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Hippocampal remodelling after MDMA neurotoxicity: a single case study.

Francesco Nifosì, Andrea Martinuzzi, Tommaso Toffanin, Raffaella Costanzo, Alec Vestri, Mariamalia Battaglia, Gian E Bertagnoni, Andrea Lupi, Pietro Amistà, Carla Carollo, Giulia Perini

The World Journal of Biological Psychiatry 2009 DOI: 10.1080/15622970701870933 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population 16-year-old girl with acute organic and psychotic syndrome following occasional MDMA use
Intervention Neuropsychological rehabilitation
Duration 16 months of rehabilitation
Topics MDMA
Key findings A 16-year-old girl developed acute organic psychosis after occasional low-to-moderate MDMA use, with neuroimaging changes correlating with severe cognitive impairment. After 16 months of rehabilitation, she showed significant improvement in hippocampal-related memory, alongside PET normalization and hippocampal remodeling, suggesting reversibility of MDMA-related brain changes.

Abstract

Acute ingestion of MDMA (ecstasy) causes a transient marked increase in serotonin and dopamine at central synapses. Recent studies demonstrated that MDMA induces damage of serotonergic nerve terminals and alters hippocampal processing. Pronounced cognitive deficits in MDMA users affect learning and memory abilities. This pattern of predominant and long-lasting memory dysfunction suggests that the functioning of the hippocampus might be affected by the neurotoxic effects of MDMA. We present the case of a 16-year-old girl who developed an acute organic and psychotic syndrome caused by occasional use of low to moderate dose of MDMA. Serial neuroimaging ((18)F-FDG-PET and brain MRI) were correlated with her neurocognitive performance and clinical evolution. The structural and metabolic changes correlated with a severe cognitive impairment. After 16 months of intensive neuropsychological rehabilitation she showed significant improvement in hippocampal-related memory cognitive functions, which correlated with normalization of her (18)F-FDG-PET and remarkable hippocampal remodelling. This case report indicates that even non-chronic MDMA use may cause subacute toxic encephalopathy in which the clinical evolution is paralleled by neuroimaging changes in specific cerebral areas. The most relevant aspect is the reversibility of the volumetric changes, which may be the structural correlate of an ongoing hippocampal remodelling.

Comparable studies

Other case reports and case series on MDMA, most cited first.

Study Year Design Participants
'Eve' and 'Ecstasy'. A report of five deaths associated with the use of MDEA and MDMA Individuals whose deaths were associated with MDMA or MDEA use 1987 Case series n = 5
Pathology of deaths associated with "ecstasy" and "eve" misuse. Young white men aged 20 to 25 who died after using ring-substituted amphetamines (MDMA... 1996 Case series n = 7
'Eve' and 'Ecstasy' Individuals who died after using MDMA or MDEA 1987 Case series n = 5
A Method of Conducting Therapeutic Sessions with MDMA Clients with clear therapeutic purpose, excluding those with serious functional... 1998 Case study n = 2
Diversity of Psychopathology Associated with use of 3,4-Methylenedioxymethamphetamine (‘Ecstasy’) Psychiatric patients presenting between 1990 and 1992 whose symptoms developed in the... 1994 Case series n = 13

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