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Ecstasy (MDMA) exposure and neuropsychological functioning: A polydrug perspective

Published online by Cambridge University Press:  21 October 2005

KRISTA LISDAHL MEDINA ,
PAULA K. SHEAR  and
KEVIN CORCORAN
KRISTA LISDAHL MEDINA
Affiliation:
Department of Psychiatry, University of California, San Diego, California Veterans Medical Research Foundation, San Diego, California
PAULA K. SHEAR
Affiliation:
Department of Psychology, University of Cincinnati, Cincinnati, Ohio Department of Psychiatry, University of Cincinnati, Cincinnati, Ohio
KEVIN CORCORAN
Affiliation:
Department of Psychology, University of Cincinnati, Cincinnati, Ohio
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Abstract

Ecstasy (MDMA) is a popular drug that can act as a selective serotonin neurotoxin in several species. The goal of the present study was to examine the relationship between ecstasy exposure and cognitive functioning after controlling for other drug use and demographic variables. Furthermore, we assessed whether gender was a moderator of the relationship between cognitive functioning and ecstasy use. Data were collected from 31 men and 34 women with a wide range of ecstasy use (17 marijuana users with no ecstasy use and 48 ecstasy users ranging from low to heavy use). Participants were interviewed and administered a battery of neuropsychological tests. The primary finding was that ecstasy exposure was significantly related to poorer verbal learning and memory ability in a dose-dependent manner, while no such relationship was observed between ecstasy exposure and executive functioning or attentional ability. Gender was found to significantly moderate the relationship between ecstasy consumption and design fluency. These results suggest primary memory dysfunction among abstinent recreational ecstasy users. This finding is consistent with reports of hippocampal vulnerability, particularly among heavy users. (JINS, 2005, 11, 753–765.)

Keywords

MethylenedioxymethamphetamineSubstance-related disordersMemoryAdverse effectsSex differencesDrug effects
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 6 , October 2005 , pp. 753 - 765
Copyright
© 2005 The International Neuropsychological Society

