The use of anabolic-androgenic steroids (AAS) is nothing new. The use of AAS by athletes has been part of many sports especially in bodybuilding and weight lifting . Various studies have examined the full extent of the long term use of anabolic-androgenic steroids in athletes (Roger, 2019). Studies have examined what the long term use does to the bodies of athletes and users over extended periods of use (Mayo Clinic Staff, n.d.) . The use of AAS in sports amongst athletes has courted controversy after studies showed that the use of steroids c ould give athletes an unfair competitive advantage over other competitors ( Chowdhury , 20 16 ). The history of use, the studies conducted and evidence of the long term effects of prolonged use of AAS will be explored with the aim of aggregat ing and summariz ing the information that is available in the public domain .
History of Use
Anabolic steroids were first introduced to the public in the late 19 th century by Charles Brown-Sequard after he bega n publiciz ing the benefits he was experiencing after using an early form of steroids ( Matfin, 2010 ) . Anabolic-androgenic steroids are synthetic compounds that were first produced in large scale in the 1930s. They mimic testosterone and often have the same effect on the human body. They have been shown to promote lean muscle growth as well as increase the rate of growth in muscles ( Matfin, 2010 ). There has been extensive use of AAS by various groups of athletes in several sports such as Baseball, American football, Rugby, Mixed Martial Arts and other intense sports. The use of steroids was not a well-researched matter until the middle 20 th century. Many of the users then seemed to be motivated by perceived benefits. Nations such as East Germany institutionalized doping with a state-sponsored program to enhance the performance athletes that was discovered later on. As the years wore on, the athletes who had used steroids began to exhibit the effects of the long term use. In the 80s and the 90s, some of the effects became more evident as these athletes advanced in age and their bodies show ed the results of extended use of steroids especially in terms of brain function ( Hoffman & Ratamess , 2006 ).
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How AAS W ork in the B rain
Anabolic androgenic steroids act as androgen receptors and usually have an effect on cellular function and even gene expression. In numerous animal studies, results have shown that anabolic steroids increase serotonin in the part of the brain that regulates mood and an increase in dopamine in the reward center of the brain ( National Institute of Drug Abuse, 2018 ). In some tests, chronic use of anabolic steroids was shown to cause dysfunction to the reward pathways in the brains of animal test subjects. In one test, rats were given a dosage of nandrolone, twice daily for a number of weeks. It was observed that after four weeks, the subjects showed a loss of preference for sweet rewards. The conclusion from the experiment was that loss of a preference for sweet rewards was a clear indicator of a reward system dysfunction that had come about from the nandrolone injections ( Mhillaj et al . , 201 5 ).
The E ffects of AAS on the B rain
Testosterone has been proven to affect the centers in the brain that affect mood regulation, aggression, and sexuality ( Seppälä , n.d ). The h ypothalamus is the part of the brain that mainly deal s with those functions. Testosterone has been found to affect the brain’s central nervous system. Excessive use of AAS has adverse effects on the mood , and in many instances, higher levels of aggression have been displayed by athletes especially after extended use over long periods ( Sanjuan et al., 2016) . Steroid use has also been shown to affect the dopamine and serotonin transmitters. Dopamine has several function s as a hormone which include the regulation of learning, mobility, appetite, positive reinforcing effects and emotions (Psychology Today, n.d.) . Dopamine is also crucial in informing how the brain rewards system functions. Excessive use of steroids interferes with the neurotransmitter pathways with adverse effects on the balance of certain hormones in the brain.
In a study by the Finnish anti-doping agency, it was shown that large scale use of anabolic-androgenic steroids has an adverse effect on organ function in the body and that it fuels the development of certain illnesses that affect the brain and the body ( Kailanto , n.d) . The study showed that the long term effects continued even after the use of AAS was discontinue d . One of the adverse effects identified was the fact that large doses of AAS induced cell death across the different cell types including neuronal cells in the brain and body ( Zelleroth et al., 2019) . This may result in irreversible negative changes to the neural network of the body.
