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Differential Effects of Ecstasy on Short-Term and Working Memory: A Meta-Analysis

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Abstract

Quantitative analysis of studies examining the effect of ecstasy on short-term and working memory in the verbal and visuo-spatial domain was undertaken. Thirty verbal short-term memory, 22 verbal working memory, 12 visuospatial short-term memory and 9 visuospatial working memory studies met inclusion criteria. Ecstasy users performed significantly worse in all memory domains, both in studies using drug-naïve controls and studies using polydrug controls. These results are consistent with previous meta-analytic findings that ecstasy use is associated with impaired short-term memory function. Lifetime ecstasy consumption predicted effect size in working memory but not in short-term memory. The current meta-analysis adds to the literature by showing that ecstasy use in humans is also associated with impaired working memory, and that this impairment is related to total lifetime ecstasy consumption. These findings highlight the long-term, cumulative behavioral consequences associated with ecstasy use in humans.

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References

  • Back-Madruga, C., Boone, K. B., Chang, L., Grob, C. S., Lee, A., Nations, H., et al. (2003). Neuropsychological effects of 3,4-methylenedioxymethamphetamine (MDMA or ecstasy) in recreational users. Clinical Neuropsychologist, 17, 446–459.

    PubMed  Google Scholar 

  • Bedi, G., & Redman, J. (2008). Ecstasy use and higher-level cognitive functions: weak effects of ecstasy after control for potential confounds. Psychological Medicine, 38, 1319–1330.

    Article  CAS  PubMed  Google Scholar 

  • Bhattachary, S., & Powell, J. H. (2001). Recreational use of 3, 4-methylenedioxymethamphetamine (MDMA) or ‘ecstasy’: evidence for cognitive impairment. Psychological Medicine, 31, 647–658.

    Article  CAS  PubMed  Google Scholar 

  • Cantor, J., Engle, R. W., & Hamilton, G. (1991). Short-term memory, working memory, and verbal abilities: how do they relate? Intelligence, 15, 229–246.

    Article  Google Scholar 

  • Capela, J. P., Carmo, H., Femião, F., Bastos, M. L., Meisel, A., & Carvalho, F. (2009). Molecular and cellular mechanisms of ecstasy-induced neurotoxicity: an overview. Molecular Neurobiology, 39, 210–271.

    Article  CAS  PubMed  Google Scholar 

  • Cohen, J. (1969). Statistical power analysis for the behavioral sciences. NY: Academic Press.

  • Cole, J. C., Michailidou, K., Jerome, L., & Sumnall, H. R. (2006). The effects of stereotype threat on cognitive function in ecstasy users. Journal of Psychopharmacology, 20, 518–525.

    Article  CAS  PubMed  Google Scholar 

  • Conway, A. R. A., Cowan, N., Bunting, M. F., Therriault, D. J., & Minkoff, S. R. B. (2002). A latent variable analysis of working memory capacity, short-term memory capacity, processing speed, and general fluid intelligence. Intelligence, 30, 163–183.

    Article  Google Scholar 

  • Croft, R. J., Mackay, A. J., Mills, A. T. D., & Gruzelier, J. G. H. (2001). The relative contributions of ecstasy and cannabis to cognitive impairment. Psychopharmacology, 153, 373–379.

    Article  CAS  PubMed  Google Scholar 

  • Curran, H. V. (2000). Is MDMA (‘Ecstasy’) neurotoxic in humans? An overview of evidence and of methodological problems in research. Neuropsychobiology, 42, 34–41.

    Article  CAS  PubMed  Google Scholar 

  • Dafters, R. I. (2006). Chronic ecstasy (MDMA) use is associated with deficits in taskswitching but not inhibition or memory updating executive functions. Drug and Alcohol Dependence, 83, 181–184.

    Article  CAS  PubMed  Google Scholar 

  • Daumann, J., Schnitker, R., Weidemann, J., Schnell, K., Thron, A., & Gouzoulis-Mayfrank, E. (2003). Neural correlates of working memory in pure and polyvalent ecstasy (MDMA) users. NeuroReport, 14, 1983–1987.

