UK Study Shows Link between Glucocorticoids Use and Changes in Brain Volume and White Matter

According to the results of the biggest research finding of its kind, which was posted in the open-access journal BMJ Open, the usage of prescribed steroids, particularly those used in inhalers, is connected to a change in the volume and structure of white and gray matter situated in the brain. Asthma, allergies, rheumatoid arthritis, and dermatological conditions are just a few of the conditions that have been treated with external corticosteroids since the 1950s.

Effects on systemic and inhaled steroid users may be severe

Data was retrieved from the UK Biobank, which included information on 500,000 people aged 40 to 69 from the general population, to determine if there were any discernible differences in brain volume and structure between systemic and inhaled steroid users and non-users. Additionally, the researchers were interested in determining whether variations in processing speed and emotional responses would be linked to steroid usage. The MRI brain scans of 24,106 non-users were compared to those of 222 users of systemic steroids and 557 users of inhaled steroids.

None of the study subjects had ever received a diagnosis of a neurological, psychiatric, or hormonal (endocrinological) illness, and none of them had ever taken medication that could have altered their mood, including antidepressants.

Participants answered a questionnaire to rate their mood during the preceding two weeks in various ways.

Systemic and inhaled steroid use were both related to less intact white matter structure than was shown in those not taking these medicines, according to a comparison of the MRI scan data. In the brain, white matter plays a part in neuronal connection and signaling.

In comparison to users of inhaled steroids, systemic users saw more potent effects. Additionally, more thorough research revealed that long-term users may have impacts that are even more pronounced.

Though evidence shows the relationship between the use of steroids and brain damage, the analyst also advised against concluding with this evidence as the findings were based on a cross-sectional design basis.

Clinical significance

Despite being quite effective and powerful, steroids are linked to several neuropsychiatric outcomes like delirium, mania, psychosis, and other systemic adverse effects that could be rather risky and unsafe. Extended medicinal steroid usage is connected to structural irregularities and atrophy of specific brain regions.

Conclusion

Both as outpatient and as inpatient treatment, corticosteroids are used to treat a range of common ailments. Therefore, all doctors are concerned about the side effects of these medications. The researchers now call for other treatment alternatives to be explored, stating that given how frequently these medications are used, doctors and patients need to be aware of any potential consequences on the brain.