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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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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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3
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Chegeni R, Notelaers G, Pallesen S, Sagoe D. Aggression and Psychological Distress in Male and Female Anabolic-Androgenic Steroid Users: A Multigroup Latent Class Analysis. Front Psychiatry 2021; 12:629428. [PMID: 34149470 PMCID: PMC8211877 DOI: 10.3389/fpsyt.2021.629428] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 05/12/2021] [Indexed: 12/11/2022] Open
Abstract
The relationship between anabolic-androgenic steroid (AAS) use and aggression and psychological distress requires further elucidation. No previous study has examined whether the latent patterns of aggression and psychological distress are the same in male and female AAS users. Multigroup latent class analysis (MLCA) can be used to classify individuals into groups based on their responses on a set of variables, and to investigate measurement invariance across subgroups. We therefore conducted a MLCA to identify discrete subgroups of aggression and psychological distress in AAS users, and used measurement invariance to examine whether the identified subgroups can be applied to both sexes. We also examined the relationship between sex and subgroup belongingness. The sample comprised 206 AAS users (females = 58.30%) aged 14-56 (mean = 26.86, SD = 7.12) years. They completed questionnaires assessing demographics, AAS use, aggression, and psychological distress. Based on the MLCA, five subgroups were identified: high aggression moderate distress users (HAMoD: 07.63%), moderate aggression distress users (18.64%), moderate direct aggression-mild indirect aggression moderate distress users (22.95%), mild direct aggression-moderate indirect aggression-distress users (11.71%), and low aggression mild distress users (LAMiD: 39.06%). Although a homogenous five-class solution was the best model for both sexes, sex was significantly associated with the probability of subgroup membership. In particular, members of the HAMoD subgroup were more likely to be male whereas members of the LAMiD subgroup were more likely to be female. Our study provides novel empirical evidence of the idiosyncratic patterns of aggression and psychological distress among male and female AAS users.
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Affiliation(s)
- Razieh Chegeni
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Guy Notelaers
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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4
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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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Wu Y, Shen B, Liao J, Li Y, Zilioli S, Li H. Single dose testosterone administration increases impulsivity in the intertemporal choice task among healthy males. Horm Behav 2020; 118:104634. [PMID: 31765657 DOI: 10.1016/j.yhbeh.2019.104634] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 12/12/2022]
Abstract
Circulating levels of testosterone have been positively associated with impulsivity. The present study investigates the effect of testosterone administration on impulsivity in an intertemporal choice task, where participants are given a choice between smaller-sooner rewards and larger-later rewards. Healthy young male participants (n = 111) received a single-dose of 150 mg testosterone gel in a double-blind, placebo-controlled, between-subjects design. At 180 min post-administration, participants performed the decision-making task. Both model-free (i.e., higher indifference point) and model-based (i.e., steeper discounting rate) parameters revealed that testosterone administration increased impulsive choice. This finding supports the hypothesis that exogenous testosterone increases impulsivity among healthy young males in a laboratory task.
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Affiliation(s)
- Yin Wu
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China; School of Psychology, Shenzhen University, Shenzhen, China.
| | - Bo Shen
- Department of Psychology, Zhejiang Normal University, Jinhua, China
| | - Jiajun Liao
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China; School of Psychology, Shenzhen University, Shenzhen, China
| | - Yansong Li
- Reward, Competition, Dominance and Social Neuroscience Lab, Department of Psychology, School of Social and Behavioral Sciences, Nanjing University, Nanjing, China; Institute for Brain Sciences, Nanjing University, Nanjing, China
| | - Samuele Zilioli
- Institute for Brain Sciences, Nanjing University, Nanjing, China; Department of Psychology, Wayne State University, Detroit, United States; Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, United States
| | - Hong Li
- Shenzhen Key Laboratory of Affective and Social Cognitive Science, Shenzhen University, Shenzhen, China; School of Psychology, Shenzhen University, Shenzhen, China
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6
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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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Calcineurin is involved in retrieval of passive avoidance memory and synaptic plasticity impairment induced by Nandrolone administration in adolescent male rats. Neurobiol Learn Mem 2019; 163:107032. [PMID: 31173920 DOI: 10.1016/j.nlm.2019.107032] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 04/20/2019] [Accepted: 06/03/2019] [Indexed: 11/20/2022]
Abstract
In spite of evidence about negative effects of Nandrolone Decanoate (ND) on cognitive and memory performance, the underlying mechanisms are complex and have remained unclear. This research examines the role of Calcineurin in synaptic plasticity and memory storage impairment in ND administrated adolescent male rats. For behavioral study by passive avoidance learning and memory (PAL), adolescent male rats were treated with ND or ND plus selective Calcineurin antagonist (Tacrolimus), before retention test. ND significantly decreased the retrieval of PAL, whereas Tacrolimus plus ND had no significant effect on PAL. For electrophysiological study hippocampal slices were perfused by ND or ND plus Tacrolimus. The magnitude of fEPSP-LTP of ND perfused slices was less than the control and a reduction of fEPSP-PS (E-S) coupling was observed, while pre-administration of Tacrolimus abolished the ND impairment effect on fEPSP-LTP and E-S coupling. This study showed that ND may induce impairing effects on hippocampal area CA1 activity and plasticity and PAL memory storage through changes in the function of the Calcineurin.