    Article  CAS  PubMed  Google Scholar 

  • de Sola, S., Tarancón, T., Peña-Casanova, J., Espadaler, J. M., Langohr, K., Poudevida, S., et al. (2008). Auditory event-related potentials (P3) and cognitive performance in recreational ecstasy polydrug users: evidence from a 12-month longitudinal study. Psychopharmacology, 200, 425–437.

    Article  CAS  PubMed  Google Scholar 

  • de Sola Llopis, S., Miguelez-Pan, M., Peña-Casanova, J., Poudevida, S., Farré, M., Pacifici, R., et al. (2008). Cognitive performance in recreational ecstasy polydrug users: a two-year follow-up study. Journal of Psychopharmacology, 22, 498–510.

    Article  PubMed  Google Scholar 

  • D’Esposito, M., Postle, B. R., Ballard, D., & Lease, J. (1999). Maintenance versus manipulation of information held in working memory: An event-related fMRI study. Brain and Cognition, 41, 66–86.

    Article  PubMed  Google Scholar 

  • Della Sala, S., Gray, C., Baddeley, A., Allamano, N., & Wilson, L. (1999). Pattern span: A tool for unwelding visuo-spatial memory. Neuropsychologia, 37, 1189–1199.

    Article  CAS  PubMed  Google Scholar 

  • Engle, R. W., Tuholski, S. W., Laughlin, J. E., & Conway, A. R. A. (1999). Working memory, short-term memory, and general fluid intelligence: a latent-variable approach. Journal of Experimental Psychology: General, 128, 309–331.

    Article  CAS  Google Scholar 

  • Fisk, J. E., & Montgomery, C. (2009). Evidence for selective executive function deficits in ecstasy/polydrug users. Journal of Psychopharmacology, 23, 40–50.

    Article  CAS  PubMed  Google Scholar 

  • Fisk, J. E., Montgomery, C., Murphy, P., & Wareing, M. (2004). Evidence for executive deficits among users of MDMA (Ecstasy). British Journal of Psychology, 95, 457–466.

    Article  PubMed  Google Scholar 

  • Fox, H. C., Parrott, A. C., & Turner, J. J. D. (2001). Ecstasy use: cognitive deficits related to dosage rather than self-reported problematic use of the drug. Journal of Psychopharmacology, 15, 273–281.

    Article  CAS  PubMed  Google Scholar 

  • Fox, H. C., McLean, A., Turner, J. J. D., Parrott, A. C., Rogers, R., & Sahakian, B. J. (2002). Neuropsychological evidence of a relatively selective profile of temporal dysfunction in drug-free MDMA (“ecstasy”) polydrug users. Psychopharmacology, 162, 203–214.

    Article  CAS  PubMed  Google Scholar 

  • Golding, J. F., Groome, D. H., Rycroft, N., & Denton, Z. (2007). Cognitive performance in light current users and ex-users of ecstasy (MDMA) and controls. The American Journal of Drug and Alcohol Abuse, 33, 301–307.

    Article  CAS  PubMed  Google Scholar 

  • Gouzoulis-Mayfrank, E., Daumann, J., Tuchtenhagen, F., Pelz, S., Becker, S., Kunert, H-J., et al. (2000). Impaired cognitive performance in drug free users of recreational ecstasy (MDMA). Journal of Neurology, Neurosurgery & Psychiatry, 68, 719–725.

    Article  CAS  Google Scholar 

  • Gouzoulis-Mayfrank, E., Thimm, B., Rezk, M., Hensen, G., & Daumann, J. (2003). Memory impairment suggests hippocampal dysfunction in abstinent ecstasy users. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 27, 819–827.

    Article  CAS  Google Scholar 

  • Green, A. R., Mechan, A. O., Elliott, J. M., O’Shea, E., & Colado, I. (2003). The pharmacology and clinical pharmacology of 3, 4-methylenedioxymethamphetamine (MDMA, “Ecstasy”). Pharmacological Reviews, 55, 463–508.

