title: Elevated impulsivity and impaired decision-making cognition in heavy users of MDMA ("Ecstasy").
abstract: BACKGROUND
  In animal studies, the common club drug 3,4-methylendioxymethamphetamine (MDMA, "Ecstasy") consistently caused a prolonged loss of presynaptic serotonergic neurons, and evidence suggests that MDMA consumption may also affect the human serotonergic system. Serotonin (5-HT) has been implicated in the regulation of impulsivity and such executive functions as decision-making cognition. In fact, MDMA users have shown elevated impulsivity in two studies, but little is known about decision making in drug-free MDMA consumers.
  
  
  OBJECTIVE
  The aim of this study was to examine the cognitive neurotoxicity of MDMA with regard to behavioral impulsivity and decision-making cognition.
  
  
  METHODS
  Nineteen male, abstinent, heavy MDMA users; 19 male, abstinent cannabis users; and 19 male, drug-naïve controls were examined with the Matching Familiar Figures Test (MFFT) as well as with a Go/No-Go Task (GNG) for impulsivity and with a Gambling Task (GT) for executive functioning.
  
  
  RESULTS
  MDMA users showed significantly elevated impulsivity in the MFFT Impulsivity score (I-score), but not in commission errors of the GNG, compared with controls. Cannabis users did not yield altered impulsivity compared with controls. In the GT, MDMA users performed significantly worse than cannabis consumers and controls, whereas cannabis users exhibited the same decision-making capacity as controls. In addition, the I-score as well as the decision-making performance was correlated with measures of MDMA intake. The I-score and the decision-making performance were also correlated.
  
  
  CONCLUSIONS
  These results suggest that heavy use of MDMA may elevate behavioral impulsivity and impair decision-making cognition possibly mediated by a selective impairment of the 5-HT system.
authors.affiliation: Department of Psychiatry, University of Zurich, Lenggstrasse 31, CH-8008, Zürich, Switzerland. quednow@bli.unizh.ch
authors.forename: Boris B
authors.initials: BB
authors.lastname: Quednow
authors.forename: Kai-Uwe
authors.initials: KU
authors.lastname: Kühn
authors.forename: Christian
authors.initials: C
authors.lastname: Hoppe
authors.forename: Jens
authors.initials: J
authors.lastname: Westheide
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Irene
authors.initials: I
authors.lastname: Daum
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000209:etiology* / Q000523:psychology; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000523:psychology; D003657:Decision Making / Q000187:drug effects*; D005715:Gambling; D006213:Hallucinogens / Q000009:adverse effects*; D006801:Humans; D007175:Impulsive Behavior / Q000139:chemically induced*; D008297:Male; D002189:Marijuana Abuse / Q000523:psychology; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000009:adverse effects*; D011795:Surveys and Questionnaires
chemical_list: D006213:Hallucinogens; D018817:N-Methyl-3,4-methylenedioxyamphetamine