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References

REFERENCES

Bolla, K.I., McCann, U.D., & Ricaurte, G.A. (1998). Memory impairment in abstinent MDMA (“Ecstasy”) users. Neurology, 51, 1532–1537.CrossRefGoogle Scholar
Chang, L., Grob, C.S., Ernst, T., Itti, L., Mishkin, F.S., Jose-Melchor, R., & Poland, R.E. (2000). Effect of ecstasy [3,4-methylenedioxymethamphetamine (MDMA)] on cerebral blood flow: A co-registered SPECT and MRI study. Psychiatry Research Neuroimaging, 98, 15–28.CrossRefGoogle Scholar
Colado, M.I., O'Shear, E., & Green, A.R. (2004). Acute and long-term effects of MDMA on cerebral dopamine biochemistry and function. Psychopharmacology, 173, 249–263.CrossRefGoogle Scholar
Croft, R.J., Mackay, A.J., Mills, A.T.D., & Gruzelier, J.G.H. (2000). The relative contributions of ecstasy and cannabis to cognitive impairment. Psychopharmacology, 153, 373–379.Google Scholar
Daumann, J., Fimm, B., Willmes, K., Thron, A., & Gouzoulis-Mayfrank, E. (2003). Cerebral activation in abstinent ecstasy (MDMA) users during a working memory task: A functional magnetic resonance imaging (fMRI) study. Cognitive Brain Research, 16, 479–487.CrossRefGoogle Scholar
Delis, D.C. & Kaplan, E. (2001). Delis-Kaplan Executive Functioning Scale manual. San Antonio, TX: The Psychological Corporation.
Delis, D.C., Kramer, J.H., Kaplan, E., & Ober, B.A. (2001). California Verbal Learning Test–Second Edition. San Antonio, TX: The Psychological Corporation.
Fals-Stewart, W., O'Farrell, T.J., Freitas, T.T., McFarlin, S.K., & Rutligliano, P. (2000). The Timeline Followback reports of psychoactive substance use by drug-abusing patients: Psychometric properties. Journal of Consulting and Clinical Psychology, 68, 134–144.CrossRefGoogle Scholar
Fox, H.C., McLean, A., Turner, J.D.D., Parrott, A.C., Rogers, R., & Sahakian, B.J. (2002). Neuropsychological evidence of a relatively selective profile of temporal dysfunction in drug-free MDMA (“ecstasy”) polydrug users. Psychopharmacology, 162, 203–214.CrossRefGoogle Scholar
Fox, H.C., Parrott, A.C., & Turner, J.J.D. (2001a). Ecstasy use: Cognitive deficits related to dosage rather than self-reported problematic use of the drug. Journal of Psychopharmacology, 15, 273–281.Google Scholar
Fox, H.C., Toplis, A.S., Turner, J.J.D., & Parrott, A.C. (2001b). Auditory verbal learning in drug-free Ecstasy polydrug users. Human Psychopharmacology, 16, 613–618.Google Scholar
Gamma, A., Buck, A., Berthold, T., & Vollenweider, F.X. (2001). No difference in brain activation during cognitive performance between ecstasy (3,4-methylenedioxymethamphetamine) users and control subjects: A [H2 15O]-Positron Emission Tomography study. Journal of Clinical Psychopharmacology, 21, 66–71.CrossRefGoogle Scholar
Gouzoulis-Mayfrank, E., Daumann, J., Tuchtenhagen, F., Pelz, S., Becker, S., Hans-Jurgen, K., Fimm, B., & Sass, H. (1999). Impaired cognitive performance in drug free users of recreational ecstasy (MDMA). Journal of Neurology, Neurosurgery, and Psychiatry, 68, 719–725.Google Scholar
Gouzoulis-Mayfrank, E., Thimm, B., Rezk, M., Hensen, G., & Daumann, J. (2003). Memory impairment suggests hippocampal dysfunction in abstinent ecstasy users. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 27, 819–827.CrossRefGoogle Scholar
Hatzidimitriou, G., McCann, U.D., & Ricaurte, G.A. (1999). Altered serotonin innervation patterns in the forebrain of monkeys treatment with 3,4-Methylenedioxymethamphetamine seven years previously: Factors influencing abnormal recovery. Journal of Neuroscience, 19, 5096–5107.CrossRefGoogle Scholar
Jacobsen, L.K., Mencl, W.E., Pugh, K.R., Skudlarski, P., & Krystal, J.H. (2004). Preliminary evidence of hippocampal dysfunction in adolescent MDMA (“ecstasy”) users: Possible relationship to neurotoxic effects. Psychopharmacology, 173, 383–390.CrossRefGoogle Scholar
Kavanagh, G., Corcoran, K., Medina, K.L., Wernke, J., & Shear, P.K. (2004, August). Welcome to the party: Ecstasy use in college students. Poster presented at the American Psychological Association, Honolulu, Hawaii.
Krystal, J.H. & Price, L.H. (1992). Chronic 3,4-methylenedioxymethamphetamine (MDMA) Use: Effects on mood and neuropsychological functioning? American Journal on Drug and Alcohol Abuse, 18, 331–341.Google Scholar