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8
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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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Garcia-Argibay M. The Relationship Between the Big Five Personality Traits, Impulsivity, and Anabolic Steroid Use. Subst Use Misuse 2019; 54:236-246. [PMID: 30375916 DOI: 10.1080/10826084.2018.1512630] [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] [Indexed: 10/28/2022]
Abstract
BACKGROUND The increase in the prevalence of anabolic-androgenic steroids (AAS) use has been the subject of study in the last decades. Several studies indicated a strong association between the use of AAS and the performance of risky behaviors mediated by factors such as aggression, impulsivity, depression, and anxiety. OBJECTIVE This study aimed to identify differences in personality trait, impulsivity, and the ability to delay gratification between AAS users and non-users that predispose or serve as a buffering mechanism against its usage and whether it is related to an increased likelihood of engaging in infidelity. METHODS Two hundred and twelve male volunteers (88 AAS users), aged between 21 and 36 years (M = 28.22), completed self-report measures of personality, impulsivity, delayed gratification, and attitudes toward infidelity. Multivariate analysis of variance and logistic regression were conducted to establish differences between AAS users and non-users. RESULTS The results showed that AAS users displayed an inability to delay gratification, a greater impulsivity, and a more benevolent attitude toward infidelity. AAS users obtained higher scores on openness and neuroticism, which was larger "off-cycle," although they presented lower scores on extraversion compared to the non-users group. Regression analysis revealed that neuroticism, impulsivity, and delaying gratification scores were significant predictors of AAS usage. In addition, impulsivity functioned as a partial mediator in the relationship between neuroticism and AAS use. CONCLUSION The results of this research highlight a pivotal implication of impulsivity in AAS use in conjunction with neuroticism, openness, and extraversion traits.
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Affiliation(s)
- Miguel Garcia-Argibay
- a Department of Behavioral Science, Faculty of Psychology , National University of Distance Education (UNED) , Madrid , Spain
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10
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Chegeni R, Sagoe D, Mentzoni RA, Pallesen S. Aggression and Anabolic-Androgenic Steroid Use Intent in Adolescents: A Longitudinal Study. Subst Use Misuse 2019; 54:1509-1518. [PMID: 30931688 DOI: 10.1080/10826084.2019.1589522] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: There is a dearth of longitudinal studies on risk factors for anabolic-androgenic steroid (AAS) use and intent. Objectives: We conducted a longitudinal investigation of factors associated with AAS use intent from age 18 to 19, examining particularly the role of physical and verbal aggression. A sample of Norwegians completed questionnaires containing demographic, AAS use and intent, other addictions, aggression, and health measures at ages 18 (N = 1333, females = 58.9%) and 19 (N = 1277, females = 61.7%). The data were analyzed using descriptive statistics, correlations, and hierarchical multiple regression. Results: Results show that AAS use prevalence increased from 1 person at age 18 to 4 persons at age 19. Intent to use AAS, being male, living alone, and AAS use (all at 18 years) were associated with higher AAS use intent at 19 years. We found no associations between physical or verbal aggression and AAS use intent from ages 18 to 19. Conclusions: Our findings indicate temporal stability in AAS use intent, as well as the influence of demographic and health factors on AAS use intent from ages 18 to 19. Implications of findings for practice and future research are discussed.
