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Scientific Papers - 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]ß-CIT SPECT

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PARTICIPANTS
Presenter
Maartje De Win MD  
Abstract Co-Author
Gerry Jager MS  
Liesbeth Reneman MD  
Jan Booij MD,PhD  
Wim van den Brink MD,PhD  
Gerard Den Heeten MD, PhD  
et al  
  CODE: SSE15-02
  SESSION: Neuroradiology/Head and Neck (Brain: Toxic, Metabolic)
  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]ß-CIT SPECT
 
 
  DATE: Monday, November 27 2006
  START TIME: 03:10 PM
  END TIME: 03:20 PM
  LOCATION: N227



  DISCLOSURES
  M.D. - Nothing to disclose.  
  G.J. - Nothing to disclose.  
  L.R. - Nothing to disclose.  
  J.B. - Nothing to disclose.  
  W.v. - Nothing to disclose.  
  G.D. - Nothing to disclose.  
  .e.  

 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.
  
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