Glucocorticoids decrease brain volume and negatively impact cognition: BMJ

The use of both systemic and inhaled glucocorticoids is related with diminished white matter integrity and modest alterations in grey matter volume (GMV), says an article published in British Medical Journal.

Glucocorticoids are among the most often prescribed medications on the market due to their immunosuppressive effects, with an estimated yearly incidence of systemic glucocorticoid usage ranging between 0.5% and 3%. Glucocorticoids, both systemic and local (particularly inhaled), are linked with a variety of potentially significant metabolic, cardiovascular, and musculoskeletal adverse effects. Merel van der Meulen and colleagues carried out this study to check if glucocorticoid use would be associated with reduced grey matter volumes in the limbic system and hippocampus, a widespread decrease in fractional anisotropy (FA) and increase in mean diffusivity (MD) throughout the brain, and worse cognitive and emotional outcomes.

This was a cross-sectional, prospective population-based cohort study of persons recruited between 2006 and 2010 in the United Kingdom. Following removal for neurological, psychiatric, or endocrinological history, as well as the use of psychotropic medication, 222 systemic glucocorticoid users, 557 inhaled glucocorticoid users, and 24,106 controls with available T1 and diffusion MRI data were included. Differences in 22 volumetric and 14 diffusion MRI parameters between glucocorticoid users and controls were identified using linear regression models adjusted for possible variables. Cognitive performance (six tests) and emotional symptoms were secondary outcomes (four questions).