MDMA, colloquially known as ecstasy or molly, has previously been linked to changes in brain function. Now, a study published in the Journal of Psychopharmacology suggests the party drug can increase risk for cognitive impairment.

Researchers from the University of Liverpool aimed to see how MDMA use affects the brain over time. The concern primarily has to do with the way MDMA stimulates the release of several neurotransmitters, the most notable of which is serotonin. Many of the brain regions associated with serotonin production and transmission are located in the prefrontal cortex, which is the part of the brain responsible for cognitive processing.

The experiment involved 20 MDMA users who had taken the drug at least 11 times and 20 control participants who had never used the substance. Subjects were asked to complete two intelligence tests while undergoing functional magnetic resonance imaging (fMRI). The fMRI allowed researchers to record the intensity of activity in the prefrontal cortex since increased activity has been associated with greater cognitive effort, according to PsyPost.

While MDMA users and non-users performed well on intelligence tests, the MDMA users’ prefrontal cortexes were much more active. The researchers said this pattern could be compensatory — meaning the users' brains needed to work harder in order to achieve the same results as the non-users. Those who had used the largest amounts of MDMA over time, as well as those who had used the most recently showed the most extreme elevation of prefrontal cortex activity.

The authors concluded MDMA damaged the serotonin receptors in the prefrontal cortex and made cognitive processing more difficult. They also determined these effects were likely to be cumulative, meaning repeated MDMA use and higher doses of the drug would increase these negative effects. The brain may recover from this damage over time; however, researchers said "the cognitive effects were most severe in those with the most recent history of MDMA use."

Interestingly, these effects appeared to be unique to MDMA since neither marijuana nor alcohol has been associated with differences in cognition over time. These results add to a plethora of studies that caution MDMA users to be weary of the potential, long-term cognitive impacts of use. Stopping or limiting additional MDMA use could help minimize damage in current users.

Source: Roberts C, Montgomery C. Cortical oxygenation suggests increased effort during cognitive inhibition in ecstasy polydrug users. Journal of Psychopharmacology. 2016.