Recreational use of MDMA does not cause significant neuronal injury, as indicated by normal levels of N-acetyl compounds in the brain. However, in the parietal white matter, the concentration of myo-inositol was 16.3% higher and the ratio of myo-inositol to creatine was 14.1% higher in MDMA users compared to non-users. These increases, which were related to the cumulative lifetime dose of MDMA, suggest that even recreational doses may lead to increased glial content in the brain. The study involved 22 MDMA users and 37 normal subjects, using magnetic resonance imaging and spectroscopy to assess neurochemical abnormalities.
Recreational MDMA (ecstasy) users show no overall cognitive deficits compared to non-users, but heavy users perform worse on tests of nonverbal (visual) memory. In a study comparing 22 recreational MDMA users with 28 matched controls, no significant differences in general cognitive functioning emerged. However, greater lifetime MDMA use correlated with poorer scores on several nonverbal memory measures. Users who had taken MDMA 50 or more times scored significantly lower on two of three nonverbal memory tests than less frequent users. Other cognitive areas appeared unaffected. The findings suggest that only heavy, frequent MDMA use is associated with specific declines in visual memory.