Neuroimaging in moderate MDMA use: A systematic review

Abstract

MDMA ("ecstasy") is widely used as a recreational drug, although there has been some debate about its neurotoxic effects in humans. However, most studies have investigated subjects with heavy use patterns, and the effects of transient MDMA use are unclear. In this review, we therefore focus on subjects with moderate use patterns, in order to assess the evidence for harmful effects. We searched for studies applying neuroimaging techniques in man. Studies were included if they provided at least one group with an average of <50 lifetime episodes of ecstasy use or an average lifetime consumption of <100 ecstasy tablets. All studies published before July 2015 were included. Of the 250 studies identified in the database search, 19 were included. There is no convincing evidence that moderate MDMA use is associated with structural or functional brain alterations in neuroimaging measures. The lack of significant results was associated with high methodological heterogeneity in terms of dosages and co-consumption of other drugs, low quality of studies and small sample sizes.

Cognitive Effects of MDMA in Laboratory Animals: A Systematic Review Focusing on Dose

“…Only about 13%-18% of MDMA users report having taken MDMA on more than 100 occasions (Scholey et al, 2004;Parrott et al, 2006), and while this research may be indicative of neurotoxicity in these heavy users, it is not indicative of the effects of MDMA in the typical user and is highly unlikely to reflect patients treated therapeutically only a few times with MDMA. Mueller et al (2016) addressed this issue with a systematic review of neuroimaging studies in moderate MDMA users (those with lifetime use of ,50 occasions or ,100 tablets). The 19 studies that met inclusion criteria provided little, if any, evidence for brain alterations in moderate MDMA users.…”

“…Others have extensively reviewed findings on the cognitive and neurotoxic effects of MDMA in humans as well as the neurotoxic effects of MDMA in animals (e.g., Baumann et al, 2007;Zakzanis et al, 2007;Mueller et al, 2016). In this paper, we summarize these review articles and discuss some potential methodological issues.…”

Could Hallucinogens Induce Permanent Pupillary Changes in (Ab)users? A Case Report from New Zealand

“…It is likely that changes may exist at a cellular level that cannot be detected with the conventional methods, or at the centrally located nuclei in the midbrain and the hypothalamus. Functional MRI (fMRI) can be useful to detect these changes, but it was not available in the medical institute at which the patient was examined [ 39 , 40 ]. Transcranial magnetic stimulation (TMS) might be of value in detecting lesions in the limbic system, temporal lobe, or the prefrontal cortex.…”

Neurobiological signatures associated with alcohol and drug use in the human adolescent brain

“…While there are several existing studies examining the effects of MDMA on brain structure and function in emerging and older adults (Cowan, 2007; Mueller et al, 2016), only one study exists that included adolescents under age 18. Adolescent MDMA users exhibited delayed reaction times and failed to deactivate left hippocampus during verbal working memory (Jacobsen et al, 2004).…”