April 5, 2006

Men with MS may benefit from testosterone

By Karla Gale

SAN DIEGO - Daily testosterone treatment of men with relapsing remitting multiple sclerosis (MS) -- the most common form of the disease in which symptoms wax and wane -- appears to be neuroprotective while improving their brain function. That's according to research presented this week at the American Academy of Neurology 58th Annual Meeting here.

"Men are less likely to get MS, and they tend to be older when they do," presenter Dr. Nancy Sicotte told Reuters Health. "So our group theorized that as testosterone levels start to decrease after age 30, men become more prone to developing the disease."

She noted that in an animal model of MS, animals that received testosterone did not get as sick. Based on those preclinical results, she and her associates at the David Geffen School of Medicine at UCLA began treating 10 men for 12 months with 100 mg testosterone gel applied topically, after a 6-month observation period.

"We did not see a lot of inflammatory activity to begin with," she noted, as manifested by the absence of lesions on MRI. No new lesions formed during the 12-month treatment period.

"Instead, we saw a 'triple whammy' of improved cognition, slowing of brain atrophy, and increases in the production of brain-derived neurotrophic factor (BDNF)," an important growth factor, the researcher said.

Specifically, BDNF more than doubled, while the rate of brain atrophy slowed by 67 percent during the last 9 months of treatment. Performance on a test of processing speed and working memory function improved about 4 percent.

Would it be possible to combine testosterone with other treatments?

"That's definitely a possibility," Sicotte said. "All the new drugs in use now mainly focus on decreasing new lesions and relapses. We think we need to hit the disease with both anti-inflammatory and neuroprotective approaches simultaneously." Such a strategy "would also be nice, especial in people with more established disease, to keep lesioned areas of the brain from degenerating further."