Persistent nigrostriatal dopaminergic abnormalities in ex-users of MDMA ('Ecstasy'): an 18F-dopa PET study
Résumé
Ecstasy (MDMA) is a popular recreational drug with known serotonergic neurotoxicity. Its long-term effects on dopaminergic function are less certain. Studying the long-term effects of ecstasy is often confounded by concomitant polydrug use and the short duration of abstinence. We used 18F-dopa positron emission tomography (PET) to investigate the long-term effects of ecstasy on nigrostriatal dopaminergic function in a group of male ex-recreational users of ecstasy who had been abstinent for a mean 3∙22 years. We studied 14 ex-ecstasy users, 14 polydrug-using controls (matched to the ex-users for other recreational drug use) and 12 drug-naïve controls. Each participant underwent one 18F-dopa PET, cognitive assessments, and hair and urinary analysis to corroborate drug use history. The putamen 18F-dopa uptake of ex-ecstasy users was 9% higher than drug-naïve controls (p=0∙021). The putamen uptake of polydrug-using controls fell between the other two groups, suggesting the hyperdopaminergic state in ex-ecstasy users may be due to the combined effects of ecstasy and polydrug use. There was no relationship between the amount of ecstasy use and striatal 18F-dopa uptake. Increased putaminal 18F-dopa uptake in ex-ecstasy users after an abstinence of over three years (mean) suggests that the effects are long-lasting. Our findings suggest potential long-term effects of ecstasy use, in conjunction with other recreational drugs, on nigrostriatal dopaminergic functions. Further longitudinal studies are needed to elucidate the significance of these findings as they may have important public health implications.
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