Psychopharmacology

, Volume 179, Issue 3, pp 620–628 | Cite as

Effect of ecstasy use on neuropsychological function: a study in Hong Kong

Original Investigation

Abstract

Rationale

Previous studies on the effects of ecstasy on neuropsychological performance have often recruited small sample sizes.

Objectives

The present study was conducted to validate previous findings regarding the effects of ecstasy consumption on neuropsychological performance.

Method

A comprehensive neuropsychological investigation was conducted in 100 abstinent ecstasy users and 100 matched non-user counterparts on standardized measures of working memory, verbal and non-verbal memory, verbal and figural fluency, and selective and switching attention.

Results

Abstinent ecstasy users were impaired on verbal and non-verbal memory, complex attention, and verbal fluency, but not on working memory, relative to their non-user counterparts. Of particular interest was the fact that abstinent ecstasy users performed better on figural fluency relative to their non-user counterparts. In addition, only cumulative ecstasy consumption correlated with neuropsychological performances among abstinent ecstasy users. Canonical discriminant analysis yielded verbal and visual memory, switching attention, and verbal fluency as potential core neuropsychological variables for differentiating abstinent ecstasy users from non-users. Levels of depression and general non-verbal intelligence, as measured by the Beck Depression Inventory and the test of non-verbal Intelligence, respectively, were not likely to affect these findings, since these measures were matched between ecstasy users and non-users.

Conclusions

These findings suggest that previous ecstasy consumption can affect a wide range of neuropsychological performance, though figural fluency may be subsequently enhanced as a result of the phenomenon of “cortical disinhibition.” Furthermore, measures of verbal and visual memory, switching attention, and verbal fluency may be particularly useful for differentiating abstinent ecstasy users from non-users.

Keywords

3,4-Methylenedioxymethamphetamine Ecstasy Neuropsychological function Cognitive function Drug 

