RSNA 2006 

Abstract Archives of the RSNA, 2006


SSE15-02

Ecstasy: Is It Safe for the Brain? First Prospective Study on Effects of Low Doses of Ecstasy on the Brain in New Ecstasy Users, Using a Combination of Advanced MR Imaging Techniques and [123I]-CIT SPECT

Scientific Papers

Presented on November 27, 2006
Presented as part of SSE15: Neuroradiology/Head and Neck (Brain: Toxic, Metabolic)

Participants

Maartje Maria Leontien De Win MD, Presenter: Nothing to Disclose
Gerry Jager MS, Abstract Co-Author: Nothing to Disclose
Liesbeth Reneman MD, Abstract Co-Author: Nothing to Disclose
Jan Booij MD,PhD, Abstract Co-Author: Nothing to Disclose
Wim van den Brink MD,PhD, Abstract Co-Author: Nothing to Disclose
Gerard J. Den Heeten MD, PhD, Abstract Co-Author: Nothing to Disclose
Thelma Schilt MS, Abstract Co-Author: Nothing to Disclose
Cristina Lavini DPhil, Abstract Co-Author: Nothing to Disclose
et al, Abstract Co-Author: Nothing to Disclose

PURPOSE

Previous studies suggested neurotoxic effects of the recreational drug ecstasy. However, most studies are retrospective so pre-existent differences between users and non-users cannot be excluded. Neurotoxicity is therefore disputed and some even advocate ecstasy as adjuvant in psychotherapy. This study, part of the Netherlands XTC Toxicity (NeXT) study, aimed to prospectively assess effects of ecstasy on the brain in new users, with a combination of neuroimaging techniques.

METHOD AND MATERIALS

A total of 188 ecstasy-naive subjects (77M, 111F, 21.7±3.0yrs) with high risk for first ecstasy use were examined at baseline. After 18 months follow-up, 59 incident ecstasy users (6.0±11.6tablets) and 56 persistent ecstasy-naives were reexamined. Groups were comparable in terms of demographics and drug-use variables at baseline. Subjects underwent 1.5T MRI, including 1H-MR spectroscopy, diffusion tensor imaging (DTI), perfusion weighted imaging, and [123I]β-CIT SPECT imaging (serotonin transporters). Apparent diffusion coefficient (ADC), fractional anisotropy (FA), cerebral blood volume (CBV) and β-CIT binding ratios (relative to cerebellar uptake) were calculated and registered to spatially normalized T13D scans. CBV values relative to CBV of white matter and ratios of N-acetylaspartate, choline and myoinositol relative to creatine were calculated. Follow-up data between the two groups were compared controlling for baseline differences.

RESULTS

Ecstasy had no effect on β-CIT binding and metabolite ratios. However, incident ecstasy users had a decreased FA in thalamus and centrum semiovale and rrCBV in globus pallidus and putamen and a increased FA in globus pallidus and ADC in thalamus (all significant at p<0.05, adjusted for confounders).

CONCLUSION

This first prospective study in novel ecstasy users shows decreased FA, increased ADC and decreased rrCBV, suggesting prolonged vasoconstriction and probably axonal loss in low-dose ecstasy users. Therefore, we cannot conclude that ecstasy even in low doses is safe for the brain.

CLINICAL RELEVANCE/APPLICATION

Low doses ecstasy have effects on the brain. Therefore, recreational use and prescription of ecstasy as adjuvant in psychotherapy should be discouraged.

Cite This Abstract

De Win, M, Jager, G, Reneman, L, Booij, J, van den Brink, W, Den Heeten, G, Schilt, T, Lavini, C, et al, , Ecstasy: Is It Safe for the Brain? First Prospective Study on Effects of Low Doses of Ecstasy on the Brain in New Ecstasy Users, Using a Combination of Advanced MR Imaging Techniques and [123I]-CIT SPECT.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4431570.html