Neuroimaging of chronic MDMA (“ecstasy”) effects: A meta-analysis
Felix Müller, Raphael Brändle, Matthias E. Liechti, Stefan Borgwardt
Neuroscience & Biobehavioral Reviews November 12, 2018 DOI: 10.1016/j.neubiorev.2018.11.004 via OpenAlex
Summary
AI-generated from the abstractA meta-analysis of neuroimaging studies found that people who use MDMA (ecstasy) have significantly lower serotonin transporter (SERT) density in eight out of thirteen brain regions examined, compared to non-users. The reduction in SERT density was positively associated with the duration of abstinence, suggesting that these brain changes may be partially reversible with sustained abstinence. No significant differences were found between users and controls in neurochemical ratios in the frontal and occipital lobes or in blood flow in the basal ganglia. The analysis included 356 MDMA users and 311 controls from sixteen studies, but the user groups showed heavy use patterns and the overall study quality was poor.
Study at a glance
| Characteristics | Meta-analysis Peer reviewed |
|---|---|
| Sample size | 667 |
| Population | MDMA users and non-user controls from neuroimaging studies |
| Topics | MDMA Serotonin |
| Keywords | Neurochemical Serotonin transporter Abstinence |
| Citations | 52 |
| Key finding | MDMA users showed significantly lower serotonin transporter density in multiple brain regions, with a positive association between abstinence duration and SERT density, suggesting potential reversibility. |
Abstract
In this meta-analysis, we aimed to assess the evidence from neuroimaging studies for chronic alterations in the brains of MDMA users. 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. 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. Overall, MDMA user groups showed heavy use patterns and study quality was poor.