References

  1. Aguirre N, Frechilla D, Garcia-Osta A, Lasheras B, Del Rio J (1997) Differential regulation by methylenedioxy-methamphetamine of 5-hydroxytryptamine 1A receptor density and mRNA expression in rat hippocampus, frontal cortex, and brainstem. J Neurochem 68:1099–1105Google Scholar
  2. Akshoomoff N, Delis DC, Kiefner MG (1989) Block constructions of chronic alcoholic and unilateral brain-damaged patients: a test of the right hemisphere vulnerability hypothesis of alcoholism. Arch Clin Neuropsychol 4:275–281CrossRefGoogle Scholar
  3. Battaglia G, Yeh SY, O’Hearn E et al. (1987) 3,4-methylenedioxymethamphetamine and 3,4-methylenedioxyamphetamine destroy serotonin terminals in rat brain: quantifications of neurodegeneration by measurement of [3H] paroxetine-labelled serotonin uptake sites. J Pharmacol Exp Ther 242:911–916Google Scholar
  4. Battaglia G, Yeh SY, De Souza EB (1988) MDMA-induced neurotoxicity: parameters of degeneration and recovery of brain serotonin neurons. Pharmacol Biochem Behav 29:269–274CrossRefGoogle Scholar
  5. Beck AT (1987) Beck depression inventory. Psychological Corporation, Tex.Google Scholar
  6. Benton AL, Hamsher K, Varney NR, Spreen O (1983) Contributions to neuropsychological assessment. Oxford University Press, New YorkGoogle Scholar
  7. Bhattachary S, Powell JH (2001) Recreational use of 3,4-methylenedioxymethamphetamine (MDMA) or “ecstasy”: evidence for cognitive impairment. Psychol Med 31:647–658CrossRefPubMedGoogle Scholar
  8. Bolla KI, McCann UD, Ricaurte GA (1998) Memory impairment in abstinent MDMA (“ecstasy”) users. Neurology 51:1532–1537PubMedGoogle Scholar
  9. Bowden SC (1988) Learning in young alcoholics. J Clin Exp Neuropsychol 10:157–168Google Scholar
  10. Braff DL, Silverton L, Saccuzzo DP, Janowsky DS (1981) Impaired speed of visual information processing in marijuana intoxication. Am J Psychiatry 138:613–617Google Scholar
  11. Brown L, Sherbenou RJ, Johnsen SK (1997) Test of non-verbal intelligence: a language-free measure of cognitive ability, 3rd edn. Pro-ed, Tex.Google Scholar
  12. Chang L, Grob CS, Ernst T, Itti L, Mishkin FS, Jose-Melchor R, Poland RE (2000) Effect of ecstasy [3,4-methylenedioxymethamphetamine (MDMA)] on cerebral blood flow: a co-registered SPECT and MRI study. Psychiatry Res 98:15–28Google Scholar
  13. Cheng W-C, Poon N-L, Chan M-F (2003) Chemical profiling of 3,4-methylenedioxymethamphetamine (MDMA) tablets seized in Hong Kong. J Forens Sci 48(6):1249–1259Google Scholar
  14. Croft RJ, Mackay AJ, Mills ATD, Gruzelier JGH (2001) The relative contributions of ecstasy and cannabis to cognitive impairment. Psychopharmacology 153:373–379CrossRefGoogle Scholar
  15. Curran HV, Travill RA (1997) Mood and cognitive effects of ±3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”): week-end “high” followed by mid-week low. Addiction 92:821–831CrossRefPubMedGoogle Scholar
  16. D’Elia LF, Satz P, Uchiyama CL, White T (1996) Color trails test: professional manual. Psychological Assessment Resources, Fla.Google Scholar
  17. Dafters RI, Duffy F, O’Donnell PJ, Bouquet C (1999) Level of use of 3,4-methylenedioxymethamphetamine (MDMA or ecstasy) in human correlates with EEG power and coherence. Psychopharmacology 145:82–90CrossRefPubMedGoogle Scholar
  18. Darley CF, Tinklenberg JR, Roth WT, Holliste LE, Atkinson RC (1973) Influence of marijuana on storage and retrieval processes in memory. Mem Cogn 1:196–200Google Scholar
  19. De Renzi E, Faglioni P, Nichelli P, Pignattari L (1984) Intellectual and memory impairment in moderate and heavy drinkers. Cortex 20:525–533Google Scholar
  20. Fischer C, Hatzidimitriou G, Wlos J, Katz J, Ricaurte G (1995) Reorganization of ascending 5-HT axon projections in animals previously exposed to the recreational drug, 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”). J Neurosci 15:5426–5485Google Scholar
