Abstract
3,4-Methylenedioxymethamphetamine (MDMA) is associated with changes in neurocognitive performance. Recent studies in laboratory animals have provided additional support for the neurodegeneration hypothesis. However, results from animal research need to be applied to humans with caution. Moreover, several of the studies that examine MDMA users suffer from methodological shortcomings. Therefore, a prospective cohort study was designed in order to overcome these previous methodological shortcomings and to assess the relationship between the continuing use of MDMA and cognitive performance in incipient MDMA users. It was hypothesized that, depending on the amount of MDMA taken, the continued use of MDMA over a 2-year period would lead to further decreases in cognitive performance, especially in visual paired association learning tasks. Ninety-six subjects were assessed, at the second follow-up assessment: 31 of these were non-users, 55 moderate-users, and 10 heavy-users. Separate repeated measures analyses of variance were conducted for each cognitive domain, including attention and information processing speed, episodic memory, and executive functioning. Furthermore, possible confounders including age, general intelligence, cannabis use, alcohol use, use of other concomitant substances, recent medical treatment, participation in sports, level of nutrition, sleep patterns, and subjective well-being were assessed. The Repeated measures analysis of variance (rANOVA) revealed that a marginally significant change in immediate and delayed recall test performances of visual paired associates learning had taken place within the follow-up period of 2 years. No further deterioration in continuing MDMA-users was observed in the second follow-up period. No significant differences with the other neuropsychological tests were noted. It seems that MDMA use can impair visual paired associates learning in new users. However, the groups differed in their use of concomitant use of illicit drugs. Therefore, performance differences between the groups cannot completely ascribed to the use of MDMA.
Highlights
3,4-Methylenedioxymethamphetamine (MDMA) is a psychostimulant drug which is commonly referred to as “ecstasy.” MDMA has historically been linked to the electronic dance-music scene, and its use is concentrated among young adults, especially young males
On average the consumption of MDMA declined in both groups in the second follow-up period
The current prospective study investigated the effect of MDMA on cognitive performances in incipient MDMA users over the course of a 2-year period
Summary
3,4-Methylenedioxymethamphetamine (MDMA) is a psychostimulant drug which is commonly referred to as “ecstasy.” MDMA has historically been linked to the electronic dance-music scene, and its use is concentrated among young adults, especially young males. Even abstinent MDMA-users seem to have dose-related impairments in delayed visual and immediate verbal memory performances (Bolla et al, 1998) These deficits are linked, among other factors, to the altered serotonergic fiber density in the hippocampus, which is crucial for the processes of learning—and especially vulnerable to the neurotoxic effects of MDMA (Hatzidimitriou et al, 1999; Daumann et al, 2005; Brown et al, 2010; Pergola and Suchan, 2013).
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