Prefrontal N-acetylaspartate is strongly associated with memory performance in (abstinent) ecstasy users: preliminary report

Background: 3,4-methylenedioxymethamphetamine (MDMA or “Ecstasy”) is known to damage brain serotonin neurons in animals and possibly humans. Because serotonergic damage may adversely affect memory, we compared verbal memory function between MDMA users and MDMA-naïve control subjects and evaluated the relationship between verbal memory function and neuronal dysfunction in the MDMA users. Methods: An auditory verbal memory task (Rey Auditory Verbal Learning Test) was used to study eight abstinent MDMA users and seven control subjects. In addition 1H-MRS was used in different brain regions of all MDMA users to measure N-acetylaspartate/creatine (NAA/Cr) ratios, a marker for neuronal viability. Results: The MDMA users recalled significantly fewer words than control subjects on delayed (p = .03) but not immediate recall (p = .08). In MDMA users, delayed memory function was strongly associated with NAA/Cr only in the prefrontal cortex (R2 = .76, P = .01). Conclusions: Greater decrements in memory function predicted lower NAA/Cr levels—and by inference greater neuronal dysfunction—in the prefrontal cortex of MDMA users.