  21. Gamma A, Buck A, Berthold T, Hell D, Vollenweider FX (2000) 3,4-Methylenedioxymethamphetamine (MDMA) modulates cortical and limbic brain activity as measured by [H215O]-PET in healthy humans. Neuropsychopharmacology 23:388–395CrossRefGoogle Scholar
  22. Gouzoulis-Mayfrank E, Daumann J, Tuchtenhagen F, Pelz S, Becker S, Kunert H-J, Fimm B, Sass H (2000) Impaired cognitive performance in drug free users of recreational ecstasy (MDMA). J Neurol Neurosurg Psychiatry 68:719–725CrossRefPubMedGoogle Scholar
  23. Grant I (1987) Alcohol and the brain: neuropsychological correlates. J Consult Clin Psychol 55:310–324CrossRefGoogle Scholar
  24. Grant I, Adams KM, Carlin AS et al. (1978a) The collaborative neuropsychological study of polydrug users. Arch Gen Psychiatry 35:1063–1064Google Scholar
  25. Grant I, Adams KM, Carlin AS et al. (1978b) Neuropsychological effects of polydrug abuse. In: Wesson DR, Carlin AS, Adams KM, Beschner G (eds) Polydrug abuse. Academic, New YorkGoogle Scholar
  26. Hatzidimitriou G, McCann DU, Ricaurte G (1999) Altered serotonin innervation patterns in the forebrain of monkeys treated with ±3,4-methylenedioxymethamphetamine seven years previously: factors influencing abnormal recovery. J Neurosci 19:5096–5107PubMedGoogle Scholar
  27. Kapur N, Butters N (1977) Visuoperceptive impairments in long-term alcoholics and alcoholics with Korsakoff’s psychosis. J Stud Alcohol 38:2025–2035Google Scholar
  28. Lee TMC, Chan CCH (2000a) Are trail making and color trails tests of equivalent constructs? J Clin Exp Neuropsychol 22:529–534CrossRefGoogle Scholar
  29. Lee TMC, Chan CCH (2000b) Stroop interference in Chinese and English. J Clin Exp Neuropsychol 22:465–471CrossRefGoogle Scholar
  30. Lee TMC, Yip JTH, Jones-Gotman M (2002a) Memory deficits after resection from left or right anterior temporal lobe in humans: a meta-analytic review. Epilepsia 43:283–291CrossRefGoogle Scholar
  31. Lee TMC, Yuen KSL, Chan CCH (2002b) Normative data for neuropsychological measures of fluency, attention, and memory measures for Hong Kong Chinese. J Clin Exp Neuropsychol 24:615–632CrossRefGoogle Scholar
  32. Lezak MD (1979) Recovery of memory and learning functions following traumatic brain injury. Cortex 15:63–70Google Scholar
  33. London ED, Ernst M, Grant S, Bonson K, Weinstein A (2000) Orbitofrontal cortex and human drug abuse: functional imaging. Cereb Cortex 10:334–342CrossRefPubMedGoogle Scholar
  34. MacVane J, Butters N, Montgomery K, Farber J (1982) Cognitive functioning in men social drinkers. J Stud Alcohol 43:81–95Google Scholar
  35. Majdan A, Sziklas V, Jones-Gotman M (1996) Performance of healthy subjects and patients with resection from the anterior temporal lobe on matched tests of verbal and visuoperceptual learning. J Clin Exp Neuropsychol 18:416–430Google Scholar
  36. McCaffrey RJ, Krahula MM, Heimberg RG et al. (1988) A comparison of the Trail Making Test, Symbol Digit Modalities Test, and the Hooper Visual Organization Test in an inpatient substance abuse population. Arch Clin Neuropsychol 3:181–187CrossRefGoogle Scholar
  37. McCann UD, Ridenour A, Shaham Y, Ricaurte GA (1994) Serotonin neurotoxicity after (±)3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”): a controlled study in humans. Neuropsychopharmacology 10:129–138Google Scholar
  38. McCann UD, Szabo Z, Scheffel U, Dannals RF, Ricaurte GA (1998) Positron emission tomographic evidence of toxic effect of MDMA (“ecstasy”) on brain serotonin neurons in human beings. Lancet 352:1433–1437CrossRefPubMedGoogle Scholar
  39. McCann UD, Mertl M, Eligulashvili V, Ricaurte GA (1999) Cognitive performance in (±)3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) users: a controlled study. Psychopharmacology 143:417–425CrossRefPubMedGoogle Scholar
  40. Mittenberg W, Motta S (1993) Effects of chronic cocaine abuse on memory and learning. Arch Clin Neuropsychol 8:477–483CrossRefGoogle Scholar
  41. Molliver ME, Berger UV, Mamounas LA et al. (1990) Neurotoxicity of MDMA and related compounds. Ann N Y Acad Sci 600:640–646Google Scholar