    Article  CAS  PubMed  Google Scholar 

  • Halpern, J. H., Pope, H. G., Jr., Sherwood, A. R., Barry, S., Hudson, J. I., & Yurgelun-Todd, D. (2004). Residual neuropsychological effects of illicit 3, 4-methylenedioxymethamphetamine (MDMA) in individuals with minimal exposure to other drugs. Drug and Alcohol Dependence, 75, 135–147.

    Article  CAS  PubMed  Google Scholar 

  • Hanson, K. L., & Luciana, M. (2004). Neurocognitive function in users of MDMA: the importance of clinically significant patterns of use. Psychological Medicine, 34, 229–246.

    Article  PubMed  Google Scholar 

  • Hatzidimitriou, G., McCann, U. D., & Ricaurte, G. A. (1999). Altered serotonin innervation patterns in the forebrain of monkeys treated with (6)3, 4-methylenedioxymethamphetamine seven years previously: factors influencing abnormal recovery. The Journal of Neuroscience, 19, 5096–5107.

    CAS  PubMed  Google Scholar 

  • Heffernan, T., Jarvis, H., Rodgers, J., Scholey, A. B., & Ling, J. (2001). Prospective memory, everyday cognitive failure and central executive function in recreational users of ecstasy. Human Psychopharmacology: Clinical and Experimental, 16(8), 607–612.

    Article  Google Scholar 

  • Kalechstein, A. D., De La Garza, R., II, Mahoney, J. J., III, Fantegrossi, W. E., & Newton, T. F. (2007). MDMA use and neurocognition: a meta-analytic review. Psychopharmacology, 189, 531–537.

    Article  CAS  PubMed  Google Scholar 

  • Kessels, R. P. C., van den Berg, E., Ruis, C., & Brands, A. M. A. (2008). The backward span of the Corsi block-tapping task and its association with the WAIS-III digit span. Assessment, 15, 426–434.

    Article  PubMed  Google Scholar 

  • Kirchner, W. K. (1958). Age differences in short-term retention of rapidly changing information. Journal of Experimental Psychology, 55, 352–358.

    Article  CAS  PubMed  Google Scholar 

  • Lamers, C. T. J., Bechara, A., Rizzo, M., & Ramaekers, J. G. (2006). Cognitive function and mood in MDMA/THC users, THC users and non-drug using controls. Journal of Psychopharmacology, 20, 302–311.

    Article  CAS  PubMed  Google Scholar 

  • Lau, J., Ioannidis, J. P. A., & Schmid, C. H. (1997). Quantitative synthesis in systematic reviews. Annals of Internal Medicine, 127, 820–826.

    CAS  PubMed  Google Scholar 

  • Laws, K. R., & Kokkalis, J. (2007). Ecstasy (MDMA) and memory function: a meta-analytic update. Human Psychopharmacology: Clinical and Experimental, 22, 381–388.

    Article  Google Scholar 

  • Lezak, M. (1995). Neuropsychological assessment (3rd ed.). New York: Oxford University Press.

    Google Scholar 

  • Luciana, M., Collins, P. F., & Depue, R. A. (1998). Opposing roles for dopamine and serotonin in the modulation of human spatial working memory functions. Cerebral Cortex, 8, 218–226.

    Article  CAS  PubMed  Google Scholar 

  • Luciana, M., Burgund, E. D., Berman, M., & Hanson, K. L. (2001). Effects of tryptophan loading on verbal, spatial and affective working memory functions in healthy adults. Journal of Psychopharmacology, 15, 219–230.

    Article  CAS  PubMed  Google Scholar 

  • McCann, U. D., Eligulashvili, V., & Ricaurte, G. A. (2000). (±)3, 4-methylenedioxymethamphetamine (‘Ecstasy’)-induced serotonin neurotoxicity: clinical studies. Neuropsychobiology, 42, 11–16.

