Kurth F, Luders E, Sicotte NL, Gaser C, Giesser BS, Swerdloff RS, Montag MJ, Voskuhl RR, Mackenzie-Graham A. Neuroprotective effects of testosterone treatment in men with multiple sclerosis. Neuroimage Clin. 2014 Mar 6;4:454-60. doi: 10.1016/j.nicl.2014.03.001. eCollection 2014.
Multiple sclerosis (MS) is an inflammatory and neurodegenerative disease of the central nervous system. While current medication reduces relapses and inflammatory activity, it has only a modest effect on long-term disability and gray matter atrophy. Here, we have characterized the potential neuroprotective effects of testosterone on cerebral gray matter in a pilot clinical trial. Ten men with relapsing-remitting MS were included in this open-label phase II trial. Subjects were observed without treatment for 6 months, followed by testosterone treatment for another 12 months. Focal gray matter loss as a marker for neurodegeneration was assessed using voxel-based morphometry. During the non-treatment phase, significant voxel-wise gray matter decreases were widespread (p≤ 0.05 corrected). However, during testosterone treatment, gray matter loss was no longer evident. In fact, a significant gray matter increase in the right frontal cortex was observed (p≤ 0.05 corrected). These observations support the potential of testosterone treatment to stall (and perhaps even reverse) neurodegeneration associated with MS. Furthermore, they warrant the investigation of testosterone's neuroprotective effects in larger, placebo controlled MS trials as well as in other neurodegenerative diseases. This is the first report of gray matter increase as the result of treatment in MS.
Sex hormones can influence many different factors In this study they were measuring shrinkage (blue) and enhancement (red) with testosterone treatment
This is one of those interesting anecdotes, that will need repeating. The brain imaging during the run-in suggested shrinkage and following treatment this shrinkage slowed and some areas increased in size. This could be "regression to mean" were disease related effects tend to attenuate with time after an active run in. However, could this be a repair effect that was found in some earlier animal studies. If there was enlargement of areas how was this achieved..nerve regrowth, nerve repair?
or was it an anti-inflammatory effect facilitating repair as the people on the trial were not taking other DMT.
Therefore, the question is where next? More trials?...Two phase III..or phase II of more RRMSers on DMT.
What's the pathway to prescription?