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Affiliation(s)
- Razieh Chegeni
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway
| | - Dominic Sagoe
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway
| | - Rune A Mentzoni
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway
| | - Ståle Pallesen
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway
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Sessa F, Salerno M, Di Mizio G, Bertozzi G, Messina G, Tomaiuolo B, Pisanelli D, Maglietta F, Ricci P, Pomara C. Anabolic Androgenic Steroids: Searching New Molecular Biomarkers. Front Pharmacol 2018; 9:1321. [PMID: 30524281 PMCID: PMC6256094 DOI: 10.3389/fphar.2018.01321] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 10/29/2018] [Indexed: 12/14/2022] Open
Abstract
Even if anabolic androgenic steroid (AAS) abuse is clearly associated with a wide spectrum of collateral effects, adolescents and athletes frequently use a large group of synthetic derivatives of testosterone, both for aesthetic uses and for improving performance. Over the last few years, the development of MicroRNA (miRNA) technologies has become an essential part of research projects and their role as potential molecular biomarkers is being investigated by the scientific community. The circulating miRNAs detection as a diagnostic or prognostic tool for the diagnosis and treatment of several diseases is very useful, because with a minimal quantity of sample (peripheral blood), miRNAs are very sensitive. Even more, miRNAs remain stable both at room temperature and during freeze-thaw cycles. These characteristics highlight the important role of miRNAs in the near future as new tools for anti-doping. The article provides a systematic review and meta-analysis on the role of miRNAs as new potential molecular biomarkers of AAS use/abuse. Particularly, this paper analyzed the “miRNA signature” use as biomarkers for health disorders, focusing on the organ damages which are related to ASS use/abuse. Moreover, this review aims to provide a future prospect for less invasive or non-invasive procedures for the detection of circulating miRNA biomarkers as doping assumption signaling.
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Affiliation(s)
- Francesco Sessa
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Monica Salerno
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giulio Di Mizio
- Department of Legal, Historical, Economic and Social Sciences, University of Catanzaro, Catanzaro, Italy
| | - Giuseppe Bertozzi
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Benedetta Tomaiuolo
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Daniela Pisanelli
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesca Maglietta
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Pietrantonio Ricci
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.,Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - Cristoforo Pomara
- Department of Medical, Surgical and Advanced Technologies "G.F. Ingrassia", University of Catania, Catania, Italy
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12
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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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13
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Goldman A, Basaria S. Adverse health effects of androgen use. Mol Cell Endocrinol 2018; 464:46-55. [PMID: 28606866 DOI: 10.1016/j.mce.2017.06.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 06/08/2017] [Indexed: 01/21/2023]
Abstract
Anabolic androgenic steroids (AAS) are performance enhancing drugs commonly used by athletes and bodybuilders to improve appearance and athletic capability. Unfortunately, these testosterone derivatives can be associated with serious and potentially irreversible side effects, and can impact multiple organ systems. It is important that physicians be familiar with these adverse consequences so that they can appropriately counsel patients whom they suspect of AAS-abuse. In this chapter, we will review the negative effects of these compounds on various organ systems in men using AAS.
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Affiliation(s)
- Anna Goldman
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Shehzad Basaria
- Research Program in Men's Health: Aging and Metabolism, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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14
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Piacentino D, Kotzalidis GD, Longo L, Pavan A, Stivali L, Stivali G, Ferracuti S, Brugnoli R, Frati P, Fineschi V, Girardi P, Sani G. Body Image and Eating Disorders are Common among Professional and Amateur Athletes Using Performance and Image Enhancing Drugs: A Cross-Sectional Study. J Psychoactive Drugs 2017; 49:373-384. [PMID: 28777732 DOI: 10.1080/02791072.2017.1359708] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
The use of performance and image enhancing drugs (PIEDs) is not uncommon in athletes and appears to be associated with several psychopathological disorders of unclear prevalence. In this multicenter, cross-sectional study, we aimed to evaluate the prevalence of body image disorders (BIDs) and eating disorders (EDs) in PIED-using athletes vs. PIED nonusers. We enrolled 84 consecutive professional and amateur athletes training in sport centers in Italy, who underwent semi-structured interviews (SCID-I, SCID-II) and completed the Body Image Concern Inventory (BICI) and the Sick, Control, One, Fat, Food Eating Disorder Screening Test (SCOFF). PIEDs were searched for in participants' blood, urine, and hair. Of these, 18 (21.4%) used PIEDs, the most common being anabolic androgenic steroids, amphetamine-like substances, coffee and caffeine derivatives, synthetic cathinones, and ephedrine. PIED users and nonusers did not differ in socio-demographic characteristics, but differed in clinical and psychopathological features, with PIED users being characterized by higher physical activity levels, higher daily coffee and psychotropic medication use (e.g., benzodiazepines), more SCID diagnoses of psychiatric disorders, especially substance use disorder, body dysmorphic disorder (BDD), EDs, and general anxiety disorder, higher BICI scores (indicating higher risk of BDD), and higher SCOFF scores (suggesting higher risks for BIDs and EDs).