    Article  CAS  PubMed  Google Scholar 

  • McCann, U. D., Mertl, M., Eligulashvili, V., & Ricaurte, G. A. (1999). Cognitive performance in (±) 3, 4-methylenedioxymethamphetamine (MDMA, “ecstasy”) users: a controlled study. Psychopharmacology, 143, 417–425.

    Article  CAS  PubMed  Google Scholar 

  • McCann, U. D., Peterson, S. C., & Ricaurte, G. A. (2007). The effect of catecholamine depletion by alpha-methyl-para-tyrosine on measures of cognitive performance and sleep in abstinent MDMA users. Neuropsychopharmacology, 32, 1695–1706.

    Article  CAS  PubMed  Google Scholar 

  • McCardle, K., Luebbers, S., Carter, J. D., Croft, R. J., & Stough, C. (2004). Chronic MDMA (ecstasy) use, cognition and mood. Psychopharmacology, 173, 434–439.

    Article  CAS  PubMed  Google Scholar 

  • Medina, K. L., Shear, P. K., & Corcoran, K. (2005). Ecstasy (MDMA) exposure and neuropsychological functioning: A polydrug perspective. Journal of the International Neuropsychological Society, 11, 753–765.

    Article  CAS  PubMed  Google Scholar 

  • Montgomery, C., & Fisk, J. E. (2007). Everyday memory deficits in ecstasy-polydrug users. Journal of psychopharmacology, 21(7), 709–717.

    Article  PubMed  Google Scholar 

  • Montgomery, C., & Fisk, J. E. (2008). Ecstasy-related deficits in the updating component of executive processes. Human Psychopharmacology: Clinical and Experimental, 23, 495–511.

    Article  Google Scholar 

  • Montgomery, C., Fisk, J. E., Newcombe, R., Wareing, M., & Murphy, P. N. (2005). Syllogistic reasoning performance in MDMA (Ecstasy) users. Experimental and Clinical Psychopharmacology, 13, 137–145.

    Article  PubMed  Google Scholar 

  • Morgan, M. J. (1998). Recreational use of ‘ecstasy’ (MDMA) is associated with elevated impulsivity. Neuropsychopharmacology, 19, 252–264.

    Article  CAS  PubMed  Google Scholar 

  • Morgan, M. J. (1999). Memory deficits associated with recreational use of “ecstasy” (MDMA). Psychopharmacology, 141, 30–36.

    Article  CAS  PubMed  Google Scholar 

  • Morgan, M. J. (2000). Ecstasy (MDMA): a review of its possible persistent psychological effects. Psychopharmacology, 153, 230–248.

    Article  Google Scholar 

  • Owen, A. M. (1997). The functional organization of working memory processes within human lateral frontal cortex: the contribution of functional neuroimaging. European Journal of Neuroscience, 9, 1329–1339.

    Article  CAS  PubMed  Google Scholar 

  • Park, D. C., Lautenschlager, G., Hedden, T., Davidson, N. S., Smith, A. D., & Smith, P. K. (2002). Models of visuospatial and verbal memory across the adult life span. Psychology and Aging, 17(2), 299–320.

    Article  PubMed  Google Scholar 

  • Parrott, A. C., Lees, A., Garnham, N. J., Jones, M., & Wesnes, K. (1998). Cognitive performance in recreational users of MDMA or ‘ecstasy’: evidence for memory deficits. Journal of Psychopharmacology, 12, 79–83.

    Article  CAS  PubMed  Google Scholar 

  • Pereira, A. P. A. (2007). Assessment of memory in rehabilitation counselling. Journal of Rehabilitation, 73, 15–25.

    Google Scholar 

  • Pollack, I., Johnson, L. B., & Knaff, P. R. (1959). Running memory span. Journal of Experimental Psychology, 57, 137–146.

    Article  CAS  PubMed  Google Scholar 

  • Quednow, B. B., Jessen, F., Kühn, K.-U., Maier, W., Daum, I., & Wagner, M. (2006). Memory deficits in abstinent MDMA (ecstasy) users: Neuropsychological evidence of frontal dysfunction. Journal of Psychopharmacology, 20, 373–384.

