PTSDNeuroimaging & Brain MeasuresMDMA

Neuroimaging of chronic MDMA (“ecstasy”) effects: A meta-analysis

This meta-analysis (2019) evaluated the adverse of effects chronic MDMA/ecstasy use across neuroimaging studies and found no alterations in cerebral blood flow in the basal ganglia and in neurochemical markers in the occipital and frontal lobes, although the serotonin transporter density was decreased in several regions. Given that there was no association between these alterations and lifetime episodes of MDMA use, other factors - such as doses taken per occasion -; might be more important determinants.

Authors

  • Stefan Borgwardt
  • Felix Müller
  • Matthias Liechti

Published

Neuroscience and Biobehavioral Reviews
meta Study

Abstract

Introduction

In this meta-analysis, we aimed to assess the evidence from neuroimaging studies for chronic alterations in the brains of MDMA users.

Methods

The databases PubMed, Embase, and Web of Science were searched for studies published from inception to August 24, 2018, without any language restriction. Sixteen independent studies comprising 356 MDMA users and 311 controls were included. Of these, five studies investigated frontal and occipital N-acetylaspartate/creatine and myo-inositol/creatine ratios, three studies assessed basal ganglia blood flow and ten studies investigated serotonin transporter (SERT) density in various regions.

Results

We found significantly decreased SERT density in eight of 13 investigated regions. Meta-regression indicated a positive association with abstinence, but none with lifetime episodes of use. Therefore, other variables (such as doses taken per occasion) might be more important determinants. Positive associations between time of abstinence and SERT density might indicate that these alterations are reversible to some extent. Furthermore, there were no significant differences between user and control groups in terms of neurochemical ratios in the frontal and occipital lobes and blood flow in the basal ganglia.

Discussion

Overall, MDMA user groups showed heavy use patterns and study quality was poor.

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Research Summary of 'Neuroimaging of chronic MDMA (“ecstasy”) effects: A meta-analysis'

Introduction

MDMA (3,4-methylenedioxymethamphetamine) is an amphetamine-type drug that primarily releases serotonin and norepinephrine. Recreational use of MDMA rose from the 1980s and research interest has continued, including recent clinical investigation of MDMA-assisted psychotherapy for post-traumatic stress disorder. However, concerns remain that MDMA may be neurotoxic to serotonergic neurons in humans. Prior neuroimaging studies have been numerous but heterogeneous in samples, methods and findings, and most have sampled heavy, polydrug-using participants rather than moderate users. Müller and colleagues set out to provide a comprehensive meta-analysis of human neuroimaging studies examining non-acute (chronic or post-use) brain alterations associated with MDMA. The study aimed to aggregate findings across imaging modalities (MRI, MRS, PET, SPECT, etc.), include both current and former users, and to test whether imaging alterations in serotonin transporter (SERT) density were associated with lifetime episodes of use or time of abstinence, using meta-regression where feasible.

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Study Details

References (6)

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