Reduced memory skills and increased hair cortisol levels in recent Ecstasy/MDMA users: significant but independent neurocognitive and neurohormonal deficits

Objectives The goals of this study were to measure the neurocognitive performance of recent users of recreational Ecstasy and investigate whether it was associated with the stress hormone cortisol. Methods The 101 participants included 27 recent light users of Ecstasy (one to four times in the last 3 months), 23 recent heavier Ecstasy users (five or more times) and 51 non-users. Rivermead paragraph recall provided an objective measure for immediate and delayed recall. The prospective and retrospective memory questionnaire provided a subjective index of memory deficits. Cortisol levels were taken from near-scalp 3-month hair samples. Results Cortisol was significantly raised in recent heavy Ecstasy users compared with controls, whereas hair cortisol in light Ecstasy users was not raised. Both Ecstasy groups were significantly impaired on the Rivermead delayed word recall, and both groups reported significantly more retrospective and prospective memory problems. Stepwise regression confirmed that lifetime Ecstasy predicted the extent of these memory deficits. Conclusions Recreational Ecstasy is associated with increased levels of the bio-energetic stress hormone cortisol and significant memory impairments. No significant relationship between cortisol and the cognitive deficits was observed. Ecstasy users did display evidence of a metacognitive deficit, with the strength of the correlations between objective and subjective memory performances being significantly lower in the Ecstasy users

The acute and long lasting psychological effects of 3, 4-methylenedioxymethampethamine (MDMA, 'ecstacy') : a cohort study conducted during the period 2002-2007

Rationale - MDMA is currently an illegally abused recreational drug. Non-human animal studies demonstrate that MDMA causes non-repairable damage to serotonergic neurons. As the acute behavioural effects of MDMA are similar between non-human animals and humans, it is plausible to suggest that the neurotoxic effects of MDMA will be the same in each group. Results from previous human research investigating the psycho biological effects of MDMA have been inconsistent. They have relied on limited sample sizes and lack adequate control groups. The overall aim of the present study was to examine behaviours associated with 5- HT including: sleep, depression, impulsivity, memory, and executive functioning. The study investigated 5- HT related behaviours comparing past and present polydrug MDMA users whilst controlling for other recreational drugs. Method - The study involved a total of 1399 participants split across 6 groups: non-drug control; nicotine/alcohol control; nicotine/alcohol/cannabis control; non-MDMA polydrug control; current MDMA polydrug and past MDMA polydrug. Participants were required to complete the following: demographic and drug history questionnaire, Becks Depression Inventory (Version II), Pittsburgh Sleep Scale, Barratt Impulsivity Questionnaire, Wechsler Memory Test (Revised), Wisconsin Card Sorting Test, and the Tower of London Test. Results - The study found that past and present MDMA users suffer from specific deficits in measures of depression (cognitive-affective subscale), sleep, impulsivity (attention and motor subscales) and memory (verbal, visual, delayed). Past and present MDMA users displayed problems in selected executive functions: planning; solution time; and number of errors. Interestingly, statistical regression analysis predicted that these deficits in executive functioning may be due to MDMA, (1) directly affecting other psychological processes: memory, impulsivity, and sleep, which indirectly affects performance on executive functions; or, (2) MDMA directly disrupts executive functions: planning, solution time, and number of errors. Discussion - The present study is the first and largest study to date to suggest that MDMA causes acute and long lasting changes to specific psychological functioning: depression, sleep, impulsivity, memory, and executive functioning; without recovery even after 5 years of abstinence. Future studies need to control for mood, sleep disturbance, memory deficits, and elevated impulsivity when investigating disruptions to executive functions in past and present polydrug MDMA users.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

A multicentre longitudinal observational study of changes in self reported health status in people with Parkinson's disease left untreated at diagnosis

Background: The issue of when to start treatment in Parkinson’s disease (PD) remains controversial. Some favour treatment at diagnosis while others opt for a “wait and watch” policy. The effect of the latter policy on the self reported health status of people with PD is unknown. Aims: To record self reported health status through longitudinal use of a validated PD specific questionnaire (PDQ-39) in untreated PD patients in multiple centres in the UK. To compare patients who were left untreated with those who were offered treatment during follow-up. Methods: A multicentre, prospective, “real life” observational audit based study addressing patient reported outcomes in relation to self reported health status and other sociodemographic details. Results: 198 untreated PD were assessed over a mean period of 18 months. During two follow-up assessments, the self reported health status scores in all eight domains of the PDQ-39 and the overall PDQ-39 summary index worsened significantly (p<0.01) in patients left untreated. In a comparative group in whom treatment was initiated at or soon after diagnosis, there was a trend towards improvement in self reported health status scores after treatment was started. Conclusions: This study addresses for the first time self reported health status, an indicator of health related quality of life, in untreated PD. The findings may strengthen the call for re-evaluation of the policy to delay treatment in newly diagnosed patients with PD