    Article  PubMed  Google Scholar 

  • Reay, J. L., Hamilton, C., Kennedy, D. O., & Scholey, A. B. (2006). MDMA polydrug users show process-specific central executive impairments coupled with impaired social and emotional judgement processes. Journal of Psychopharmacology, 20, 385–388.

    Article  CAS  PubMed  Google Scholar 

  • 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, 322–324.

    Article  CAS  PubMed  Google Scholar 

  • Reneman, L., Lavalaye, J., Schmand, B., de Wolff, F., van den Brink, W., den Heeten, G., et al. (2001a). Cortical serotonin transporter density and verbal memory in individuals who stopped using 3, 4-methylenedioxymethamphetamine (MDMA or “Ecstasy”): Preliminary findings. Archives of General Psychiatry, 58, 901–906.

    Article  CAS  Google Scholar 

  • Reneman, L., Majoie, C. B. L. M., Schmand, B., van den Brink, W., & den Heeten, G. J. (2001b). Prefrontal N-acetylaspartate is strongly associated with memory performance in (abstinent) ecstasy users: preliminary report. Biological Psychiatry, 50, 550–554.

    Article  CAS  Google Scholar 

  • Reneman, L., Schilt, T., de Win, M. M., Booij, J., Schmand, B., van den Brink, W., et al. (2006). Memory function and serotonin transporter promoter gene polymorphism in ecstasy (MDMA) users. Journal of Psychopharmacology, 20, 389–399.

    Article  PubMed  Google Scholar 

  • Repovs, G., & Baddeley, A. (2006). The multi-component model of working memory: explorations in experimental cognitive psychology. Neuroscience, 139, 5–21.

    Article  CAS  PubMed  Google Scholar 

  • Richardson, J. T. E. (2007). Measures of short-term memory: a historical review. Cortex, 43, 635–650.

    Article  PubMed  Google Scholar 

  • Rodgers, J. (2000). Cognitive performance amongst recreational users of “ecstasy”. Psychopharmacology, 151, 19–24.

    Article  CAS  PubMed  Google Scholar 

  • Roiser, J. P., Rogers, R. D., & Sahakian, B. J. (2007). Neuropsychological function in ecstasy users: a study controlling for polydrug use. Psychopharmacology, 189, 505–516.

    Article  CAS  PubMed  Google Scholar 

  • Rosenthal, R. (1979). The “file drawer problem” and tolerance for null results. Psychological Bulletin, 86, 638–641.

    Article  Google Scholar 

  • Schifano, F., Di Furia, L., Forza, G., Minicuci, N., & Bricolo, R. (1998). MDMA (‘ecstasy’) consumption in the context of polydrug abuse: a report on 150 patients. Drug and Alcohol Dependence, 52, 85–90.

    Article  CAS  PubMed  Google Scholar 

  • Schilt, T., De Win, M. M., Koeter, M., Jager, G., Korf, D. J., van den Brink, W., et al. (2007). Cognition in novice ecstasy users with minimal exposure to other drugs: a prospective cohort study. Archives of General Psychiatry, 64, 728–736.

    Article  PubMed  Google Scholar 

  • Thomasius, R., Zapletalova, P., Petersen, K., Buchert, R., Andresen, B., Wartberg, L., et al. (2006). Mood, cognition and serotonin transporter availability in current and former ecstasy (MDMA) users: the longitudinal perspective. Journal of Psychopharmacology, 20, 211–225.

    Article  CAS  PubMed  Google Scholar 

  • Verbaten, M. N. (2003). Specific memory deficits in ecstasy users? The results of a meta-analysis. Human Psychopharmacology: Clinical and Experimental, 18, 281–290.

    Article  Google Scholar 

  • Verkes, R. J., Gijsman, H. J., Pieters, M. S. M., Schoemaker, R. C., de Visser, S., Kuijpers, M., et al. (2001). Cognitive performance and serotonergic function in users of ecstasy. Psychopharmacology, 153, 196–202.

