Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Eidgenössische Technische Hochschule Zurich and University of Zurich, Zurich, Switzerland.
Geriatric Psychiatry, Department of Psychiatry, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland; Institute of Neuroradiology, Kantonsspital Aarau, Aarau, Switzerland.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2023 Sep;8(9):956-966. doi: 10.1016/j.bpsc.2023.02.005. Epub 2023 Feb 26.
The common club drug MDMA (also known as ecstasy) enhances mood, sensory perception, energy, sociability, and euphoria. While MDMA has been shown to produce neurotoxicity in animal models, research on its potential neurotoxic effects in humans is inconclusive and has focused primarily on the serotonin system.
We investigated 34 regular, largely pure MDMA users for signs of premature neurodegenerative processes in the form of increased iron load in comparison to a group of 36 age-, sex-, and education-matched MDMA-naïve control subjects. We used quantitative susceptibility mapping, a novel tool able to detect even small tissue (nonheme) iron accumulations. Cortical and relevant subcortical gray matter structures were grouped into 8 regions of interest and analyzed.
Significantly increased iron deposition in the striatum was evident in the MDMA user group. The effect survived correction for multiple comparisons and remained after controlling for relevant confounding factors, including age, smoking, and stimulant co-use. Although no significant linear relationship between measurements of the amounts of MDMA intake (hair analysis and self-reports) and quantitative susceptibility mapping values was observed, increased striatal iron deposition might nevertheless point to MDMA-induced neurotoxic processes. Additional factors (hyperthermia and simultaneous co-use of other substances) that possibly amplify neurotoxic effects of MDMA during the state of acute intoxication are discussed.
The demonstrated increased striatal iron accumulation may indicate that regular MDMA users have an increased risk potential for neurodegenerative diseases with progressing age.
常见的摇头丸（MDMA）俱乐部毒品（也称为摇头丸）可增强情绪、感官知觉、能量、社交能力和欣快感。虽然 MDMA 已被证明在动物模型中具有神经毒性，但对其在人类中的潜在神经毒性影响的研究尚无定论，主要集中在血清素系统上。
我们调查了 34 名经常使用、基本为纯 MDMA 的使用者，与 36 名年龄、性别和教育程度匹配的 MDMA 未使用者对照组相比，他们出现了神经退行性病变的早期迹象，表现为铁负荷增加。我们使用了定量磁敏感图，这是一种能够检测到微小组织（非血红素）铁积聚的新工具。将皮质和相关的皮质下灰质结构分为 8 个感兴趣区域进行分析。
在 MDMA 使用者组中，纹状体的铁沉积明显增加。该效应在进行多次比较校正后仍然存在，并且在控制了年龄、吸烟和兴奋剂共同使用等相关混杂因素后仍然存在。尽管未观察到 MDMA 摄入量（毛发分析和自我报告）的测量值与定量磁敏感图值之间存在显著的线性关系，但纹状体铁沉积的增加可能指向 MDMA 引起的神经毒性过程。讨论了在急性中毒状态下可能放大 MDMA 神经毒性作用的其他因素（体温升高和同时使用其他物质）。
所证明的纹状体铁积累增加可能表明，经常使用摇头丸的人随着年龄的增长，患神经退行性疾病的风险增加。
