Incidental use of ecstasy: no evidence for harmful effects on cognitive brain function in a prospective fMRI study

Abstract

Rationale Heavy ecstasy use in humans has been associated with cognitive impairments and changes in cognitive brain function supposedly due to damage to the serotonin system. There is concern that even a single dose of 3,4-methylenedioxymethamphetamine may be neurotoxic, but very little is known about the consequences of a low dose of ecstasy for cognitive brain function. Objectives The objective of the study was to assess the effects of a low dose of ecstasy on human cognitive brain function using functional magnetic resonance imaging (fMRI). Materials and method We prospectively studied, as part of the NeXT (Netherlands XTC toxicity) study, sustained effects of a low dose of ecstasy on brain function in 25 subjects before and after their first episode of ecstasy use (mean 2.0±1.4 ecstasy pills, on average 11.1±12.9 weeks since last ecstasy use), compared to 24 persistent ecstasy-naive controls, also measured twice and matched with the novice users on age, gender, IQ, and cannabis use. Cognitive brain function was measured in the domains of working memory, selective attention, and associative memory using fMRI.Results No significant effects were found of a low dose of ecstasy on working memory, selective attention, or associative memory neither at the behavioral level nor at the neurophysiological level. Conclusions This study yielded no firm evidence for sustained effects of a low dose of ecstasy on human cognitive brain function. The present findings are relevant for the development of prevention and harm reduction strategies. Furthermore, the study is relevant to the discussion concerning potential therapeutic use of ecstasy.

Prior MDMA (Ecstasy) use is associated with increased basal ganglia–thalamocortical circuit activation during motor task performance in humans: An fMRI study

“…To our knowledge, prior studies have not used functional neuroimaging to probe task-evoked motor function in human MDMA users. Studies using fMRI to investigate other cognitive processes have found either no (Jager et al, 2007b) or mixed task-dependent effects for prospective use (Jager et al, 2008a). Cross-sectional fMRI studies have found task and region dependent effects.…”

“…MDMA use is associated with a broad range of neuropsychiatric sequelae, but there has not been consensus regarding MDMA effects on brain neurophysiology, with functional neuroimaging studies reporting increased, decreased, or mixed activation differences in MDMA user groups versus comparison groups (Cowan et al, 2006, 2007a,b; Cowan, 2007; Daumann et al, 2003a,b, 2004a; Jacobsen et al, 2004; Jager et al, 2007a,b, 2008b; Moeller et al, 2004, 2007; Valdes et al, 2006). Examining the specific neurophysiological consequences of MDMA use is complicated by several factors, including the possibility that brain differences that may be associated with a tendency for MDMA or polydrug use pre-date MDMA use and the fact that contemporary MDMA users are largely polydrug users.…”

Molecular and Cellular Mechanisms of Ecstasy-Induced Neurotoxicity: An Overview

“…Some studies point out that a low dose of MDMA (one to two tablets containing the usual amount of MDMA) has neither effects on human cognitive brain function in the domains of working memory, selective attention, and associative memory nor indications for structural neuronal damage [375,376]. Some authors suggest that "ecstasy" is a risk factor for earlier onset and/or more severe decline of age-related memory deficits in later years.…”

Is moderate substance use associated with altered executive functioning in a population‐based sample of young adults?

“…Prospective longitudinal studies are necessary to disentangle the causal relationships between drug use and cognitive performance. The Netherlands XTC toxicity (NeXT) study (de Win et al, 2006;Jager et al, 2007;Schilt et al, 2007) has made initial steps into this direction: Assessing young adults before and after initiation of ecstasy use, they found suggestive evidence for a reduction of memory performance in novice ecstasy users, although in this case there was no sign of additional performance reductions in working memory functions.…”