How M emory W orks
The human brain is not only complex but also contains over 100 billion neurons (Lewis, 2018) . These nerve cells also contain over 100 trillion synaptic connections that enable sensory information to be ‘stored’ and higher order functions like thinking, planning and the processing of information to take place ( Mastin , 201 8a ). There is a connection between each neuron and thousands of other neurons. This is facilitated by synaptic connections that number in the trillions. This makes the human brain a compact but very complex organ. These synaptic connections enable t he brain to interpret events and the sensory stimulation that occurred in those events to be retained in different parts of the brain. Different parts of the brain are used to store memories. Memories can also be broken down into three types namely explicit, implicit and working memories (Mastin , 201 8b) .
Explicit memory
Explicit memories are about the events that happen to an individual ( Roediger III et al., 2008) . They are the life events of an individual’s life. Explicit events are stored in 3 main parts of the human brain. They are stored in the Hippocampus, Amygdala and the Neocortex. In the Hippocampus , which is located in the temporal lobe of the brain, memories of episodes and events are formed and indexed to enable them to be accessed later (Mandal, 2019) . The Amygdala is responsible for attaching emotions to a particular memory or event in an individual's life (Williams, n.d.) . Memories formed in the Amygdala usually last a long time which suggests an interaction through synaptic connections of the Amygdala, the Neocortex and the Hippocampus. Be ing the largest part of the cerebral cortex, the Neocortex is involved in functions of the brain that are more complex (Science Daily, n.d.) . Language, spatial reasoning and sensory perception are some of the functions of the neocortex. Scientists have suggested that there is a nocturnal interaction between the hippocampus and neocortex that occurs while humans sleep . This interaction enables the transfer of short-term memories from the hippocampus to the neocortex.
Implicit memory
Implicit memory facilitates motor functions and what is sometimes referred to as muscle memory ( Dharani, 2014 ) . Two main part s of the brain are involved in implicit memory. One of these parts is the Basal Ganglia (Neuroscientifically Challenged, n.d.). The basal ganglia are a series of parts of the brain that are involved in a wide range of complex processes. They assist in the processing of emotions, movement, learning, the forming of habits as well as processing of rewards. The other part is the Cerebellum (Healthline, n.d.). The cerebellum is located in the lower part of the brain and is responsible for the abilities of fine motor functions such as being able to manipulate cutlery at a dinner table or being able to play certain musical instruments that require coordinated input.
Working M emory
The working memory involves cognitive brain functions (McLeod, 2012). It rel ies mainly on the prefrontal cortex (PFC) . The PFC is important because it enables short term memories to e stored as an individual undertakes certain tasks that require both cognitive and motor input (The Science of Psychotherapy, 2017) .
How AAS A ffects M emory
Long term use of AAS can have egative effects on memory. Diseases such as Steroid Dementia Syndrome can negatively affect the parts of the brain that have high levels of glucocorticoid receptors ( Wolkowitz et al . , 200 4 ). These regions include the hypothalamus, the hippocampus and the prefrontal cortex which are particularly sensitive to elevated levels of glucocorticoids , which a type of steroid. Some studies have shown that the reward pathways over time can be adversely affected by the high use of steroids. Motor functions and short term memory loss are some of the other symptoms that have been seen in some long term steroids users. Numerous studies have been conducted to show a strong correlation between long - term steroid use and gradual degeneration of memory function in test subjects.
Scientific data point s to the reality that the use of steroids over extended periods expose s the brain to adverse effects in memory, cognitive and motor functions. The benefits of s teroids such as quick muscle growth and elevated levels of performance carry a significant risk with the user. In athletes, the use of steroids has always courted controversy especially given the fact that many athletic disciplines have banned the use of steroids. However, m ore data is needed to understand the effects of steroids on the brain fully. There are also certain inconsistencies especially due to the physiological reactions in some subjects due to such factors as genetic differences in individuals that lead to discrepancies in a number of studies. Therefore, to understand the comprehensive impacts of steroid s on the human brain, more research is needed. However, there is a consensus that high levels of steroid use over time have a number of negative effects on brain function and memory.
References
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