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

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.

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