Cerebral1H MRS alterations in recreational 3,4-methylenedioxymethamphetamine (MDMA, ?ecstasy?) users

Recreational use of MDMA does not cause significant neuronal injury, as indicated by normal levels of N-acetyl compounds in the brain. However, in the parietal white matter, the concentration of myo-inositol was 16.3% higher and the ratio of myo-inositol to creatine was 14.1% higher in MDMA users compared to non-users. These increases, which were related to the cumulative lifetime dose of MDMA, suggest that even recreational doses may lead to increased glial content in the brain. The study involved 22 MDMA users and 37 normal subjects, using magnetic resonance imaging and spectroscopy to assess neurochemical abnormalities.

Study at a glance

Abstract

3,4-methylenedioxymethamphetamine (MDMA) is an illicit drug that has been associated with serotonergic axonal degeneration in animals. This study evaluates neurochemical abnormalities in recreational MDMA users. Twenty-two MDMA users and 37 normal subjects were evaluated with magnetic resonance imaging (MRI) and proton magnetic resonance spectroscopy ((1)H MRS) in the mid-frontal, mid-occipital, and parietal brain regions. (1)H MRS showed normal N-acetyl (NA) compounds in all brain regions. The myo-inositol (MI) concentration (+16.3%, P = 0.04) and the MI to creatine (CR) ratio (+14.1%, P = 0. 01) were increased in the parietal white matter of MDMA users. The cumulative lifetime MDMA dose showed significant effects on [MI] in the parietal white matter and the occipital cortex. The normal NA concentration suggests a lack of significant neuronal injury in recreational MDMA users. However, the usage-related increase in MI suggests that exposure to MDMA, even at recreational doses, may cause increased glial content. J. Magn. Reson. Imaging 1999;10:521-526.