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



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.



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.



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.
Department of Physical Medicine and Rehabilitation, Unit of Neuropsychology, Oslo, Norway; National Advisory Unit on Substance Use Disorder Treatment, Oslo, Norway. Electronic address: askrbj@ous-hf.no.
Astrid
A
Bjørnebekk
Research Group for Lifespan Changes in Brain and Cognition, Oslo, Norway.
Kristine B
KB
Walhovd
National Advisory Unit on Substance Use Disorder Treatment, Oslo, Norway.
Marie L
ML
Jørstad
Department of Radiology, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway.
Paulina
P
Due-Tønnessen
Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway.
Ingunn R
IR
Hullstein
Research Group for Lifespan Changes in Brain and Cognition, Oslo, Norway.
Anders M
AM
Fjell
D000328:Adult; D000367:Age Factors; D000728:Androgens / Q000009:adverse effects / Q000494:pharmacology*; D001921:Brain / Q000000981:diagnostic imaging* / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D012044:Regression Analysis; D014891:Weight Lifting; D055815:Young Adult
D000728:Androgens
Anabolic-androgenic steroids; Cerebral cortex; Cortical thinning; Gray matter; Neuroimaging; Putamen