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Affiliation(s)
- Daria Piacentino
- a Professor, NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department , Sapienza-University of Rome , Rome , Italy.,b Resident, Department of Psychiatry , San Maurizio Hospital, Sanitary Agency of South Tyrol , Bolzano-Bozen , Italy
| | - Georgios D Kotzalidis
- a Professor, NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department , Sapienza-University of Rome , Rome , Italy
| | - Livia Longo
- a Professor, NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department , Sapienza-University of Rome , Rome , Italy
| | - Antonio Pavan
- c Professor, Department of Clinical and Molecular Medicine, Immunohematology and Transfusion Medicine Service , Sant'Andrea Hospital, Sapienza-University of Rome , Rome , Italy
| | | | - Guido Stivali
- e Colonel, Aerospace Medicine Institute of the Italian Armed Forces , Milan , Italy
| | - Stefano Ferracuti
- a Professor, NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department , Sapienza-University of Rome , Rome , Italy
| | - Roberto Brugnoli
- a Professor, NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department , Sapienza-University of Rome , Rome , Italy
| | - Paola Frati
- f Professor, Department of Anatomical, Histological, Forensic and Orthopedic Sciences , Sapienza-University of Rome , Rome , Italy
| | - Vittorio Fineschi
- f Professor, Department of Anatomical, Histological, Forensic and Orthopedic Sciences , Sapienza-University of Rome , Rome , Italy
| | - Paolo Girardi
- a Professor, NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department , Sapienza-University of Rome , Rome , Italy
| | - Gabriele Sani
- a Professor, NESMOS (Neuroscience, Mental Health, and Sensory Organs) Department , Sapienza-University of Rome , Rome , Italy
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15
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Asken BM, Sullan MJ, Snyder AR, Houck ZM, Bryant VE, Hizel LP, McLaren ME, Dede DE, Jaffee MS, DeKosky ST, Bauer RM. Factors Influencing Clinical Correlates of Chronic Traumatic Encephalopathy (CTE): a Review. Neuropsychol Rev 2016; 26:340-363. [PMID: 27561662 PMCID: PMC5507554 DOI: 10.1007/s11065-016-9327-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 08/08/2016] [Indexed: 12/14/2022]
Abstract
Chronic traumatic encephalopathy (CTE) is a neuropathologically defined disease reportedly linked to a history of repetitive brain trauma. As such, retired collision sport athletes are likely at heightened risk for developing CTE. Researchers have described distinct pathological features of CTE as well a wide range of clinical symptom presentations, recently termed traumatic encephalopathy syndrome (TES). These clinical symptoms are highly variable, non-specific to individuals described as having CTE pathology in case reports, and are often associated with many other factors. This review describes the cognitive, emotional, and behavioral changes associated with 1) developmental and demographic factors, 2) neurodevelopmental disorders, 3) normal aging, 4) adjusting to retirement, 5) drug and alcohol abuse, 6) surgeries and anesthesia, and 7) sleep difficulties, as well as the relationship between these factors and risk for developing dementia-related neurodegenerative disease. We discuss why some professional athletes may be particularly susceptible to many of these effects and the importance of choosing appropriate controls groups when designing research protocols. We conclude that these factors should be considered as modifiers predominantly of the clinical outcomes associated with repetitive brain trauma within a broader biopsychosocial framework when interpreting and attributing symptom development, though also note potential effects on neuropathological outcomes. Importantly, this could have significant treatment implications for improving quality of life.
