Long-term anabolic androgenic steroid use is associated with deviant brain aging

Long-term anabolic androgenic steroid use is associated with deviant brain aging / Astrid Bjørnebekk, Tobias Kaufmann, Lisa E. Hauger, Sandra Klonteig, Ingunn R. Hullstein, Lars T. Westlye. - (Biological Psychiatry: Cognitive Neuroscience and Neuroimaging (2021), 13 January; p. 1-11)

  • DOI: 10.1016/j.bpsc.2021.01.001



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.


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.


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.


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.

Original document


Research / Study
13 January 2021
Bjørnebekk, Astrid
Hauger, Lisa E.
Hullstein, Ingunn R.
Kaufmann, Tobias
Klonteig, Sandra
Westlye, Lars T.
Other organisations
Eberhard Karls Universität Tübingen - University of Tübingen
Oslo universitetssykehus HF - Oslo University Hospital
Universitetet i Oslo - University of Oslo
Oslo, Norway: Norwegian Doping Control Laboratory
Doping classes
S1. Anabolic Agents
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Health effects
Long term effects
Mental disorders
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Scientific article
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Date generated
31 March 2021
Date of last modification
2 December 2021
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