Testosterone Halts Gray Matter Atrophy in MS

SAN DIEGO — Testosterone treatment was associated with reversal of gray matter atrophy in a population of men with multiple sclerosis (MS), researchers reported here.

In a small pilot study of male multiple sclerosis patients, treatment with 100 mg of testosterone was associated with diminished atrophy of gray matter over a 6-month window and reversal to pre-study levels with significant increase in the right middle frontal gyrus after 12 months of therapy, according to Florian Kurth, MD, of the University of California Los Angeles, and colleagues.

However, there was no association with lesion volume or newly occurring lesions with testosterone treatment, Kurth said during an oral presentation at the Society for Neuroscience meeting.

Kurth also acknowledged the risks of myocardial infarction associated with testosterone therapy, but noted that treatment should be delivered on a patient-by-patient basis that should not overshadow the need for further randomized, controlled trials with larger populations to study this association, adding that the differences from therapy were “not merely cosmetic.”

Kurth and his colleagues conducted a pilot clinical trial to study the effect of testosterone on cerebral gray matter in 10 men with relapsing-remitting MS, having noted that gray matter atrophy “correlates better with disability than [white matter] lesions do” in multiple sclerosis.

They also noted that past research has shown that testosterone has neuroprotective properties in men.

Current MS treatments predominantly affect relapse and white matter lesions.

Participants were 29 to 61 and had not received disease-modifying treatment. Over the 18 months of the study, they underwent voxel-based morphometry in MRI scans at baseline, month 6, month 12, and month 18 to measure changes in gray matter volume.

During the initial 6 months, there was an observation phase during which participants received no treatment. Over the next 6 months, they underwent a “wash-in” period where they were observed for efficacy of treatment. The final 6 months was the “treatment phase” during which it was expected that the full effects of testosterone treatment would be visible on brain scans.

Over the observation period, there was a significant widespread decrease in gray matter. This loss was strongly tempered during the wash-in period, and gray matter volume had returned to baseline levels after 12 months of treatment.

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