Long-term use of performance-enhancing substances can make brains appear older than their years.

IF A SCIENTIST SCANNED YOUR BRAIN, what do you think it would show? If you've ever taken steroids, the answer might not be what you expected.

Anabolic-androgenic steroids, the type of drugs that athletes, weightlifters, and even recreational athletes may take in hopes of building lean muscle mass and improving their athletic performance, have been linked to a host of health risks, including decreased testosterone production, psychiatric problems, and cardiovascular issues. But there's more.

Now, a study published this week in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging reveals powerful evidence that long-term use of these drugs can accelerate brain aging to the extent that your brain appears demonstrably older than your biological age on brain scans.

HERE IS THE BACKGROUND:

That steroids are harmful to health is not a new idea, but the effects of these drugs on the brain and cognitive abilities are “understudied,” according to the authors of this paper. This study is the largest of its kind to date, but as Astrid Bjørnebekk, senior author of the study and leader of the Anabolic Androgenic Steroids Research Group at Oslo University Hospital, tells Inverse, “There are few studies that have looked at the use of AAS [anabolic androgenic steroids] in relation to brain aging, so there is a lot to learn.”

High doses of certain common anabolic steroids appear to have toxic effects on brain cells in animals and even cause cell death. And some of the best-studied health impacts of steroid use, such as cardiovascular problems, hypogonadism, and insulin sensitivity, are linked to cognitive decline later in life.

Studies that have directly analyzed the brains of anabolic steroid users suggest that these drugs may be linked to psychiatric and cognitive problems, reduced connectivity in some parts of the brain, and changes in brain volume and density in certain regions.

Cognitive testing of long-term steroid users has also revealed problems with pattern recognition, difficulty establishing relationships between objects, cognitive processing speed, memory, executive function and problem-solving skills. “All of these findings point in the same direction and suggest long-term consequences on brain health,” says Bjørnebekk, along with the results of the new study.

WHAT THEY FOUND:

Among the anabolic-androgenic steroid users included in this study, those who had used steroids for more than 10 years and met the criteria for being "dependent" on these substances, their MRI brain scans revealed a worrying trend: Their brains appeared older than their true biological age.

To reach this conclusion, the researchers first trained machine learning algorithms to guess the “brain age” of participants using a dataset comprised of the brain scans of nearly 2,000 healthy men of varying ages. They then ran the brain scans of each of the 130 male weightlifters who used anabolic steroids long-term and the 99 male weightlifters who had not used steroids through the computer model to predict their brain age.

The difference between the predicted age based on the brain scan and the individual's actual age was considered the "brain age gap."

The "brain age gap" was greater for long-term dependent steroid users than for nonusers. And the longer the weightlifters had used steroids, the greater the gap—in other words, the aging process seemed to accelerate with prolonged steroid use.

The researchers controlled for confounding factors such as cognitive ability and depression. They found that while steroid users were more likely to be prescribed psychiatric medications such as antidepressants, this did not affect the findings of accelerated brain aging.

WHY IT'S IMPORTANT:

As the brain ages, some areas change in thickness, volume and surface area; an older-looking brain is associated with cognitive decline, mortality and a host of other problems.

Unfortunately, the study doesn't identify whether one steroid is worse than another, and as Bjørnebekk says, "we don't know the exact practical effects yet," but he hopes to study them next. Weightlifters and other athletes may use a combination or a variety of anabolic-androgenic steroids, making it difficult to pinpoint the culprit for cognitive risks. Not to mention, it's difficult to recruit study participants who are involved in drug use that could put their professional and personal lives at risk.

In general, drug use and addiction are also associated with older-looking brains. Moreover, in one study, brains appear “younger” than biological age among people who are more educated and exercise regularly. Particularly in this study, the brains of steroid users who quit did not differ much from healthy participants in the control group, suggesting that recovery is possible.

In addition to serving as a warning to those considering taking anabolic steroids, the findings of this study reinforce the case that long-term use of anabolic steroids actually leads to measurable cognitive changes. Health care providers can use these findings to prevent and treat steroid use.

Fountain: https://www.inverse.com/