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Related Experiment Videos

Steroids and brain atrophy in multiple sclerosis.

Robert Zivadinov1

  • 1Department of Neurology, SUNY-University at Buffalo School of Medicine and Biomedical, Sciences, Buffalo, NY, USA. rzivadinov@thejni.org

Journal of the Neurological Sciences
|May 11, 2005
PubMed
Summary

Corticosteroids can cause both temporary and permanent brain volume changes. While high doses may offer short-term benefits in multiple sclerosis (MS) by reducing inflammation, chronic low-dose use might lead to irreversible brain tissue loss.

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Area of Science:

  • Neuroendocrinology
  • Immunology
  • Neurology

Background:

  • Corticosteroids impact brain volume through various mechanisms.
  • Their effects differ based on dose, duration, and underlying condition.
  • Understanding these effects is crucial for managing neurological disorders.

Purpose of the Study:

  • To review the pathogenetic mechanisms of corticosteroid-induced brain volume changes.
  • To explore how these mechanisms affect autoimmune diseases and multiple sclerosis (MS).
  • To differentiate between short-term reversible and long-term irreversible effects.

Main Methods:

  • Review of existing literature on corticosteroid effects on brain volume.
  • Analysis of pathogenetic pathways including immunomodulation, immunosuppression, and anti-inflammatory actions.

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  • Examination of studies in humans and nonhuman primates.

    • Main Results:

    • Chronic low-dose corticosteroids may cause irreversible brain tissue loss via protein catabolism.
    • High-dose corticosteroids can induce reversible short-term brain volume changes (e.g., water loss, reduced vascular permeability).
    • High-dose intravenous methylprednisolone (IVMP) in MS may slow brain atrophy through immunological mechanisms.

    Conclusions:

    • Corticosteroid-induced brain volume fluctuations are complex and dose-dependent.
    • While high-dose IVMP may benefit MS patients by reducing atrophy progression, chronic low-dose use poses risks.
    • Further longitudinal studies are needed to fully elucidate these mechanisms.