title: The Netherlands XTC Toxicity (NeXT) study: objectives and methods of a study investigating causality, course, and clinical relevance.
abstract: This paper describes the objectives and methods of The Netherlands XTC Toxicity (NeXT) study focussing on the causality, course, and clinical relevance of ecstasy neurotoxicity. Previous studies suggest that ecstasy (3,4 methylene-dioxymethamphetamine, MDMA, XTC) is toxic toward brain serotonin axons, but most of these studies have serious methodological limitations. The current study is a combination of different approaches with three substudies: (1) a crosssectional substudy among heavy ecstasy users and controls with variation in drug use, which will provide information about potential neurotoxic consequences of ecstasy in relation to other drugs; (2) a prospective cohort substudy in ecstasy-naive subjects with high risk for future ecstasy use, which will provide information on the causality and short-term course of ecstasy use and potential neurotoxicity, and (3) a retrospective cohort substudy in lifetime ecstasy users and matched controls of an existing epidemiological sample that will provide information on long-term course and outcome of ecstasy use in the general population. Neurotoxicity is studied using (a) different imaging techniques (beta-CIT SPECT, 1H-MR spectroscopy, diffusion tensor imaging, perfusion weighted imaging and functional magnetic resonance imaging), and (b) neuropsychological and psychiatric assessments of memory, depression, and personality. The combined results will lead to conclusions that can be used in prevention messages, clinical decision making, and the development of an (inter)national ecstasy policy.
authors.affiliation: Department of Radiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. m.m.dewin@amc.uva.nl
authors.forename: Maartje M L
authors.initials: MM
authors.lastname: De Win
authors.forename: Gerry
authors.initials: G
authors.lastname: Jager
authors.forename: Hylke K E
authors.initials: HK
authors.lastname: Vervaeke
authors.forename: Thelma
authors.initials: T
authors.lastname: Schilt
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Reneman
authors.forename: Jan
authors.initials: J
authors.lastname: Booij
authors.forename: Frank C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: Gerard J
authors.initials: GJ
authors.lastname: Den Heeten
authors.forename: Nick F
authors.initials: NF
authors.lastname: Ramsey
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Korf
authors.forename: Wim
authors.initials: W
authors.lastname: Van den Brink
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D009426:Netherlands / Q000453:epidemiology; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012701:Serotonin / Q000378:metabolism*; D050486:Serotonin Plasma Membrane Transport Proteins / Q000378:metabolism; D019966:Substance-Related Disorders / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*
chemical_list: D050486:Serotonin Plasma Membrane Transport Proteins; D012701:Serotonin; D018817:N-Methyl-3,4-methylenedioxyamphetamine