Rationale: Clinical reports indicate that acute exposure to 3,4-methylenedioxymethamphetamine (MDMA; "Ecstasy") may induce pathological cerebrovascular responses in human users of the drug, however, the mechanism by which MDMA might effect these pathological changes is not clear.
Objectives: To examine the effects of acute MDMA administration on the relationship between local cerebral blood flow (LCBF) and local cerebral glucose utilisation (LCMRglu); to determine the effect, if any, acute exposure to MDMA has on the cerebral circulation, independently of alterations in cerebral metabolic demand.
Methods: Dark Agouti rats were injected with 15 mg.kg(-1) i.p. MDMA or saline equivalent. LCBF and LCMRglu were measured in 50 brain areas using the fully quantitative [14C]iodoantipyrine and [14C]2-deoxyglucose autoradiographic techniques, respectively.
Results: MDMA produced significant increases in LCMRglu in 23 brain areas, most markedly in the motor system (globus pallidus; +82%; medial striatum; +71%). In contrast, significant decreases in LCBF were observed in 28 brain areas, most markedly in primary sensory nuclei (superior colliculus; -32%) and limbic areas (anterior thalamus; -34%). Global analysis revealed a close correlation (r=0.87) between LCMRglu and LCBF with a ratio of 1.53 in controls. Despite the divergence of LCMRglu (increases) and LCBF (decreases) in MDMA-treated groups, there was a similar close correlation (r=0.84), but the ratio was decreased to 1.22.
Conclusions: This study provides clear evidence that acute exposure to MDMA results in cerebrovascular dysfunction. The uncoupling of LCBF from underlying metabolic demand, possibly due to the vasoconstrictor action of 5-HT, could provide the basis for oligaemia-induced pathological changes in the brain.