Lezak, M.D. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.
Manly, J.J., Jacobs, D.M., & Touradji, P. (2002). Reading level attenuates differences in neuropsychological test performance between African American and White elders. Journal of the International Neuropsychological Society, 8, 341–348.CrossRefGoogle Scholar
McCann, U.D., Eligulashvili, V., Mertl, M., Murphy, D.L., & Ricaurte, G.A. (1999). Altered neuroendocrine and behavioral responses to m-chlorophenylpiperazine in 3,4-methylenedioxymethamphetamine (MDMA) users. Psychopharmacology, 147, 56–65.CrossRefGoogle Scholar
McCann, U.D., Eligulashvili, V., & Ricaurte, G.A. (2000). 3,4-Methylenedioxymethamphetamine (‘Ecstasy’)-Induced serotonin neurotoxicity: Clinical studies. Neuropsychobiology, 42, 11–16.CrossRefGoogle Scholar
McCann, U.D., Ridenour, A., Shaham, Y., & Ricaurte, G.A. (1994). Serotonin neurotoxicity after 3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”): A controlled study in humans. Neuropsychopharmacology, 10, 129–138.CrossRefGoogle Scholar
McCann, U.D., Szabo, Z., Scheffel, U., Matthews, W.B., Dannals, R.F., Ravert, H.T., Musachio, J.L., Mertl, M.M., & Ricaurte, G.A. (1998). Positron tomographic evidence of toxic effects of MDMA (‘Ecstasy’) on brain serotonin neurons in human beings. Lancet, 352, 1433–1437.CrossRefGoogle Scholar
Miller, F.G. & Lazowski, L.E. (1999). SASSI manual, second edition, substance abuse measures. Bloomington, IN: Baugh Enterprises.
Morgan, M.J. (1999). Memory deficits associated with recreational use of “ecstasy” (MDMA). Psychopharmacology, 141, 30–36.CrossRefGoogle Scholar
Morgan, M.J. (2000). Ecstasy (MDMA): A review of its possible persistent psychological effects. Psychopharmacology, 152, 230–248.CrossRefGoogle Scholar
Morgan, M.J., McFie, L., Fleetwood, L.H., & Robinson, J.A. (2002). Ecstasy (MDMA): Are the psychological problems associated with its use reversed by prolonged abstinence? Psychopharmacology, 159, 294–303.Google Scholar
Nigg, J.T., Glass, J.M., Wong, M.M., Poon, E., Jester, J.M., Fitzgerald, H.E., Puttler, L.I., Adams, K.M., & Zucker, R.A. (2004). Neuropsychological executive functioning in children at elevated risk for alcoholism: Findings in early adolescence. Journal of Abnormal Psychology, 113, 302–314.CrossRefGoogle Scholar
Norman, M.A., Evans, J.D., Miller, S.W., & Heaton, R.K. (2000). Demographically corrected norms for the California Verbal Learning Test. Journal of Clinical and Experimental Neuropsychology, 22, 80–94.CrossRefGoogle Scholar
O'Shea, E., Granados, R., Esteban, B., Colado, M.I., & Green, A.R. (1998). The relationship between the degree of neurodegeneration of rat brain 5-HT nerve. Neuropharmacology, 37, 919–926.CrossRefGoogle Scholar
Parrott, A.C. (2001). Human psychopharmacology of Ecstasy (MDMA): A review of 15 years of empirical research. Human Psychopharmacology, 16, 557–577.CrossRefGoogle Scholar
Parrott, A.C. & Lasky, J. (1998). Ecstasy (MDMA) effects upon mood and cognition: Before, during and after a Saturday night dance. Psychopharmacology, 139, 261–268.CrossRefGoogle Scholar
Parrott, A.C., Sisk, E., & Turner, J.J.D. (2000). Psychobiological problems in heavy ‘ecstasy’ (MDMA) polydrug users. Drug and Alcohol Dependence, 60, 105–110.Google Scholar
Reneman, L., Booij, J., de Bruin, K., Reitsma, J.B., de Wolff, F., Gunning, W.B., den Heeten, G.J., & van de Brink, W. (2001). Effects of dose, sex, and long-term abstention from use of toxic effects of MDMA (ecstasy) on brain serotonin neurons. Lancet, 358, 1864–1869.CrossRefGoogle Scholar
Reneman, L., Booij, J., Lavalaye, J., de Bruin, K., Reitsma, J.B., Gunning, W.B., de Heeten, G.J., & van de Brink, W. (2002a). Use of amphetamine by recreational users of ecstasy (MDMA) is associated with reduced striatal dopamine transporter densities: A [123I]B-CIT SPECT-preliminary report. Psychopharmacology, 159, 335–140.Google Scholar
Reneman, L., Booij, J., Schmand, B., van de Brink, W., & Boudewijn, G. (2000). Memory disturbances in “Ecstasy” users are correlated with an altered brain serotonin neurotransmission. Psychopharmacology, 148, 322–324.CrossRefGoogle Scholar