  42. Morgan MJ (1998) Recreational use of “ecstasy” (MDMA) is associated with elevated impulsivity. Neuropsychopharmacology 19:252–264CrossRefPubMedGoogle Scholar
  43. Morgan MJ (1999) Memory deficits associated with recreational use of “ecstasy” (MDMA). Psychopharmacology 141:30–36CrossRefPubMedGoogle Scholar
  44. Morgan MJ (2000) Ecstasy (MDMA): a review of its possible persistent psychological effects. Psychopharmacology 152:230–248CrossRefPubMedGoogle Scholar
  45. O’Hearn EG, Battaglia G, De Souza EB et al. (1988) Methylenedioxyamphetamine (MDA) and methylenedioxymethamphetamine (MDMA) cause selective ablation of serotonergic axon terminals in forebrain: immunocytochemical evidence for neurotoxicity. J Neurosci 8:2788–2803Google Scholar
  46. Obrocki J, Buchert R, Väterlein O, Thomasius R, Beyer W (1999) Ecstasy—long term effects on the human central nervous system revealed by positron emission tomography. Br J Psychiatry 175:186–188Google Scholar
  47. Parker ES, Noble EP (1977) Alcohol consumption and cognitive functioning in social drinkers. J Stud Alcohol 38:1224–1232Google Scholar
  48. Parrott AC (2000) Human research on MDMA (3,4-methylene-dioxymethamphetamine) neurotoxicity: cognitive and behavioural indices of change. Neuropsychobiology 42:17–24CrossRefGoogle Scholar
  49. Parrott AC (2001) Human psychopharmacology of ecstasy (MDMA): a review of 15 years of empirical research. Hum Psychopharmacol 16:557–577CrossRefGoogle Scholar
  50. Parrott AC, Lasky J (1998) Ecstasy (MDMA) effects upon mood and cognition: before, during and after a Saturday night dance. Psychopharmacology 139:261–268CrossRefGoogle Scholar
  51. Parsons OA, Farr SP (1981) The neuropsychology of alcohol and drug use. In: Filskov SB, Boll TJ (eds) Handbook of clinical neuropsychology. Wiley-Interscience, New YorkGoogle Scholar
  52. Regard M (1981) Cognitive rigidity and flexibility: a neuropsychological study. Unpublished PhD dissertation, University of Victoria, British ColumbiaGoogle Scholar
  53. Reneman L, Booij J, Schmand B, van den Brink W, Gunning B (2000) Memory disturbances in “ecstasy” users are correlated with an altered brain serotonin neurotransmission. Psychopharmacology 148:322–324CrossRefGoogle Scholar
  54. Reneman L, Booij J, de Bruin K, Reitsma JB, de Wolff FA, Gunning WB, den Heeten GJ, van den Brink W (2001) Effects of dose, sex, and long-term abstention from use on toxic effects of MDMA (ecstasy) on brain serotonin neurons. Lancet 358 (9296):1864–1869CrossRefGoogle Scholar
  55. Rey A (1959) Sollicitation de la mémoire de fixation par des mots et des objets presentés simultanément. Arch Psychol 37:126–139Google Scholar
  56. Ricaurte GA, Bryan G, Strauss L et al (1985) Hallucinogenic amphetamine selectively destroys brain serotonin nerve terminals. Science 22:986–988Google Scholar
  57. Ricaurte GA, DeLanney LE, Irwin I, Langston JW (1988a) Toxic effects of 3,4-methylenedioxymethamphetamine (MDMA) on central serotonergic neurons in the primate: importance of route and frequency of drug administration. Brain Res 446:165–168CrossRefGoogle Scholar
  58. Ricaurte GA, Forno LS, Wilson MA et al. (1988b) MDMA selectively damages central serotonergic neurons in the primate. JAMA 260:51–55CrossRefGoogle Scholar
  59. Ricaurte GA, Martello AL, Katz JL et al. (1992) Lasting effects of MDMA on central serontonergic neurons in nonhuman primates: neurochemical observations. J Pharmacol Exp Ther 261:616–622PubMedGoogle Scholar
  60. Rodgers J (2000) Cognitive performance amongst recreational users of “ecstasy.” Psychopharmacology 151:19–24CrossRefGoogle Scholar
  61. Ruff RM (1996) Ruff figural fluency test: professional manual. Psychological Assessment Resources, Fla.Google Scholar
  62. Ruff RM, Allen CC, Farrow CE, Niemann H, Wylie T (1994) Figural fluency: differential impairment in patients with left versus right frontal-lobe lesions. Arch Clin Neuropsychol 9:41–55CrossRefGoogle Scholar