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Affiliation(s)
- Breton M Asken
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
| | - Molly J Sullan
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Aliyah R Snyder
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Zachary M Houck
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Vaughn E Bryant
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Loren P Hizel
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Molly E McLaren
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Duane E Dede
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Michael S Jaffee
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Steven T DeKosky
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Russell M Bauer
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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16
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Sagoe D, Mentzoni RA, Hanss D, Pallesen S. Aggression Is Associated With Increased Anabolic-Androgenic Steroid Use Contemplation Among Adolescents. Subst Use Misuse 2016; 51:1462-9. [PMID: 27356242 DOI: 10.1080/10826084.2016.1186696] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We investigated the relationship between aggression and anabolic-androgenic steroid (AAS) use intent among adolescents. A nationally representative sample of Norwegian 18-year-olds (N = 1,334, females = 58.7%) took part in a survey in 2013 (response rate = 64.9%). Participants completed the physical and verbal subscales of the Short-Form Buss-Perry Aggression Questionnaire, the Intent to use AAS Scale, the Alcohol Use Disorders Identification Test-Consumption, and the Hospital Anxiety and Depression Scale. They also provided demographic information and answered questions about AAS use, gambling participation, as well as cigarette and snus use. Descriptive statistics and multinomial logistic regression were used to analyze the data. Lifetime and past year prevalence of AAS use was 0.1%. Between 0.4% and 1.7% of participants disclosed intent to use while between 1.1% and 2.5% expressed neutral intent to initiate AAS use. Compared to persons low on aggression, individuals high on aggression were more likely to report intent and curiosity towards initiating AAS use. Our findings indicate that aggression is a risk factor for AAS use contemplation among adolescents.
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Affiliation(s)
- Dominic Sagoe
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway
| | - Rune A Mentzoni
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway.,b KoRus-Øst, Innlandet Hospital Trust , Ottestad , Norway
| | - Daniel Hanss
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway.,c Department of Social and Cultural Sciences and Social Work , Darmstadt University of Applied Sciences , Darmstadt , Germany
| | - Ståle Pallesen
- a Department of Psychosocial Science , University of Bergen , Bergen , Norway
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17
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Grönbladh A, Nylander E, Hallberg M. The neurobiology and addiction potential of anabolic androgenic steroids and the effects of growth hormone. Brain Res Bull 2016; 126:127-137. [DOI: 10.1016/j.brainresbull.2016.05.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/03/2016] [Accepted: 05/04/2016] [Indexed: 12/30/2022]
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18
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El Osta R, Almont T, Diligent C, Hubert N, Eschwège P, Hubert J. Anabolic steroids abuse and male infertility. Basic Clin Androl 2016; 26:2. [PMID: 26855782 PMCID: PMC4744441 DOI: 10.1186/s12610-016-0029-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 01/25/2016] [Indexed: 12/27/2022] Open
Abstract
For several decades, testosterone and its synthetic derivatives have been used with anabolic and androgenic purposes. These substances were first restricted to professional bodybuilders, but become more and more popular among recreational athletes. Up to date, 3,000,000 anabolic-androgenic steroids (AAS) users have been reported in the United States with an increasing prevalence, making AAS consumption a major public health growing concern. Infertility is defined by the WHO as the failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse and a male factor is present in up to 50 % of all infertile couples. Several conditions may be related to male infertility. Substance abuse, including AAS, is commonly associated to transient or persistent impairment on male reproductive function, through different pathways. Herein, a brief overview on AAS is offered. Steroids biochemistry, patterns of use, physiological and clinical issues are enlightened. A further review about fertility outcomes among male AAS abusers is also presented, including the classic reports on transient anabolic steroid-induced hypogonadism (ASIH), and the more recent experimental reports on structural and genetic sperm damage.
