Pilot study finds testosterone has neuroprotective effect in men with RRMS

Testosterone treatment is well tolerated and has potential neuroprotective effects in men with relapsing-remitting MS, findings from a small pilot study suggest. Writing in the May edition of the Archives of Neurology, Dr Sicotte and colleagues (Department of Neurology, David Geffen school of Medicine, LA) observe that men are less susceptible to many autoimmune diseases, including MS. They suggest that possible causes for this include sex hormones and/or sex chromosome effects, noting that testosterone has a protective effect in many animal models of autoimmune disease, including the most widely used animal model of MS, experimental autoimmune encephalomyelitis. They go on to explain that testosterone treatment has been shown to be immunomodulatory in vivo and in vitro consistent with observations that testosterone treatment is protective not only for experimental autoimmune encephalomyelitis, but also for other autoimmune diseases, such as lupus, arthritis, and diabetes mellitus, which do not have the central nervous system as the target organ.Therefore, the researchers studied ten men with relapsing-remitting MS using a crossover design whereby each patient served as his own control. There was a six-month pretreatment period followed by a 12-month period of daily treatment with 10 g of the gel containing 100 mg of testosterone.Main outcome measures were clinical measures of disability and cognition (the Multiple Sclerosis Functional Composite and the 7/24 Spatial Recall Test) and monthly magnetic resonance imaging measures of enhancing lesion activity and whole brain volumes. At one year, results showed that treatment with testosterone gel was associated with improvement in cognitive performance (P = 0.008) and a slowing of brain atrophy (P "As is the case with any initial pilot clinical trial, conclusions from our study must be made with caution primarily because of the small sample size," the researchers caution. However, they conclude that their findings suggest a possible neuroprotective effect of testosterone treatment in men, which "warrants further investigation". Reference...