    Article  CAS  PubMed  Google Scholar 

  • von Geusau, N. A., Stalenhoef, P., Huizinga, M., Snel, J., & Ridderinkof, K. R. (2004). Impaired executive function in male MDMA (“ecstasy”) users. Psychopharmacology, 175, 331–341.

    Article  Google Scholar 

  • Wager, T. D., & Smith, E. E. (2003). Neuroimaging studies of working memory: a meta-analysis. Cognitive, Affective, & Behavioral Neuroscience, 3, 255–274.

    Article  Google Scholar 

  • Wareing, M., Fisk, J. E., & Murphy, P. N. (2000). Working memory deficits in current and previous users of MDMA (‘ecstasy’). British Journal of Psychology, 91, 181–188.

    Article  PubMed  Google Scholar 

  • Wareing, M., Fisk, J. E., Murphy, P., & Montgomery, C. (2004a). Verbal working memory deficits in current and previous users of MDMA. Human Psychopharmacology: Clinical and Experimental, 19, 225–234.

    Article  CAS  Google Scholar 

  • Wareing, M., Murphy, P. N., & Fisk, J. E. (2004b). Visuospatial memory impairments in users of MDMA (‘ecstasy’). Psychopharmacology, 173, 391–397.

    Article  CAS  Google Scholar 

  • Wareing, M., Fisk, J. E., Murphy, P., & Montgomery, C. (2005). Visuo-spatial working memory deficits in current and former users of MDMA (‘ecstasy’). Human Psychopharmacology: Clinical and Experimental, 20, 115–123.

    Article  Google Scholar 

  • Wareing, M., Fisk, J. E., Montgomery, C., Murphy, P. N., & Chandler, M. D. (2007). Information processing speed in ecstasy (MDMA) users. Human Psychopharmacology: Clinical and Experimental, 22, 81–88.

    Article  Google Scholar 

  • Yip, J. T. H., & Lee, T. M. C. (2005). Effect of ecstasy use on neuropsychological function: a study in Hong Kong. Psychopharmacology, 179, 620–628.

    Article  CAS  PubMed  Google Scholar 

  • Zakzanis, K. K., & Young, D. A. (2001). Memory impairment in abstinent MDMA (“Ecstasy”) users: a longitudinal investigation. Neurology, 56, 966–969.

    CAS  PubMed  Google Scholar 

  • Zakzanis, K. K., & Campbell, Z. (2006). Memory impairment in now abstinent MDMA users and continued users: a longitudinal follow-up. Neurology, 66(5), 740–741.

    Article  PubMed  Google Scholar 

  • Zakzanis, K. K., Young, D. A., & Campbell, Z. (2003). Prospective memory impairment in abstinent MDMA (“Ecstasy”) users. Cognitive Neuropsychiatry, 8(2), 141–153.

    Article  PubMed  Google Scholar 

  • Zakzanis, K. K., Campbell, Z., & Jovanovski, D. (2007). The neuropsychology of ecstasy (MDMA) use: a quantitative review. Human Psychopharmacology: Clinical and Experimental, 22, 427–435.

    Article  CAS  Google Scholar 

  • Zaninotto, A. L. C., Bueno, O. F. A., Pradella-Hallinan, M., Tufik, S., Rusted, J., Stough, C., et al. (2009). Acute cognitive effects of donepezil in young, healthy volunteers. Human Psychopharmacology: Clinical and Experimental, 24, 453–464.

    Article  CAS  Google Scholar 

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Acknowledgements

This study was supported by an Australian Postgraduate Award provided to C. Nulsen.

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Nulsen, C.E., Fox, A.M. & Hammond, G.R. Differential Effects of Ecstasy on Short-Term and Working Memory: A Meta-Analysis. Neuropsychol Rev 20, 21–32 (2010). https://doi.org/10.1007/s11065-009-9124-z

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