Study reveals how ecstasy acts on brain, hints at therapeutic uses

January 17, 2014

Science Daily/Imperial College London

Brain imaging experiments have revealed for the first time how ecstasy produces feelings of euphoria in users.

Results of the study at Imperial College London, parts of which were televised in Drugs Live on Channel 4 in 2012, have now been published in the journal Biological Psychiatry.

The findings hint at ways that ecstasy, or MDMA, might be useful in the treatment of anxiety and post-traumatic stress disorder (PTSD).

MDMA has been a popular recreational drug since the 1980s, but there has been little research on which areas of the brain it affects. The new study is the first to use functional magnetic resonance imaging (fMRI) on resting subjects under its influence.

Twenty-five volunteers underwent brain scans on two occasions, one after taking the drug and one after taking a placebo, without knowing which they had been given.

The results show that MDMA decreases activity in the limbic system -- a set of structures involved in emotional responses. These effects were stronger in subjects who reported stronger subjective experiences, suggesting that they are related.

Communication between the medial temporal lobe and medial prefrontal cortex, which is involved in emotional control, was reduced. This effect, and the drop in activity in the limbic system, are opposite to patterns seen in patients who suffer from anxiety.

MDMA also increased communication between the amygdala and the hippocampus. Studies on patients with PTSD have found a reduction in communication between these areas.

The project was led by David Nutt, the Edmond J. Safra Professor of Neuropsychopharmacology at Imperial College London, and Professor Val Curran at UCL.

Dr Robin Carhart-Harris from the Department of Medicine at Imperial, who performed the research, said: "We found that MDMA caused reduced blood flow in regions of the brain linked to emotion and memory. These effects may be related to the feelings of euphoria that people experience on the drug."

Professor Nutt added: "The findings suggest possible clinical uses of MDMA in treating anxiety and PTSD, but we need to be careful about drawing too many conclusions from a study in healthy volunteers. We would have to do studies in patients to see if we find the same effects."

MDMA has been investigated as an adjunct to psychotherapy in the treatment of PTSD, with a recent pilot study in the US reporting positive preliminary results.

As part of the Imperial study, the volunteers were asked to recall their favourite and worst memories while inside the scanner. They rated their favourite memories as more vivid, emotionally intense and positive after MDMA than placebo, and they rated their worst memories less negatively. This was reflected in the way that parts of the brain were activated more or less strongly under MDMA. These results were published in the International Journal of Neuropsychopharmacology.

Dr Carhart-Harris said: "In healthy volunteers, MDMA seems to lessen the impact of painful memories. This fits with the idea that it could help patients with PTSD revisit their traumatic experiences in psychotherapy without being overwhelmed by negative emotions, but we need to do studies in PTSD patients to see if the drug affects them in the same way."

https://www.sciencedaily.com/releases/2014/01/140117103941.htm

Long-term users of ecstasy risk structural brain damage

April 15, 2011

Science Daily/BMJ-British Medical Journal

Long term users of the popular recreational drug ecstasy (MDMA) risk structural brain damage, suggests preliminary research published online in the Journal of Neurology, Neurosurgery and Psychiatry.

Other research has suggested that people who use ecstasy develop significant memory problems, so the Dutch researchers wanted to find out if there was any clinical evidence of structural changes in the brain to back this up.

They focused on the hippocampus, which is the area of the brain responsible for long term memory.

They measured the volume of the hippocampus using MRI scans in 10 young men in their mid 20s who were long term users of ecstasy and seven of their healthy peers in their early 20s with no history of ecstasy use.

Although the ecstasy group had used more amphetamine and cocaine than their peers, both sets of young men had used similar amounts of recreational drugs, bar ecstasy, and drank alcohol regularly.

The ecstasy group had not been using on average for more than two months before the start of the study, but had taken an average of 281 ecstasy tablets over the preceding six and a half years.

The MRI scans showed that hippocampal volume in this group was 10.5% smaller than that of their peers, and the overall proportion of grey matter was on average 4.6% lower, after adjusting for total brain volume.

This indicates that the effects of ecstasy may not be restricted to the hippocampus alone, say the authors

"Taken together, these data provide preliminary evidence suggesting that ecstasy users may be prone to incurring hippocampal damage, following chronic use of this drug," they write.

They add that their findings echo those of other researchers who have reported acute swelling and subsequent atrophy of hippocampal tissue in long term ecstasy users.

And they point out: "Hippocampal atrophy is a hallmark for diseases of progressive cognitive impairment in older patients, such as Alzheimer's disease."

https://www.sciencedaily.com/releases/2011/04/110406192435.htm