Elevated impulsivity and impaired decision-making cognition in heavy users of MDMA (“Ecstasy”)

Abstract

Rationale: In animal studies, the common club drug 3,4-methylendioxymethamphetamine (MDMA, "Ecstasy") consistently caused a prolonged loss of presynaptic serotonergic neurons, and evidence suggests that MDMA consumption may also affect the human serotonergic system. Serotonin (5-HT) has been implicated in the regulation of impulsivity and such executive functions as decision-making cognition. In fact, MDMA users have shown elevated impulsivity in two studies, but little is known about decision making in drug-free MDMA consumers. Objective: The aim of this study was to examine the cognitive neurotoxicity of MDMA with regard to behavioral impulsivity and decision-making cognition. Methods: Nineteen male, abstinent, heavy MDMA users; 19 male, abstinent cannabis users; and 19 male, drug-naïve controls were examined with the Matching Familiar Figures Test (MFFT) as well as with a Go/No-Go Task (GNG) for impulsivity and with a Gambling Task (GT) for executive functioning. Results: MDMA users showed significantly elevated impulsivity in the MFFT Impulsivity score (I-score), but not in commission errors of the GNG, compared with controls. Cannabis users did not yield altered impulsivity compared with controls. In the GT, MDMA users performed significantly worse than cannabis consumers and controls, whereas cannabis users exhibited the same decision-making capacity as controls. In addition, the I-score as well as the decision-making performance was correlated with measures of MDMA intake. The I-score and the decision-making performance were also correlated. Conclusion: These results suggest that heavy use of MDMA may elevate behavioral impulsivity and impair decision-making cognition possibly mediated by a selective impairment of the 5-HT system.

The Effect of Catecholamine Depletion by Alpha-Methyl-Para-Tyrosine on Measures of Cognitive Performance and Sleep in Abstinent MDMA Users

“…As suggested in a recent study by Quednow et al (2007), MDMA users may be more likely to display impulsivity on tasks related to disinhibition/attention than on tasks related to punishment or extinction, two distinct, but related facets of impulsivity, as defined by Moeller et al (2001). This observation is notable because, as mentioned above, disinhibition is believed to be modulated by brain 5-HT systems.…”

“…Night 1 Time ( et al, 2007;Quednow et al, 2007). As suggested in a recent study by Quednow et al (2007), MDMA users may be more likely to display impulsivity on tasks related to disinhibition/attention than on tasks related to punishment or extinction, two distinct, but related facets of impulsivity, as defined by Moeller et al (2001).…”

“…Other clinical and physiological abnormalities that have been reported in MDMA users include impulsivity (Morgan et al, 2006;Quednow et al, 2007), neuroendocrine dysfunction (Gerra et al, 1998(Gerra et al, , 2000(Gerra et al, , 2003McCann et al, 2000;Verkes et al, 2001), alterations in pain modulation (O'Regan and Clow, 2004), sleep architecture (Allen et al, 1993;Ricaurte and McCann, 2001), visual-evoked potentials (Casco et al, 2005), and event-related potentials (Mejias et al, 2005). Like cognitive function, all of these behavioral spheres are known to be influenced, in part, by brain 5-HT systems.…”

Understanding Within-Session Loss-Chasing: An Experimental Investigation of the Impact of Stake Size on Cognitive Control

“…When attempting to understand if specific executive control processes contribute to within-session loss-chasing behaviour it is prudent to begin exploring two of the most commonly observed executive function deficits observed in addiction populations, including problem gamblers, principally Response Inhibition (Billieux et al 2012;Conversano et al 2012;Goudriaan et al 2006;Kertzman et al 2008) and Reflection Impulsivity (Lawrence et al 2009b;Clark et al 2009a;Cohen et al 2010;Quednow et al 2007).…”

Reward-related decision-making deficits and elevated impulsivity among MDMA and other drug users

“…However, Morgan et al (2006) found risky decision-making among MDMA users relative to polydrug and drug-naïve controls, and Roiser et al (2006) detected reduced attention to the probability of winning on a risky choices task among MDMA users with the ss allele of the 5-HT transporter gene. Furthermore, MDMA users made more disadvantageous choices on the IGT relative to marijuana and non-drug controls, which may be related to poor inhibitory processes (Quednow et al, 2007) and reduced white matter integrity in the anterior corpus callosum (Moeller et al, 2007). Conversely, other studies reported similar performance among MDMA users and control groups on the IGT or other decision-making tasks, although the impact of marijuana use remains unclear (Fox et al, 2002;Lamers et al, 2006).…”