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Hurley RA, Reneman L, Taber KH. 
“Ecstasy in the brain: a model for neuroimaging”. 
J Neuropsychiatry Clin Neurosci. 2002;14(2).
None provided: Review of functional imaging studies of MDMA and MDE and of comparisons between ecstasy users and nonusers)

This review focuses on the use of imaging in studies relating to MDMA or ecstasy. Examinations are made of PET employed during the acute effects of MDMA and MDE in humans, and imaging techniques, such as SPECT, PET with radioligands and MRI in comparisons between regular ecstasy users and various control groups. The strongest point of this report is its exploration of two different research programs that are often not related together or described together, and the attempt at presenting each paper in detail. The weakest points of the paper are its introductory section and the absence of synthesis within each section. The introductory statement contains many errors concerning the history of MDMA and its medical and non-medical use. For instance, while it is true that ecstasy can be smoked or injected, these routes of administration are almost never used (see Solowij and Hall 1992; Topp et al. 1999). It is also not the case that MDMA was popularized in Europe before its use in psychotherapy. While studies are described in detail, the authors do not always synthesize findings into a strong conclusion as to whether imaging studies produce conflicting results due to aspects of methodology, sample variance or for some other reason. One of the studies addressed in the section on functional imaging is a study of the related compound MDE, and not MDMA (Schreckenberger et al 1999; see also Gouzolis-Mayfrank et al. 1999). In discussing the studies comparing serotonin transporter binding and 5-HT2A receptor density, the authors fail to note that studies published by one of the authors contain overlapping samples of subjects. The general conclusion, claiming a consensus for ecstasy-induced neurotoxicity in the frontostriatal and cerebellar networks, is not strongly supported by the studies described in the review itself. This paper is an uneven report that lacks coherent presentation, but it does bring together imaging data from two different lines of research.
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