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Affiliation(s)
- Rabih El Osta
- Urology Department of Brabois University Hospital, CHU de Nancy, Allée du Morvan, 54511 Vandœuvre les Nancy, France
| | - Thierry Almont
- EA3694 Human Fertility Research Group, CHU Paule de Viguier, TSA 70034, 31059 Toulouse cedex 9, France
| | - Catherine Diligent
- Laboratory of reproductive biology, CHU de Nancy, 10 rue du Dr Heydenreich, 54042 Nancy, France
| | - Nicolas Hubert
- Urology Department of Brabois University Hospital, CHU de Nancy, Allée du Morvan, 54511 Vandœuvre les Nancy, France
| | - Pascal Eschwège
- Urology Department of Brabois University Hospital, CHU de Nancy, Allée du Morvan, 54511 Vandœuvre les Nancy, France
| | - Jacques Hubert
- Urology Department of Brabois University Hospital, CHU de Nancy, Allée du Morvan, 54511 Vandœuvre les Nancy, France
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Kaufman MJ, Janes AC, Hudson JI, Brennan BP, Kanayama G, Kerrigan AR, Jensen JE, Pope HG. Brain and cognition abnormalities in long-term anabolic-androgenic steroid users. Drug Alcohol Depend 2015; 152:47-56. [PMID: 25986964 PMCID: PMC4458166 DOI: 10.1016/j.drugalcdep.2015.04.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/21/2015] [Accepted: 04/22/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Anabolic-androgenic steroid (AAS) use is associated with psychiatric symptoms including increased aggression as well as with cognitive dysfunction. The brain effects of long-term AAS use have not been assessed in humans. METHODS This multimodal magnetic resonance imaging study of the brain compared 10 male weightlifters reporting long-term AAS use with 10 age-matched weightlifters reporting no AAS exposure. Participants were administered visuospatial memory tests and underwent neuroimaging. Brain volumetric analyses were performed; resting-state fMRI functional connectivity (rsFC) was evaluated using a region-of-interest analysis focused on the amygdala; and dorsal anterior cingulate cortex (dACC) metabolites were quantified by proton magnetic resonance spectroscopy (MRS). RESULTS AAS users had larger right amygdala volumes than nonusers (P=0.002) and reduced rsFC between right amygdala and frontal, striatal, limbic, hippocampal, and visual cortical areas. Left amygdala volumes were slightly larger in AAS users (P=0.061) but few group differences were detected in left amygdala rsFC. AAS users also had lower dACC scyllo-inositol levels (P=0.004) and higher glutamine/glutamate ratios (P=0.028), possibly reflecting increased glutamate turnover. On a visuospatial cognitive task, AAS users performed more poorly than nonusers, with the difference approaching significance (P=0.053). CONCLUSIONS Long-term AAS use is associated with right amygdala enlargement and reduced right amygdala rsFC with brain areas involved in cognitive control and spatial memory, which could contribute to the psychiatric effects and cognitive dysfunction associated with AAS use. The MRS abnormalities we detected could reflect enhanced glutamate turnover and increased vulnerability to neurotoxic or neurodegenerative processes, which could contribute to AAS-associated cognitive dysfunction.
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Affiliation(s)
- Marc J. Kaufman
- McLean Imaging Center, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Amy C. Janes
- McLean Imaging Center, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - James I. Hudson
- Biological Psychiatry Laboratory, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Brian P. Brennan
- Biological Psychiatry Laboratory, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Gen Kanayama
- Biological Psychiatry Laboratory, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Andrew R. Kerrigan
- McLean Imaging Center, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - J. Eric Jensen
- McLean Imaging Center, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
| | - Harrison G. Pope
- Biological Psychiatry Laboratory, McLean Hospital, and the Department of Psychiatry, Harvard Medical School, 115 Mill St., Belmont, Massachusetts, 02478, USA
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20
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de Almeida RMM, Cabral JCC, Narvaes R. Behavioural, hormonal and neurobiological mechanisms of aggressive behaviour in human and nonhuman primates. Physiol Behav 2015; 143:121-35. [DOI: 10.1016/j.physbeh.2015.02.053] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Revised: 02/25/2015] [Accepted: 02/28/2015] [Indexed: 12/27/2022]
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21
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Sagoe D, Pallesen S. Anabolic Androgenic Steroid use in the Nordic Countries: A Reply to Bilgrei and Sand⊘y. NORDIC STUDIES ON ALCOHOL AND DRUGS 2015. [DOI: 10.1515/nsad-2015-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Dominic Sagoe
- Department of Psychosocial Science University of Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science University of Bergen, Norway
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