Neuroimaging of MDMA-Induced Neurotoxicity

Abstract

(±) 3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”) is an increasingly popular drug of abuse in the United States, Europe, and Australia (1–3). MDMA is a synthetic amphetamine analog that bears structural similarity to both the psychomotor stimulant, amphetamine, and the hallucinogen, mescaline. MDMA users report that in addition to having some stimulant and hallucinogenic effects, MDMA has unique qualities distinct from both of these drug classes (4). Although it has been suggested that MDMA has potential therapeutic effects that may be useful in psychotherapy (5), it is primarily used illicitly, in the setting of the “club” scene at dance parties known as “raves.” In this venue, some MDMA users report using as much as 10 doses of MDMA in any given night (6). In the present chapter, we will first briefly review the pharmacology of MDMA and evidence that it produces selective neurotoxicity toward brain serotonin (5-HT) neurons. We will then focus the discussion on recent efforts to detect MDMA-induced 5-HT injury using neuroimaging techniques and directions for future research endeavors.