Effects of ecstasy (MDMA) on the brain in abstinent users: Initial observations with diffusion and perfusion MR imaging

PURPOSE: To evaluate the effects of 3,4-methylenedioxymethamphetamine (MDMA, ecstasy) on the human brain by using diffusion and perfusion magnetic resonance (MR) imaging. MATERIALS AND METHODS: Eight abstinent ecstasy users and six ecstasy nonusers underwent diffusion and perfusion MR imaging. Apparent diffusion coefficient and relative cerebral volume maps were reconstructed. Differences in apparent diffusion coefficient values and relative cerebral volume ratios between the groups were analyzed with the Mann-Whitney-Wilcoxon test. The relationship between apparent diffusion coefficient and relative cerebral volume and the extent of previous ecstasy use was investigated with Spearman rank correlation. RESULTS: Apparent diffusion coefficient values (0.84 vs 0.65 X 10(-5) cm(2)/sec, P < .025) and relative cerebral volume ratios (1.22 vs 1.01, P < .025) were significantly higher in the globus pallidus of ecstasy users compared with nonusers, respectively. Increases in pallidal relative cerebral volume were positively correlated with the extent of previous use of ecstasy (rho = 0.73, P < .04). CONCLUSION: Ecstasy use is associated with tissue changes in the globus pallidus. These findings are in agreement with findings in case reports, suggesting that the globus pallidus is particularly sensitive to the effects of ecstasy.