53:667-699. [DOI: 10.1136/bjsports-2019-100715] [Citation(s) in RCA: 349] [Impact Index Per Article: 69.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/03/2022]
Abstract
Mental health symptoms and disorders are common among elite athletes, may have sport related manifestations within this population and impair performance. Mental health cannot be separated from physical health, as evidenced by mental health symptoms and disorders increasing the risk of physical injury and delaying subsequent recovery. There are no evidence or consensus based guidelines for diagnosis and management of mental health symptoms and disorders in elite athletes. Diagnosis must differentiate character traits particular to elite athletes from psychosocial maladaptations.Management strategies should address all contributors to mental health symptoms and consider biopsychosocial factors relevant to athletes to maximise benefit and minimise harm. Management must involve both treatment of affected individual athletes and optimising environments in which all elite athletes train and compete. To advance a more standardised, evidence based approach to mental health symptoms and disorders in elite athletes, an International Olympic Committee Consensus Work Group critically evaluated the current state of science and provided recommendations.
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Goldman AL, Pope HG, Bhasin S. The Health Threat Posed by the Hidden Epidemic of Anabolic Steroid Use and Body Image Disorders Among Young Men. J Clin Endocrinol Metab 2019; 104:1069-1074. [PMID: 30239802 DOI: 10.1210/jc.2018-01706] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 09/10/2018] [Indexed: 01/21/2023]
Abstract
CONTEXT The prevalence of body image disorders and anabolic-androgenic steroid (AAS) use is increasing, despite the evidence of their serious adverse health effects and despite the passage of laws regulating their sales. Here we review the evolution of the dual emerging epidemics of body image disorders and AAS use, adverse health effects of AASs, and the need for an integrated health policy and regulatory response. EVIDENCE ACQUISITION We searched for studies published prior to June 2018. Quality of evidence was low to moderate because of its observational nature; heterogeneity of eligibility criteria; variable doses; reliance on retrospective self-reported data in many studies; and variable quality of outcome ascertainment. EVIDENCE SYNTHESIS Most AAS users are nonathlete young men, who use these substances to look lean and more muscular. Some of these men suffer from "muscle dysmorphia," a form of body dysmorphic disorder. AASs has been associated with cardiovascular disorders, psychiatric disorders, AAS-withdrawal hypogonadism, infertility, neurotoxic effects, musculoskeletal injuries, liver toxicity, and needle-borne infections. Potential adverse effects may be compounded by the use of other substances (e.g., opioids) and high-risk behaviors. Unregulated Internet sales of AASs and selective androgen receptor modulators, which are easily purchased without a prescription, are of concern because of their potential to fuel the epidemic among adolescents and the military. CONCLUSIONS Integrated nationwide efforts are necessary to raise public awareness of this epidemic, to study long-term health effects of AASs and treatment strategies, and to reform regulations to stem the epidemics of AAS use and body image disorders.
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Affiliation(s)
- Anna L Goldman
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Harrison G Pope
- Harvard Medical School, Boston, Massachusetts
- Biological Psychiatry Laboratory, McLean Hospital, Belmont, Massachusetts
| | - Shalender Bhasin
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Boston Claude D. Pepper Older Americans Independence Center, Boston, Massachusetts
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Kaufman MJ, Kanayama G, Hudson JI, Pope HG. Supraphysiologic-dose anabolic-androgenic steroid use: A risk factor for dementia? Neurosci Biobehav Rev 2019; 100:180-207. [PMID: 30817935 DOI: 10.1016/j.neubiorev.2019.02.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/13/2019] [Accepted: 02/17/2019] [Indexed: 02/06/2023]
Abstract
Supraphysiologic-dose anabolic-androgenic steroid (AAS) use is associated with physiologic, cognitive, and brain abnormalities similar to those found in people at risk for developing Alzheimer's Disease and its related dementias (AD/ADRD), which are associated with high brain β-amyloid (Aβ) and hyperphosphorylated tau (tau-P) protein levels. Supraphysiologic-dose AAS induces androgen abnormalities and excess oxidative stress, which have been linked to increased and decreased expression or activity of proteins that synthesize and eliminate, respectively, Aβ and tau-P. Aβ and tau-P accumulation may begin soon after initiating supraphysiologic-dose AAS use, which typically occurs in the early 20s, and their accumulation may be accelerated by other psychoactive substance use, which is common among non-medical AAS users. Accordingly, the widespread use of supraphysiologic-dose AAS may increase the numbers of people who develop dementia. Early diagnosis and correction of sex-steroid level abnormalities and excess oxidative stress could attenuate risk for developing AD/ADRD in supraphysiologic-dose AAS users, in people with other substance use disorders, and in people with low sex-steroid levels or excess oxidative stress associated with aging.
