fNIRS suggests increased effort during executive access in ecstasy polydrug users.

BACKGROUND: Ecstasy use is associated with cognitive impairment, believed to result from damage to 5-HT axons. Neuroimaging techniques to investigate executive dysfunction in ecstasy users provide a more sensitive measure of cognitive impairment than behavioural indicators. The present study assessed executive access to semantic memory in ecstasy polydrug users and non-users. METHODS: Twenty ecstasy polydrug users and 20 non-user controls completed an oral variant of the Chicago Word Fluency Test (CWFT), whilst the haemodynamic response to the task was measured using functional near-infrared spectroscopy (fNIRS). RESULTS: There were no between-group differences in many background measures including measures of sleep and mood state (anxiety, arousal, hedonic tone). No behavioural differences were observed on the CWFT. However, there were significant differences in oxy-Hb level change at several voxels relating to the left dorsolateral prefrontal cortex (DLPFC) and right medial prefrontal cortex (PFC) during the CWFT, indicating increased cognitive effort in ecstasy users relative to controls. Regression analyses showed that frequency of ecstasy use, total lifetime dose and amount used in the last 30 days was significant predictors of oxy-Hb increase at several voxels after controlling for alcohol and cannabis use indices. CONCLUSION: The results suggest that ecstasy users show increased activation in the PFC as a compensatory mechanism, to achieve equivalent performance to non-users. These findings are in agreement with much of the literature in the area which suggests that ecstasy may be a selective serotonin neurotoxin in humans.