  63. Ryan C, Butters N (1986) Neuropsychology of alcoholism. In: Wedding D, Horton AM Jr, Webster JS (eds) The neuropsychology handbook. Springer, New YorkGoogle Scholar
  64. Schmidt CJ (1987) Acute administration of methylenedioxymethamphetamine: comparison with the neurochemical effects of its N-desmethyl and N-ethyl analogs. Eur J Pharmacol 136:81–88CrossRefGoogle Scholar
  65. Schmidt CJ, Wu L, Lovenberg W (1986) Methylenedioxymethamphetamine: a potentially neurotoxic amphetamine analog. Eur J Pharmacol 124:175–178CrossRefGoogle Scholar
  66. Shelton MD, Parsons OA, Leber WR (1984) Verbal and visuospatial performance in male alcoholics: a test of the premature-aging hypothesis. J Consult Clin Psychol 52:200–206CrossRefGoogle Scholar
  67. Smith A (1982) Symbol digit modalities test (SDMT): manual (revised). Western Psychological Services, Los AngelesGoogle Scholar
  68. Solowij N, Hall W, Lee N (1992) Recreational MDMA use in Sydney: a profile of “ecstasy” users and their experiences with the drug. Br J Addict 87:1161–1172Google Scholar
  69. Stone DM, Stahl DS, Hanson GL, Gibb JW (1986) The effects of 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-methylenedioxyamphetamine on monoaminergic systems in the rat brain. Eur J Pharmacol 128:41–48CrossRefGoogle Scholar
  70. Sweeney JA, Meisel L, Walsh VL, Castro-vinci D (1989) Assessment of cognitive functioning in poly-substance abusers. J Clin Psychol 45:346–351Google Scholar
  71. Talland GA (1965) Deranged memory. Academic, New YorkGoogle Scholar
  72. Tarter RE (1976) Neuropsychological investigations of alcoholism. In: Goldstein G, Neuringer C (eds) Empirical studies of alcoholism. Ballinger, Cambridge, Mass.Google Scholar
  73. Taylor EM (1959) Psychological appraisal of children with cerebral deficits. Harvard University Press, Cambridge, Mass.Google Scholar
  74. Thomasius R, Petersen K, Buchert R, Andresen B, Zapletalova P, Wartberg L, Nebeling B, Schmoldt A (2003) Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users. Psychopharmacology 167:85–96Google Scholar
  75. Tucha O, Smely C, Lange KW (1999) Verbal and figural fluency in patients with mass lesions of the left or right frontal lobes. J Clin Exp Neuropsychol 21:229–236CrossRefGoogle Scholar
  76. Verkes RJ, Gijsman HJ, Pieters MSM, Schoemaker RC, de Visser S, Kuijpers M, Pennings EJM, de Bruin D, Van de Wijngaart G, Van Gerven JMA, Cohen AF (2001) Cognitive performance and serotonergic function in users of ecstasy. Psychopharmacology 153:196–202CrossRefPubMedGoogle Scholar
  77. Walsh KW (1985) Understanding brain damage. Churchill-Livingstone, EdinburghGoogle Scholar
  78. Wareing M, Fisk JE, Murphy PN (2000) Working memory deficits in current and previous users of MDMA (“ecstasy”). Br J Psychol 91:181–188CrossRefPubMedGoogle Scholar
  79. Washton AM, Stone NS (1984) The human cost of chronic cocaine use. Med Asp Hum Sex 18:36–44Google Scholar
  80. Wechsler D (1987) Wechsler memory scale manual. Psychological Corporation, Tex.Google Scholar
  81. Weingartner H, Galanter M, Lemberger L et al. (1972) Effect of marijuana and synthetic Δ9-THC on information processing. In: Proceedings of the 80th Annual Convention of the American Psychological Association, pp 813–814Google Scholar
  82. Wilson MA, Ricaurte GA, Molliver ME (1989) Distinct morphologic classes of serotonergic axons in primates exhibit differential vulnerability to the psychotropic drug 3,4-methylene amphetamine. Neuroscience 28:121–137CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  1. 1.Aphasia, Dyslexia, and Dysgraphia Laboratory, Division of Speech and Hearing SciencesThe University of Hong KongHong KongChina
  2. 2.Neuropsychology Laboratory, Department of PsychologyThe University of Hong KongHong KongChina
  3. 3.Institute of Clinical Neuropsychology, MacLehose Medical Rehabilitation CentreThe University of Hong KongHong KongChina
  4. 4.Neuropsychology LaboratoryThe University of Hong KongHong KongChina

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