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Affiliation(s)
- Marc J Kaufman
- McLean Imaging Center, McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
| | - Gen Kanayama
- Biological Psychiatry Laboratory, McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - James I Hudson
- Biological Psychiatry Laboratory, McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
| | - Harrison G Pope
- Biological Psychiatry Laboratory, McLean Hospital, 115 Mill St., Belmont, MA 02478, USA; Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA
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Zelleroth S, Nylander E, Nyberg F, Grönbladh A, Hallberg M. Toxic Impact of Anabolic Androgenic Steroids in Primary Rat Cortical Cell Cultures. Neuroscience 2018; 397:172-183. [PMID: 30500611 DOI: 10.1016/j.neuroscience.2018.11.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 11/19/2018] [Accepted: 11/23/2018] [Indexed: 10/27/2022]
Abstract
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.
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Affiliation(s)
- Sofia Zelleroth
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Division of Biological Research on Drug Dependence, SE-751 24, Uppsala University, Sweden.
| | - Erik Nylander
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Division of Biological Research on Drug Dependence, SE-751 24, Uppsala University, Sweden.
| | - Fred Nyberg
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Division of Biological Research on Drug Dependence, SE-751 24, Uppsala University, Sweden.
| | - Alfhild Grönbladh
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Division of Biological Research on Drug Dependence, SE-751 24, Uppsala University, Sweden.
| | - Mathias Hallberg
- The Beijer Laboratory, Department of Pharmaceutical Biosciences, Division of Biological Research on Drug Dependence, SE-751 24, Uppsala University, Sweden.
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Kara M, Ozcagli E, Kotil T, Alpertunga B. Effects of stanozolol on apoptosis mechanisms and oxidative stress in rat cardiac tissue. Steroids 2018; 134:96-100. [PMID: 29477345 DOI: 10.1016/j.steroids.2018.02.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 01/24/2018] [Accepted: 02/15/2018] [Indexed: 12/18/2022]
Abstract
Stanozolol is a widely used 17α-alkylated anabolic androgenic steroid (AAS) derivative. Despite stanozolol's adverse effects, its effect on oxidative stress parameters and mitochondrial apoptosis pathway is not clearly defined. In our study, thirty four male Sprague-Dawley rats were divided into 5 groups as control (C), vehicle control (VC), steroid (ST), vehicle control-exercise (VCE), and steroid-exercise (STE). Animals were subcutaneously administered stanozolol 5 mg/kg in steroid groups and propylene glycol 1 ml/kg in the vehicle-control groups. On the 28th day-after sacrification, oxidative stress (MDA, GSH, PC, SOD, CAT) and apoptosis parameters (TUNEL, Cytochrome-c) in cardiac tissue were evaluated. Also, blood vessel morphology of cardiac tissue was evaluated with Verhoeff-van Giesen staining. It has been demonstrated that stanozolol administration triggers apoptosis by using TUNEL assay and cytochrome-c immunohistochemical staining intensity, while this effect is significantly reduced in the presence of exercise. In conclusion, the present study demonstrated that stanozolol administration induces apoptosis with increasing PC and CAT levels, while GSH, MDA and SOD parameters do not reveal any significant change. Exercise has a protective role in stanozolol induced oxidative stress and apoptosis. According to Verhoeff-van Giesen staining results for blood vessel morphology assessment, it has been seen that exercise has a protective role on cardiac blood vessels. This mechanism needs further investigations with long term exposure studies for clarifying possible pathways.
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Affiliation(s)
- Mehtap Kara
- Istanbul University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Istanbul, Turkey.
| | - Eren Ozcagli
- Istanbul University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Istanbul, Turkey
| | - Tuğba Kotil
- Istanbul University, Istanbul Faculty of Medicine, Department of Histology and Embryology, Istanbul, Turkey
| | - Buket Alpertunga
- Istanbul University, Faculty of Pharmacy, Department of Pharmaceutical Toxicology, Istanbul, Turkey
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Abstract
PURPOSE OF REVIEW To summarize recent findings regarding the public health impact of androgen abuse. RECENT FINDINGS Abuse of androgens (also called 'anabolic-androgenic steroids') has grown into a major worldwide substance abuse problem involving tens of millions of individuals, of whom about 98% are men. Most androgen abusers are still under age 50 today, and thus, the long-term effects of these drugs are only beginning to be understood. Recent studies confirm that long-term supraphysiologic androgen exposure produces cardiovascular toxicity, characterized especially by cardiomyopathy and atherosclerotic disease. Withdrawal from androgens after long-term use may produce prolonged and sometimes irreversible hypogonadism in men. Supraphysiologic androgen levels may sometimes cause irritability, aggressiveness, and violence, whereas androgen withdrawal may cause depression. However, these psychiatric effects are idiosyncratic, affecting only a minority of users. Emerging evidence now also suggests that long-term androgen exposure may cause neurotoxicity, raising the possibility that aging androgen abusers may be at increased risk for dementia. Several recent studies have also described androgen-induced hepatotoxicity, nephrotoxicity, and adverse musculoskeletal effects. SUMMARY Recent studies have demonstrated marked adverse effects of long-term androgen abuse. As increasing numbers of androgen abusers reach middle age, these effects will likely represent an emerging public health problem.
