Functional Brain Imaging in Recreational Users of Ecstasy
Condition: Amphetamine-Related Disorders
MeSH terms: Amphetamine-Related Disorders
Study type: Observational

Summary: 
      Recreational use of "ecstasy" (MDMA; 3,4-methylenedioxymethamphetamine) is associated with
      long-lasting effects on metabolism in the human brain. The investigators propose to
      investigate whether chronic use of "ecstasy" is associated with impairment in motor skills
      and function of the dopaminergic system in recreational users of "ecstasy" compared with
      healthy volunteers. This will be done by scanning control subjects and "ecstasy" users at
      baseline and after performing on a motorbike riding computer game, while imaging dopamine in
      vivo with I123-IBZM (a D2 receptor radiotracer), using single photon emission computed
      tomography (SPECT).
    

Detailed description: 
      Recreational use of "ecstasy" (MDMA; 3, 4-Methylenedioxymethamphetamine) is associated with
      long-lasting effects on metabolism in the human brain. In particular, there is evidence of
      long-term damage to the brains' neurotransmitter serotonin (5-HT). It is also known that
      chronic use of Methamphetamine (which is similar in its chemical structure to "ecstasy") is
      linked to impaired cognitive and motor skills despite recovery of dopamine transporters
      (DAT). We have investigated whether chronic use of "ecstasy" is causing any impairment in
      motor skills and function of the dopaminergic system in recreational users of "ecstasy". In
      our preliminary study, we have scanned control subjects and "ecstasy" users, at baseline and
      after performing on a motorbike riding computer game while imaging dopamine in vivo with
      [123I] IBZM (a D2 receptor radiotracer) in Single Photon Emission Computed Tomography
      (SPECT). We showed:

        1. Lower measures of D2 at baseline in ecstasy users compared with control subjects, that
           means lower level of dopaminergic activity in "ecstasy" users.

        2. Significant displacement of [123I] IBZM by endogenous dopamine released during the game
           in healthy subjects unlike "ecstasy" users, that means that recreational users of
           "ecstasy" release much less natural dopamine.

        3. No difference between the groups in performance (reaction time) on riding the game after
           a year of recovery.

      Our results show preliminary evidence for dopaminergic deficiency in "ecstasy" users, a
      finding that has not been shown before. However, similar to other drugs of abuse, it is not
      known whether dopaminergic deficiency is the cause or consequence of the use of "ecstasy". We
      now propose to proceed to scan more recreational users of "ecstasy" in order to assess
      whether chronic use of "ecstasy" is associated with deficient dopaminergic neurotransmission
      in the brain.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Patients from treatment centers for drug abuse. Control subjects will be recruited from the
        general population.
      
Keywords: Ecstasy; D2 Dopamine Receptor; IBZM; MDMA