Cerebral H-1 MRS alterations in recreational 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") users

3,4-Methylenedioxymethamphetamine (MDMA) is an illicit drug that has been a ssociated with serotonergic axonal degeneration In animals. This study eval uates neurochemical abnormalities in recreational MDMA users. Twenty-two MD MA users and 37 normal subjects were evaluated with magnetic resonance imag ing (MRI) and proton magnetic resonance spectroscopy (H-1 MRS) in the mid-f rontal, mid-occipital, and parietal brain regions. H-1 MRS showed normal N- acetyl (NA) compounds in all brain regions. The myo-inositol (MI) concentra tion (+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 whit e matter and the occipital cortex. The normal NA concentration suggests a l ack of significant neuronal injury in recreational MDMA users. However, the usage-related increase in MI suggests that exposure to MDMA, even at recre ational doses, may cause increased glial content. (C) 1999 Wiley-Liss, Inc.