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Affiliation(s)
- Gen Kanayama
- Department of Psychiatry, Harvard Medical School, McLean Hospital, Boston, Massachusetts, USA
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Hildebrandt T, Heywood A, Wesley D, Schulz K. Defining the Construct of Synthetic Androgen Intoxication: An Application of General Brain Arousal. Front Psychol 2018; 9:390. [PMID: 29651261 PMCID: PMC5885244 DOI: 10.3389/fpsyg.2018.00390] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/08/2018] [Indexed: 01/01/2023] Open
Abstract
Synthetic androgens (i. e., anabolic-androgenic steroids) are the primary component to the majority of problematic appearance and performance enhancing drug (APED) use. Despite evidence that these substances are associated with increased risk for aggression, violence, body image disturbances, and polypharmacy and can develop a pattern of chronic use consistent with drug dependence, there are no formal definitions of androgen intoxication. Consequently, the purpose of this paper is to establish a testable theory of androgen intoxication. We present evidence and theorize that synthetic androgen intoxication can be defined by a pattern of poor self-regulation characterized by increased propensity for a range of behaviors (e.g., aggression, sex, drug seeking, exercise, etc.) via androgen mediated effects on general brain arousal. This theory posits that androgens reduce threshold for emotional reactivity, motor response, and alertness to sensory stimuli and disrupt inhibitory control over the behaviors associated with synthetic androgen use. These changes result from alteration to basic neurocircuitry that amplifies limbic activation and reduces top-down cortical control. The implications for this definition are to inform APED specific hypotheses about the behavioral and psychological effects of APED use and provide a basis for establishing clinical, legal, and public health guidelines to address the use and misuse of these substances.
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Affiliation(s)
- Tom Hildebrandt
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Ashley Heywood
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Daniel Wesley
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Kurt Schulz
- Eating and Weight Disorders Program, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
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Jørstad ML, Skogheim TS, Bergsund HB. “Mer hjelp, mindre moralpreken”. NORDIC STUDIES ON ALCOHOL AND DRUGS 2018; 35:69-76. [PMID: 32934514 PMCID: PMC7434117 DOI: 10.1177/1455072517748871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Accepted: 11/15/2017] [Indexed: 11/17/2022] Open
Abstract
Background: Anabolic-androgenic steroid (AAS) use can lead to increased muscle mass and
strength as well as undesired side effects with varying severities. In
Norway, the specialized health services responsible for treating substance
use disorders are also responsible for help provision to AAS users with
health problems. The aim of this study was to find out how health services
can be made more accessible to AAS users in need of treatment. Methods: A questionnaire was posted on four online forums, and explored the following
themes: use of AAS, side effects, need for health services, and interest in
health services. Results: Seventy-four respondents answered the questionnaire, of which 57 were current
AAS users and 17 were previous users. Only one of the previous users had
received treatment after ceasing use of AAS; the majority ceased use without
external assistance. To facilitate uptake of health services, respondents
identified assurance of confidentiality, treatment provider expertise of
AAS, and respect during treatment as important factors. Most respondents
expressed interest in a no-obligation health assessment. Conclusion: Increased knowledge of AAS among health services providers may help
counteract stigma, build up users’ trust in help provision, and reach those
who want health services without disclosing their AAS use. AAS users should
be made aware of providers’ confidentiality obligations and the fact that
treatment will not lead to punishment. Treatment offers which include easy
access to a no-obligation health assessment and information about treatment
options may be key to reaching AAS users in need.
