Neurocognitive Consequences of MDMA Use in HIV It is now well established that HIV infection can be associated with CNS dysfunction, manifested as neurologic abnormalities and neuropsychological deficits. The recreational drug MDMA (""""""""ecstasy"""""""") has shown to be neurotoxic in laboratory animals and there is mounting evidence that misuse of MDMA may have neurocognitive consequences for human users. The prevalence of MDMA use is high among young dance club patrons, particularly in the gay community. As this population continues to compose a substantial portion of HIV infected individuals, the possibility of combined effects of HIV and MDMA insults to the brain warrants investigation. The primary aim of the proposed study is to investigate neurocognitive effects of MDMA in persons who are infected with HIV. Specifically, we hope to 1) characterize the neurocognitive effects of MDMA use combined with HIV infection, 2) explore relationships between neurobehavioral functioning and levels of serotonin in CSF, 3) characterize the relationship of MDMA use and neurocognitive functioning to neurochemical changes as may be ascertained with proton magnetic resonance spectroscopy (MRS), and 4) explore relationships between MDMA use and CSF HIV viral load as a possible mechanism for combined neurocognitive manifestations. This study would be among the first investigations of the possible interaction between effects of HIV and MDMA on brain functioning. The proposed work would be the first to investigate the nature of possible brain injury associated with MDMA use in HIV+ persons by obtaining converging evidence of brain integrity from neuropsychological testing and tissue imaging via MR spectroscopy. Finally, this investigation would provide clues about possible mechanisms of neurocognitive dysfunction related to serotonin, changes in CSF viral load, and their interaction. It is anticipated that this pilot project will lead to a larger-scale, prospective investigation of the combined neurocognitive effects of HIV and MDMA.
| Bousman, Chad A; Cherner, Mariana; Emory, Kristen T et al. (2010) Preliminary evidence of motor impairment among polysubstance 3,4-methylenedioxymethamphetamine users with intact neuropsychological functioning. J Int Neuropsychol Soc 16:1047-55 |
