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This study evaluated the effects of exogenous glucose and corticosterone (<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>) pretreatment alone or in combination with<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>on blood glucose levels and the neural and vascular toxicity produced.<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>exposure consisted of four sequential injections of 5, 7.5, 10, and 10\u00a0mg\/kg (2\u00a0h between injections) D\u2010<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>. The three groups given<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>in combination with saline, glucose (<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>+Glucose), or<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>(<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>+<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>) had significantly higher glucose levels compared to the corresponding treatment groups without<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>except at 3\u00a0h after the last injection. At this last time point, the<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>and<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>+Glucose groups had lower levels than the non\u2010<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>groups, while the<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>+<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>group did not.<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>alone or glucose alone did not significantly increase blood glucose. Mortality rates for the<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>+<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>(40%) and<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>+Glucose (44%) groups were substantially higher than the<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>(&lt;\u00a010%) group. Additionally,<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>+<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>significantly increased neurodegeneration above the other three METH treatment groups (\u2248\u00a02.5\u2010fold in the parietal cortex). Thus, maintaining elevated levels of glucose during<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>exposure increases lethality and may exacerbate neurodegeneration. Neuroinflammation, specifically microglial activation, was associated with degenerating neurons in the parietal cortex and thalamus after<jats:styled-content style=\"fixed-case\">METH<\/jats:styled-content>exposure. The activated microglia in the parietal cortex were surrounding vasculature in most cases and the extent of microglial activation was exacerbated by<jats:styled-content style=\"fixed-case\">CORT<\/jats:styled-content>pretreatment. Our findings show that acute CORT exposure and elevated blood glucose levels can exacerbate METH\u2010induced vascular damage, neuroinflammation, neurodegeneration and lethality.<\/jats:p><\/jats:sec><jats:sec><jats:label\/><jats:p><jats:boxed-text content-type=\"graphic\" position=\"anchor\"><jats:graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" mimetype=\"image\/png\" position=\"anchor\" specific-use=\"enlarged-web-image\" xlink:href=\"graphic\/jnc14143-fig-0007-m.png\"><jats:alt-text>image<\/jats:alt-text><\/jats:graphic><\/jats:boxed-text><\/jats:p><jats:p><jats:bold>Cover Image<\/jats:bold>for this issue: doi.<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"doi\" xlink:href=\"10.1111\/jnc.13819\">10.1111\/jnc.13819<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jnc.14143","type":"journal-article","created":{"date-parts":[[2017,8,9]],"date-time":"2017-08-09T14:12:37Z","timestamp":1502287957000},"page":"198-213","source":"Crossref","is-referenced-by-count":16,"title":["Corticosterone and exogenous glucose alter blood glucose levels, neurotoxicity, and vascular toxicity produced by methamphetamine"],"prefix":"10.1111","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8003-3819","authenticated-orcid":false,"given":"John F.","family":"Bowyer","sequence":"first","affiliation":[{"name":"Division of Neurotoxicology National Center for Toxicology\/FDA Jefferson Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen M.","family":"Tranter","sequence":"additional","affiliation":[{"name":"Division of Neurotoxicology National Center for Toxicology\/FDA Jefferson Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumit","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Division of Neurotoxicology National Center for Toxicology\/FDA Jefferson Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nysia I.","family":"George","sequence":"additional","affiliation":[{"name":"Division of Bioinformatics and Biostatistics National Center for Toxicological Research\/FDA Jefferson Arkansas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph P.","family":"Hanig","sequence":"additional","affiliation":[{"name":"Center for Drug Evaluation and Research\/FDA Silver Spring Silver Spring Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly A.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Health Effects Laboratory Division Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Morgantown Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay T.","family":"Michalovicz","sequence":"additional","affiliation":[{"name":"Health Effects Laboratory Division Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Morgantown Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane B.","family":"Miller","sequence":"additional","affiliation":[{"name":"Health Effects Laboratory Division Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Morgantown Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8497-4598","authenticated-orcid":false,"given":"James P.","family":"O'Callaghan","sequence":"additional","affiliation":[{"name":"Health Effects Laboratory Division Centers for Disease Control and Prevention National Institute for Occupational Safety and Health Morgantown Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,21]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0019258"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750-1326-6-23"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jps.3030380405"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-1716.1978.tb06078.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn2038"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1385\/CBB:47:1:131"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/tp.2016.6"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/syn.20324"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.4161\/23328940.2014.982049"},{"key":"e_1_2_9_11_1","first-page":"845","volume-title":"Handbook of Neurotoxicology","author":"Bowyer J. 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