Testosterone plays a crucial role in neuronal function, but elevated concentrations can have deleterious effects. Here we show that supraphysiological levels of testosterone (micromolar range) initiate the apoptotic cascade. We used three criteria, annexin V labeling, caspase activity, and DNA fragmentation, to determine that apoptotic pathways were activated by testosterone. Micromolar, but not nanomolar, testosterone concentrations increased the response in all three assays of apoptosis. signals lead to apoptotic cell death. These effects of testosterone on neurons will have long term effects on brain function.Neurosteroids have been implicated as components essential for the normal function of the central nervous system (1-4). The gonadal steroid hormones are required for reproductive function, but androgens also affect areas of the brain that are not primarily involved in reproduction such as the hippocampus (5), preoptic area, amygdala, and medial hypothalamic area (6). At physiological levels, androgens are involved in neuronal differentiation, neuroprotection, neuronal survival and development (7-9). These responses occur slowly (over hours) and are mediated through the intracellular androgen receptor. In the developing brain, androgens are capable of changing the ultrastructural characteristics of the neuronal plasma membrane with a relatively fast pace (10, 11). Recently, we have shown that nanomolar levels of testosterone induce rapid intracellular Ca 2ϩ increases in neuroblastoma cells (within seconds), which begin as Ca 2ϩ transients in the cytosol, propagate as waves of Ca 2ϩ in the cytoplasm and nucleus, and develop into an oscillatory pattern (12). These Ca 2ϩ signals depend on an interplay between Ca 2ϩ efflux from the endoplasmic reticulum through inositol 1,4,5-trisphosphate-sensitive Ca 2ϩ release channels (InsP 3 Rs) 4 and Ca 2ϩ reuptake into the endoplasmic reticulum by Ca 2ϩ pumps. This new testosterone-induced pathway in neuronal cells leads to neurite outgrowth (12), an essential event in neuronal differentiation (13). These results suggest an important physiological mechanism for the action of testosterone in neurons at physiological concentrations. However, it is unknown how these cells respond to high plasma levels of this neurosteroid, generally administered exogenously to achieve an increase in muscle mass (14, 15) or for replacement therapy (16). In vivo administration of large doses of androgens has been correlated with neurobehavioral changes like hyperexcitability, supra-aggressive nature, and suicidal tendencies (17, 18). These behavioral changes could be the outward manifestation of neuronal damage resulting from exposure to high concentrations of testosterone.In this investigation, we evaluated the hypothesis that high concentrations of testosterone can induce deleterious effects in neurons. We show that high levels of testosterone initiate an apoptotic program in neuroblastoma cells. Apoptosis is the normal and controlled process of cell death (19). Precise control of apoptos...