Neuroimaging & Brain MeasuresPublic Health, Prevention & Behaviour ChangeMDMA

Neuroimaging in moderate MDMA use: A systematic review

This systematic review (2015; 19 studies) found no convincing evidence that moderate use of MDMA is associated with significant brain alterations. However, the authors point out that the included studies were very heterogeneous and often of low quality.

Authors

Stefan Borgwardt
Patrick Dolder
Matthias Liechti

Published

December 30, 2015

Neuroscience and Biobehavioral Reviews

meta Study

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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.

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Research Summary of 'Neuroimaging in moderate MDMA use: A systematic review'

Introduction

Mueller and colleagues frame the review around ongoing uncertainty over whether MDMA ("ecstasy") produces neurotoxic effects in humans. Much of the prior neuroimaging literature sampled heavy or long‑term users, with cumulative lifetime exposure in the hundreds or thousands of tablets and frequent polydrug use, whereas most MDMA consumers use the drug transiently and at much lower cumulative doses. The authors note additional relevance given renewed interest in MDMA as an adjunct in psychotherapy, where administration is limited to a few controlled sessions, and argue that evidence specific to moderate patterns of use is required to inform both public health debates and clinical considerations. This systematic review therefore set out to identify and synthesise human neuroimaging studies that examined non‑acute brain structure, function or neurochemistry in groups with moderate MDMA exposure. Moderate use was pre‑defined as an average of <50 lifetime episodes of ecstasy use or a lifetime consumption of <100 ecstasy tablets. The review aims to assess whether neuroimaging findings in such cohorts provide convincing evidence of MDMA‑related brain alterations and to characterise methodological limitations that affect interpretation.

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Study Details

Study Type
meta
Journal
Neuroscience and Biobehavioral Reviews
Compound
MDMA
Topics
Neuroimaging & Brain Measures Public Health, Prevention & Behaviour Change
Authors
Stefan Borgwardt Patrick Dolder Matthias Liechti Felix Mueller Claudia Lenz
APA Citation
Mueller, F., Lenz, C., Steiner, M., Dolder, P., Walter, M., Lang, U., Liechti, M., & Borgwardt, S. (2016). Neuroimaging in moderate MDMA use: A systematic review. Neuroscience & Biobehavioral Reviews, 62, 21-34. https://doi.org/10.1016/j.neubiorev.2015.12.010