title: Potential long-term effects of MDMA on the basal ganglia-thalamocortical circuit: a proton MR spectroscopy and diffusion-tensor imaging study.
abstract: OBJECTIVE
  To investigate the effects of 3,4-methylenedioxymethamphetamine (MDMA, commonly known as "ecstasy") on the alterations of brain metabolites and anatomic tissue integrity related to the function of the basal ganglia-thalamocortical circuit by using proton magnetic resonance (MR) spectroscopy and diffusion-tensor MR imaging.
  
  
  METHODS
  This study was approved by a local institutional review board, and written informed consent was obtained from all subjects. Thirty-one long-term (>1 year) MDMA users and 33 healthy subjects were enrolled. Proton MR spectroscopy from the middle frontal cortex and bilateral basal ganglia and whole-brain diffusion-tensor MR imaging were performed with a 3.0-T system. Absolute concentrations of metabolites were computed, and diffusion-tensor data were registered to the International Consortium for Brain Mapping template to facilitate voxel-based group comparison.
  
  
  RESULTS
  The mean myo-inositol level in the basal ganglia of MDMA users (left: 4.55 mmol/L ± 2.01 [standard deviation], right: 4.48 mmol/L ± 1.33) was significantly higher than that in control subjects (left: 3.25 mmol/L ± 1.30, right: 3.31 mmol/L ± 1.19) (P < .001). Cumulative lifetime MDMA dose showed a positive correlation with the levels of choline-containing compounds (Cho) in the right basal ganglia (r = 0.47, P = .02). MDMA users also showed a significant increase in fractional anisotropy (FA) in the bilateral thalami and significant changes in water diffusion in several regions related to the basal ganglia-thalamocortical circuit as compared with control subjects (P < .05; cluster size, >50 voxels).
  
  
  CONCLUSIONS
  Increased myo-inositol and Cho concentrations in the basal ganglia of MDMA users are suggestive of glial response to degenerating serotonergic functions. The abnormal metabolic changes in the basal ganglia may consequently affect the inhibitory effect of the basal ganglia to the thalamus, as suggested by the increased FA in the thalamus and abnormal changes in water diffusion in the corresponding basal ganglia-thalamocortical circuit.
authors.affiliation: Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, 325 Cheng-Kung Rd, NeiHu, Taipei, Taiwan 114, Republic of China.
authors.forename: Hua-Shan
authors.initials: HS
authors.lastname: Liu
authors.forename: Ming-Chung
authors.initials: MC
authors.lastname: Chou
authors.forename: Hsiao-Wen
authors.initials: HW
authors.lastname: Chung
authors.forename: Nai-Yu
authors.initials: NY
authors.lastname: Cho
authors.forename: Shih-Wei
authors.initials: SW
authors.lastname: Chiang
authors.forename: Chao-Ying
authors.initials: CY
authors.lastname: Wang
authors.forename: Hung-Wen
authors.initials: HW
authors.lastname: Kao
authors.forename: Guo-Shu
authors.initials: GS
authors.lastname: Huang
authors.forename: Cheng-Yu
authors.initials: CY
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001479:Basal Ganglia / Q000187:drug effects* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods*; D002540:Cerebral Cortex / Q000187:drug effects* / Q000503:physiopathology; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007294:Inositol / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000633:toxicity*; D010725:Phosphocreatine / Q000378:metabolism; D018709:Statistics, Nonparametric; D013788:Thalamus / Q000187:drug effects* / Q000503:physiopathology
chemical_list: D010725:Phosphocreatine; D001224:Aspartic Acid; D007294:Inositol; C000179:N-acetylaspartate; D018817:N-Methyl-3,4-methylenedioxyamphetamine; D003401:Creatine; D002794:Choline