There is no convincing evidence that moderate MDMA use is associated with structural or functional brain alterations in neuroimaging measures .
MDMA ( " ecstasy " ) is widely used as a recreational drug , although there has been some debate about its neurotoxic effects in humans .
However , most studies have investigated subjects with heavy use patterns , and the effects of transient MDMA use are unclear .
In this review , we therefore focus on subjects with moderate use patterns , in order to assess the evidence for harmful effects .
A Prospective Cohort Study on Sustained Effects of Low-Dose Ecstasy Use on the Brain in New Ecstasy Users
It is debated whether ecstasy use has neurotoxic effects on the human brain and what the effects are of a low dose of ecstasy use . We prospect ively studied sustained effects ( > 2 weeks abstinence ) of a low dose of ecstasy on the brain in ecstasy-naive volunteers using a combination of advanced MR techniques and self-report question naires on psychopathology as part of the NeXT ( Netherl and s XTC Toxicity ) study . Outcomes of  proton magnetic resonance spectroscopy ( 1H-MRS ) , diffusion tensor imaging ( DTI ) , perfusion-weighted imaging ( PWI ) , and question naires on depression , impulsivity , and sensation seeking were compared in 30 subjects ( 12 M , 21.8±3.1 years ) in two sessions before and after first ecstasy use ( 1.8±1.3 tablets ) . Interval between baseline and follow-up was on average 8.1±6.5 months and time between last ecstasy use and follow-up was 7.7±4.4 weeks . Using 1H-MRS , no significant changes were observed in metabolite concentrations of N-acetylaspartate ( NAA ) , choline ( Cho ) , myo-inositol ( mI ) , and creatine ( Cr ) , nor in ratios of NAA , Cho , and mI relative to Cr . However , ecstasy use was followed by a sustained 0.9 % increase in fractional anisotropy ( FA ) in frontoparietal white matter , a 3.4 % decrease in apparent diffusion ( ADC ) in the thalamus and a sustained decrease in relative regional cerebral blood volume ( rrCBV ) in the thalamus ( −6.2 % ) , dorsolateral frontal cortex ( −4.0 % ) , and superior parietal cortex ( −3.0 % ) ( all significant at p<0.05 , paired t-tests ) . After correction for multiple comparisons , only the rrCBV decrease in the dorsolateral frontal cortex remained significant . We also observed increased impulsivity ( + 3.7 % on the Barratt Impulsiveness Scale ) and decreased depression ( −28.0 % on the Beck Depression Inventory ) in novel ecstasy users , although effect sizes were limited and clinical relevance question able . As no indications were found for structural neuronal damage with the currently used techniques , our data do not support the concern that incidental ecstasy use leads to extensive axonal damage . However , sustained decreases in rrCBV and ADC values may indicate that even low ecstasy doses can induce prolonged vasoconstriction in some brain areas , although it is not known whether this effect is permanent . Additional studies are needed to replicate these findings
There is no convincing evidence that moderate MDMA use is associated with structural or functional brain alterations in neuroimaging measures .
MDMA ( " ecstasy " ) is widely used as a recreational drug , although there has been some debate about its neurotoxic effects in humans .
However , most studies have investigated subjects with heavy use patterns , and the effects of transient MDMA use are unclear .
In this review , we therefore focus on subjects with moderate use patterns , in order to assess the evidence for harmful effects .