Abstract
Background
The common club drug 3,4-methylendioxymethamphetamine (MDMA, “Ecstasy”) enhances mood,
sensory perception, energy, sociability, and euphoria. While MDMA has been shown to
produce neurotoxicity in animal models, research on its potential neurotoxic effects
in humans is inconclusive and has focused primarily on the serotonin system.
Methods
We investigated 34 regular, largely pure MDMA users for signs of premature neurodegenerative
processes in the form of increased iron load in comparison to a group of 36 age-,
sex-, and education-matched MDMA-naïve controls. We employed quantitative susceptibility
mapping (QSM), a novel tool able to detect even small tissue (non-heme) iron accumulations.
Cortical and relevant subcortical gray matter structures were grouped into eight regions-of-interest
(ROIs) and analyzed.
Results
Significantly increased iron deposition in the striatum was evident in the MDMA user
group. The effect survived correction for multiple comparisons and remained after
controlling for relevant confounding factors, including age, smoking and stimulant
co-use. Although no significant linear relationship between measurements of the amounts
of MDMA intake (hair analysis and self-reports) and QSM values could be observed,
increased striatal iron deposition might nevertheless point to MDMA-induced neurotoxic
processes. Additional factors (hyperthermia, simultaneous co-use of other substances)
that possibly amplify neurotoxic effects of MDMA during the state of acute intoxication
are discussed.
Conclusion
The demonstrated increased striatal iron accumulation may indicate that regular MDMA
users have an increased risk potential for neurodegenerative diseases with progressing
age.
Keywords
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Article info
Publication history
Accepted:
February 17,
2023
Received in revised form:
December 30,
2022
Received:
October 14,
2022
Handling Editor: Dr C. CarterPublication stage
In Press Journal Pre-ProofFootnotes
Disclosures
The authors report no biomedical financial interests or potential conflicts of interest.
Identification
Copyright
© 2023 Published by Elsevier Inc on behalf of Society of Biological Psychiatry.
