Effects of ecstasy (MDMA) on the brain in abstinent users: Initial observations with diffusion and perfusion MR imaging

PURPOSE: To evaluate the effects of 3,4-methylenedioxymethamphetamine (MDMA , ecstasy) on the human brain by using diffusion and perfusion magnetic res onance (MR) imaging. MATERIALS AND METHODS: Eight abstinent ecstasy users and six ecstasy nonuse rs underwent diffusion and perfusion MR imaging. Apparent diffusion coeffic ient and relative cerebral volume maps were reconstructed. Differences in a pparent diffusion coefficient values and relative cerebral volume ratios be tween the groups were analyzed with the Mann-Whitney-Wilcoxon test. The rel ationship between apparent diffusion coefficient and relative cerebral volu me and the extent of previous ecstasy use was investigated with Spearman ra nk correlation. RESULTS: Apparent diffusion coefficient values (0.84 vs 0.65 X 10(-5) cm(2) /sec, P < .025) and relative cerebral volume ratios (1.22 vs 1.01, P < .025 ) were significantly higher in the globus pallidus of ecstasy users compare d with nonusers, respectively. Increases in pallidal relative cerebral volu me were positively correlated with the extent of previous use of ecstasy (r ho = 0.73, P < .04). CONCLUSION: Ecstasy use is associated with tissue changes in the globus pal lidus. These findings are in agreement with findings in case reports, sugge sting that the globus pallidus is particularly sensitive to the effects of ecstasy.