Cerebral 1H MRS alterations in recreational 3,4‐methylenedioxymethamphetamine (MDMA, “ecstasy”) users

Recreational use of MDMA (ecstasy) may increase glial content in the brain without causing significant neuronal injury. In a comparison of 22 MDMA users and 37 non-users, magnetic resonance spectroscopy showed normal levels of N-acetyl compounds, indicating no major neuronal damage. However, MDMA users had a 16.3% higher concentration of myo-inositol and a 14.1% higher myo-inositol-to-creatine ratio in parietal white matter, with effects linked to cumulative lifetime MDMA dose. These findings suggest that even recreational MDMA exposure may alter brain glial cells.

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 (1H MRS) in the mid-frontal, mid-occipital, and parietal brain regions. 1H 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. © 1999 Wiley-Liss, Inc.