“…Prolonged Na 1 entry, secondary to protracted DAT activation, would decrease the Na 1 gradient, were it not for the action of neuronal Na 1 / K 1 ATPase, which transports Na 1 out of the DA cell, against a concentration gradient using neuronal ATP (Stahl 1986;Erecinska and Dagani 1990;Erecinska et al 1994). However, in the setting of METH neurotoxicity, wherein high levels of METH are maintained for an extended time period (either by giving a single high dose or multiple lower doses), Na 1 /K 1 ATPase function is likely to be impaired because of either direct (Jeffrey and Gibbs 1976;Rangaraj and Kalant 1978) or indirect (Komissarov et al 1985;Shulman and Fox 1996;Nishi et al 1999) inhibitory effects of METH on the enzyme, and reduced energy stores (ATP) secondary continued Na 1 /K 1 ATPase function (Stahl 1986;Erecinska and Dagani 1990;Erecinska et al 1994). As Na 1 /K 1 ATPase function declines, less Na 1 would be transported out of the cell, resulting in compromise of the Na 1 gradient.…”