Preliminary evidence of hippocampal dysfunction in adolescent MDMA ("ecstasy") users: possible relationship to neurotoxic effects.
BACKGROUND
3,4-Methylenedioxymethamphetamine (MDMA or ecstasy) is a potent and selective serotonin neurotoxin whose use is growing among adolescents. Although cognitive deficits among adult MDMA users are well documented, little is known of the cognitive and brain functional sequelae of MDMA use during adolescence.


OBJECTIVE
We tested for evidence of cognitive deficits and changes in brain function in a pilot sample of adolescent MDMA users, who were compared with adolescent non-users of MDMA.


METHODS
Selective and divided attention and verbal working memory were examined in six adolescent MDMA users and six non-users of MDMA who were similar in age, gender, IQ, and other substance use. Brain function was assessed during performance of the working memory task using functional magnetic resonance imaging (fMRI).


RESULTS
MDMA users had significantly prolonged reaction times during tests of selective and divided attention, and failed to deactivate the left hippocampus normally during high verbal working memory load.


CONCLUSIONS
MDMA use in adolescence may be associated with cognitive impairments and dysfunction of inhibitory circuits within the hippocampus. Further work is urgently needed to delineate the developmental impact and long-term functional and clinical significance of MDMA use during adolescence.
Jacobsen
Leslie K
LK
Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. 06511, USA. leslie.jacobsen@yale.edu
Mencl
W Einar
WE
Pugh
Kenneth R
KR
Skudlarski
Pawel
P
Krystal
John H
JH
D000293:Adolescent; D001288:Attention / Q000187:drug effects; D005260:Female; D006624:Hippocampus / Q000187:drug effects* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000187:drug effects; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D018490:Serotonin Agents / Q000009:adverse effects*; D014705:Verbal Behavior / Q000187:drug effects
D018490:Serotonin Agents; D018817:N-Methyl-3,4-methylenedioxyamphetamine