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From the Department of Neurology (Drs. Bolla and Ricaurte), Johns Hopkins Medical Institutions, Baltimore; and the Unit on Anxiety (Dr. McCann), Biological Psychiatry Branch, National Institute of Mental Health, Bethesda, MD.
Address correspondence and reprint requests to Dr. Karen I. Bolla, Johns Hopkins Bayview Medical Center, Department of Neurology, 4940 Eastern Ave., Baltimore, MD 21224.
Background: Methylenedioxymethamphetamine (MDMA, or "Ecstasy") is a popular recreational drug of abuse that is known to damage brain serotonergic neurons in animals and possibly humans. Few functional consequences of MDMA-induced serotonin (5-HT) neurotoxicity have been identified, either in animals or humans. This study sought to determine whether individuals with a history of extensive MDMA use showed evidence of memory impairment, because brain serotonin has been implicated in mnemonic function.
Method: The authors compared 24 abstinent MDMA users and 24 control subjects on several standardized tests of memory, after matching subjects for age, gender, educational level, and vocabulary score (a surrogate of verbal intelligence). The authors also explored correlations between changes in memory function and decrements in CSF 5-hydroxyindoleacetic acid (5-HIAA), which serves as a marker of central 5-HT neural function.
Results: Greater use of MDMA (total milligrams per month) was associated with greater impairment in immediate verbal memory (p < 0.02) and delayed visual memory (p < 0.06). Furthermore, lower vocabulary scores were associated with stronger dose-related effects, with men having greater dose-related deficits than women. Lastly, lower concentrations of CSF 5-HIAA were associated with poorer memory performance.
Conclusion: Abstinent MDMA users have impairment in verbal and visual memory. The extent of memory impairment correlates with the degree of MDMA exposure and the reduction in brain 5-HT, as indexed by CSF 5-HIAA.
Supported by National Institutes of Health (NIH) grants PHS R01 DA06275, DA05707, DA05938, DA10217, and K02 DA00206 (G.A.R.); by National Institute of Mental Health-Intramural Research Program support (U.D.M.); and by a General Clinical Research Center grant (M01 RR02719, National Center for Research Resources, NIH) to Johns Hopkins Bayview Medical Center, Baltimore, MD.
Received May 7, 1998. Accepted in final form August 20, 1998.
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