Reneman, L., Endert, E., de Bruin, K., Lavalaye, J., Feenstra, M.G., de Wolff, F., & Booij, J. (2002b). The acute and chronic effects of MDMA (“Ecstasy”) on cortical 5-HT2A receptors in rat and human brain. Neuropsychopharmacology, 26, 387–396.Google Scholar
Ricaurte, G.A., McCann, U.D., Szabo, Z., & Scheffel, U. (2000). Toxicodynamics and long-term toxicity of the recreational drug, 3,4-methylenedioxymethamphetamine (MDMA, ‘Ecstasy’). Toxicology Letters, 112–113, 143–146.CrossRefGoogle Scholar
Rodgers, J. (2000). Cognitive performance amongst recreational users of “ecstasy.” Psychopharmacology, 151, 19–24.CrossRefGoogle Scholar
Ruff, R.M. & Allen, C.C. (1996). Ruff 2 & 7 Selective Attention Test. Odessa, FL: Psychological Assessment Resources, Inc.
Scheffel, U., Lever, J.R., Stathis, M., & Ricaurte, G.A. (1992). Repeated administration of MDMA causes transient down-regulation of serotonin 5-HT2 receptors. Neuropharmacology, 31, 881–893.CrossRefGoogle Scholar
Scheffel, U., Szabo, Z., Mathews, W.B., Finley, P.A., Dannals, R.F., Ravert, H.T., Szabo, K., Yuan, J., & Ricaurte, G.A. (1998). In vivo detection of short and long-term MDMA neurotoxicity—A Positron Emission Tomography study in the living baboon brain. Synapse, 29, 183–192.3.0.CO;2-3>CrossRefGoogle Scholar
Sharkey, J., McBean, D.E., & Kelly, P.A. (1991). Alterations in hippocampal function following repeated exposure to the amphetamine derative methylenedioxymethamphetamine (“ecstasy”). Psychopharmacology, 105, 113–118.CrossRefGoogle Scholar
Sivon, A.B. (1992). Benton Visual Retention Test (5th ed.). San Antonio, TX: The Psychological Corporation.
Sobell, L.C., Maisto, S.A., Sobell, M.B., & Cooper, A.M. (1979). Reliability of alcohol abusers' self-reports of drinking behavior. Behaviour Research and Therapy, 17, 157–160.CrossRefGoogle Scholar
Sprague, J.E., Preston, A.S., Leifheit, M., & Woodside, B. (2003). Hippocampal serotonergic damage induced by MDMA (ecstasy): Effects on spatial learning. Physiology and Behavior, 79, I281–287.CrossRefGoogle Scholar
Strote, J., Lee, J.E., & Wechsler, H. (2001). Increasing MDMA use among college students: Results of a national survey. Journal of Adolescent Health, 30, 64–72.Google Scholar
Taffe, M.A., Weed, M.R., Davis, S., Huitron-Resendiz, S., Schroeder, R., Parsons, L.H., Henriksen, S.J., & Gold, L.H. (2001). Functional consequences of repeated 3,4-Methylenedioxymethamphetamine (MDMA) treatment in rhesus monkeys. Neuropsychopharmacology, 24, 230–239.CrossRefGoogle Scholar
Thomasius, R., Petersen, K., Buchert, R., Andresen, B., Zapletalova, P., Wartberg, L., Nebeling, B., & Schmoldt, A. (2003). Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users. Psychopharmacology, 167, 85–96.CrossRefGoogle Scholar
Verbaten, M.N. (2003). Specific memory deficits in ecstasy users? The results of a meta-analysis. Human Psychopharmacology, 18, 281–290.CrossRefGoogle Scholar
Verkes, R.J., Gijsman, H.J., Pieters, M.S.M., Schoemaker, R.C., de Visser, S., Kuijpers, M., Pennings, E.J.M., de Bruin, D., Van de Wijngaart, G., Van Gerven, J.M.A., & Cohen, A.F. (2001). Cognitive performance and serotonergic function in users of ecstasy. Psychopharmacology, 153, 196–202.CrossRefGoogle Scholar
Wareing, M., Fisk, J.E., & Murphy, P.N. (2000). Working memory deficits in current and previous users of MDMA (‘ecstasy’). British Journal of Psychology, 91, 181–188.CrossRefGoogle Scholar
Wechsler, D. (1997). Wechsler Adult Intelligence Scale Third Edition manual. New York: The Psychological Corporation.
Wilkinson, G. (1993). Wide Range Achievement Test, Third Edition manual. Wilmington, DE: Wide Range, Inc.
Zakzanis, K.K. & Young, D.A. (2001). Memory impairment in abstinent MDMA (“Ecstasy”) users: A longitudinal investigation. Neurology, 56, 966–969.CrossRefGoogle Scholar
Zakzanis, K.K., Young, D.A., & Radkhoshnoud, N.F. (2002). Attentional processes in abstinent methylenedioxymethamphetamine (Ecstasy) users. Applied Neuropsychology, 9, 84–91.CrossRefGoogle Scholar
Zickler, P. (May, 2001). NIDA Notes, Volume 16, Number 2. Annual survey finds increasing teen use of Ecstasy, Steroids. U.S. Department of Health and Human Services, National Institute on Drug Abuse: Rockville, MN, May, 2001.