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Affiliation(s)
- Marie Lindvik Jørstad
- Steroideprosjektet, Nasjonal kompetansetjeneste TSB, Oslo universitetssykehus, Oslo, Norway
| | | | - Hans Bugge Bergsund
- Regionsenter for barn og unges psykiske helse (RBUP), Helseregion Øst og Sør, Oslo, Norway
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Tobiansky DJ, Wallin-Miller KG, Floresco SB, Wood RI, Soma KK. Androgen Regulation of the Mesocorticolimbic System and Executive Function. Front Endocrinol (Lausanne) 2018; 9:279. [PMID: 29922228 PMCID: PMC5996102 DOI: 10.3389/fendo.2018.00279] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 05/11/2018] [Indexed: 12/21/2022] Open
Abstract
Multiple lines of evidence indicate that androgens, such as testosterone, modulate the mesocorticolimbic system and executive function. This review integrates neuroanatomical, molecular biological, neurochemical, and behavioral studies to highlight how endogenous and exogenous androgens alter behaviors, such as behavioral flexibility, decision making, and risk taking. First, we briefly review the neuroanatomy of the mesocorticolimbic system, which mediates executive function, with a focus on the ventral tegmental area (VTA), nucleus accumbens (NAc), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC). Second, we present evidence that androgen receptors (AR) and other steroid receptors are expressed in the mesocorticolimbic system. Using sensitive immunohistochemistry and quantitative polymerase chain reaction (qPCR) techniques, ARs are detected in the VTA, NAc, mPFC, and OFC. Third, we describe recent evidence for local androgens ("neuroandrogens") in the mesocorticolimbic system. Steroidogenic enzymes are expressed in mesocorticolimbic regions. Furthermore, following long-term gonadectomy, testosterone is nondetectable in the blood but detectable in the mesocorticolimbic system, using liquid chromatography tandem mass spectrometry. However, the physiological relevance of neuroandrogens remains unknown. Fourth, we review how anabolic-androgenic steroids (AAS) influence the mesocorticolimbic system. Fifth, we describe how androgens modulate the neurochemistry and structure of the mesocorticolimbic system, particularly with regard to dopaminergic signaling. Finally, we discuss evidence that androgens influence executive functions, including the effects of androgen deprivation therapy and AAS. Taken together, the evidence indicates that androgens are critical modulators of executive function. Similar to dopamine signaling, there might be optimal levels of androgen signaling within the mesocorticolimbic system for executive functioning. Future studies should examine the regulation and functions of neurosteroids in the mesocorticolimbic system, as well as the potential deleterious and enduring effects of AAS use.
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Affiliation(s)
- Daniel J. Tobiansky
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- *Correspondence: Daniel J. Tobiansky,
| | - Kathryn G. Wallin-Miller
- Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, United States
| | - Stan B. Floresco
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
| | - Ruth I. Wood
- Department of Integrative Anatomical Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, CA, United States
| | - Kiran K. Soma
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
- Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada
- Department of Zoology, University of British Columbia, Vancouver, BC, Canada
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The experimental analysis of problematic video gaming and cognitive skills: A systematic review. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jtcc.2017.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Structural Brain Imaging of Long-Term Anabolic-Androgenic Steroid Users and Nonusing Weightlifters. Biol Psychiatry 2017; 82:294-302. [PMID: 27616036 DOI: 10.1016/j.biopsych.2016.06.017] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 06/02/2016] [Accepted: 06/21/2016] [Indexed: 12/11/2022]
Abstract
BACKGROUND Prolonged high-dose anabolic-androgenic steroid (AAS) use has been associated with psychiatric symptoms and cognitive deficits, yet we have almost no knowledge of the long-term consequences of AAS use on the brain. The purpose of this study is to investigate the association between long-term AAS exposure and brain morphometry, including subcortical neuroanatomical volumes and regional cortical thickness. METHODS Male AAS users and weightlifters with no experience with AASs or any other equivalent doping substances underwent structural magnetic resonance imaging scans of the brain. The current paper is based upon high-resolution structural T1-weighted images from 82 current or past AAS users exceeding 1 year of cumulative AAS use and 68 non-AAS-using weightlifters. Images were processed with the FreeSurfer software to compare neuroanatomical volumes and cerebral cortical thickness between the groups. RESULTS Compared to non-AAS-using weightlifters, the AAS group had thinner cortex in widespread regions and significantly smaller neuroanatomical volumes, including total gray matter, cerebral cortex, and putamen. Both volumetric and thickness effects remained relatively stable across different AAS subsamples comprising various degrees of exposure to AASs and also when excluding participants with previous and current non-AAS drug abuse. The effects could not be explained by differences in verbal IQ, intracranial volume, anxiety/depression, or attention or behavioral problems. CONCLUSIONS This large-scale systematic investigation of AAS use on brain structure shows negative correlations between AAS use and brain volume and cortical thickness. Although the findings are correlational, they may serve to raise concern about the long-term consequences of AAS use on structural features of the brain.
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