Burst spinal artery aneurysm linked to Ecstasy use

Taking the street drug Ecstasy could lead to a potentially fatal weakening and rupture of the spinal cord artery, doctors have warned in the Journal of NeuroInterventional Surgery.

Posterior spinal artery aneurysms - a blood-filled swelling of the spinal cord artery, caused by a weakening and distension of the vessel wall - are rare, with only 12 cases reported to date. But all of them caused spinal bleeding which affected the function of the spinal cord.

Doctors discovered one of these aneurysms in a previously healthy teenager who had taken Ecstasy or MDMA.

The morning after the night before, he woke up with headache, neck pain and muscle spasms. After a week these symptoms suddenly took a turn for the worse, accompanied by nausea, prompting him to seek help at his local emergency department.

A week later the teen was transferred to a specialist neurosurgical unit for further investigations, which revealed an aneurysm, measuring 2 x 1 mm, on the left side of the spinal cord artery at the back of his neck.

The aneurysm was successfully removed, along with the weakened portion of the artery. The teen made a full recovery, with no lasting nerve damage.

But the authors reiterate that Ecstasy use has already been linked to severe systemic and neurological complications, including stroke, inflammation of the arteries in the brain (vasculitis) and internal brain bleeds.

And now, posterior spinal artery aneurysm can be added to the list, they say.

The drug acts on the sympathetic nervous system, sparking a sudden hike in blood pressure, as a result of the surge in serotonin it releases. And this could make any pre-existing aneurysms or other arterial abnormalities prone to rupture, they warn.

Study reveals how ecstasy acts on the brain and hints at therapeutic uses

Brain imaging experiments have revealed for the first time how ecstasy produces feelings of euphoria in users.

Results of the study at Imperial College London, parts of which were televised in Drugs Live on Channel 4 in 2012, have now been published in the journal Biological Psychiatry.

The findings hint at ways that ecstasy, or MDMA, might be useful in the treatment of anxiety and post-traumatic stress disorder (PTSD).

MDMA has been a popular recreational drug since the 1980s, but there has been little research on which areas of the brain it affects. The new study is the first to use functional magnetic resonance imaging (fMRI) on resting subjects under its influence.

Twenty-five volunteers underwent brain scans on two occasions, one after taking the drug and one after taking a placebo, without knowing which they had been given.

The results show that MDMA decreases activity in the limbic system – a set of structures involved in emotional responses. These effects were stronger in subjects who reported stronger subjective experiences, suggesting that they are related.

Communication between the medial temporal lobe and medial prefrontal cortex, which is involved in emotional control, was reduced. This effect, and the drop in activity in the limbic system, are opposite to patterns seen in patients who suffer from anxiety.

MDMA also increased communication between the amygdala and the hippocampus. Studies on patients with PTSD have found a reduction in communication between these areas.

The project was led by David Nutt, the Edmond J. Safra Professor of Neuropsychopharmacology at Imperial College London, and Professor Val Curran at UCL.

Dr Robin Carhart-Harris from the Department of Medicine at Imperial, who performed the research, said: “We found that MDMA caused reduced blood flow in regions of the brain linked to emotion and memory. These effects may be related to the feelings of euphoria that people experience on the drug.”

Professor Nutt added: “The findings suggest possible clinical uses of MDMA in treating anxiety and PTSD, but we need to be careful about drawing too many conclusions from a study in healthy volunteers. We would have to do studies in patients to see if we find the same effects.”

MDMA has been investigated as an adjunct to psychotherapy in the treatment of PTSD, with a recent pilot study in the US reporting positive preliminary results.

As part of the Imperial study, the volunteers were asked to recall their favourite and worst memories while inside the scanner. They rated their favourite memories as more vivid, emotionally intense and positive after MDMA than placebo, and they rated their worst memories less negatively. This was reflected in the way that parts of the brain were activated more or less strongly under MDMA. These results were published in the International Journal of Neuropsychopharmacology.

Dr Carhart-Harris said: “In healthy volunteers, MDMA seems to lessen the impact of painful memories. This fits with the idea that it could help patients with PTSD revisit their traumatic experiences in psychotherapy without being overwhelmed by negative emotions, but we need to do studies in PTSD patients to see if the drug affects them in the same way.”

Ecstasy Harms Memory With One Year of Recreational Use

New research published online July 25 by the scientific journal Addiction, gives some of the first information available on the actual risk of using ecstasy. It shows that even in recreational amounts over a relatively short time period, ecstasy users risk specific memory impairments. Further, as the nature of the impairments may not be immediately obvious to the user, it is possible people wouldn’t get the signs that they are being damaged by drug use until it is too late.

According to the study, new ecstasy users who took ten or more ecstasy pills over their first year of use showed decreased function of their immediate and short-term memory compared with their pre-ecstasy performance. These findings are associated with damage of the hippocampus, the area of the brain that oversees memory function and navigation. Interestingly, hippocampal damage is one of the first signs of Alzheimer’s disease, resulting in memory loss and disorientation.