Striatal Iron Deposition in Recreational MDMA (Ecstasy) Users.
Rebecca C Coray, Jatta Berberat, Josua Zimmermann, Erich Seifritz, Ann-Kathrin Stock, Christian Beste, David M. Cole, Paul G Unschuld, Boris B. Quednow
Biological psychiatry. Cognitive neuroscience and neuroimaging September 2023 DOI: 10.1016/j.bpsc.2023.02.005 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case-control study Peer reviewed |
|---|---|
| Sample size | 70 |
| Population | 34 regular, largely pure MDMA users and 36 age-, sex-, and education-matched MDMA-naive control subjects |
| Intervention | MDMA (ecstasy) |
| Measures | quantitative susceptibility mapping |
| Topics | Addiction MDMA |
| Keywords | Empathogens Imaging Iron load Neurotoxicity Quantitative susceptibility mapping Stimulants Substance use |
| Key findings | MDMA users showed significantly increased iron deposition in the striatum compared with controls, an effect that survived correction for multiple comparisons and adjustment for age, smoking, and stimulant co-use. No significant linear relationship was found between estimated MDMA intake (hair analysis and self-reports) and quantitative susceptibility mapping values. The authors suggest the increased striatal iron may point to MDMA-induced neurotoxic processes and a possible increased risk of neurodegenerative disease with age. |
Abstract
The common club drug MDMA (also known as 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. 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 control subjects. We used quantitative susceptibility mapping, a novel tool able to detect even small tissue (nonheme) iron accumulations. Cortical and relevant subcortical gray matter structures were grouped into 8 regions of interest and analyzed. 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 quantitative susceptibility mapping values was observed, increased striatal iron deposition might nevertheless point to MDMA-induced neurotoxic processes. Additional factors (hyperthermia and simultaneous co-use of other substances) that possibly amplify neurotoxic effects of MDMA during the state of acute intoxication are discussed. The demonstrated increased striatal iron accumulation may indicate that regular MDMA users have an increased risk potential for neurodegenerative diseases with progressing age.
Comparable studies
Other observational and cohort studies on MDMA for addiction, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Death rates from ecstasy (MDMA, MDA) and polydrug use in England and Wales 1996–2002 Ecstasy-related fatalities in England and Wales, August 1996–April 2002 | 2003 | Observational cohort | n = 202 |
| Screened Attention Deficit/Hyperactivity Disorder as a Predictor of Substance Use Initiation and Escalation in Early Adulthood and the Role of Self-Reported Conduct Disorder and Sensation Seeking: A 5-Year Longitudinal Study with Young Adult Swiss Men Young Swiss men aged 20 at baseline and 25 at follow-up | 2020 | Observational cohort | |
| Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders German adolescent patients with a substance use disorder | 2021 | Observational cohort | n = 121 |
| Intensity dependence of auditory evoked dipole source activity in polydrug ecstasy users: evidence from an 18 months longitudinal study. Polydrug ecstasy users | 2006 | Observational cohort | n = 18 |