Hippocampal remodelling after MDMA neurotoxicity: a single case study

acute ingestion of MDMA (ectstasy) causes a transient marked increase in serotonin and dopamine at central synapses. Recent studies demostrated that MDMA induces damages at serrotoninergic nerve terminals and alters hippocampal processing. Pronounced cognitive deficits in MDMA users affect learning and memory abilities. this pattern of predominant and long lasting memory dysfunction suggests that the functioning of the hippocampus might be affected by the neurotoxic effects of MDMA. We present a case of a 16-year-old girl who developed an acute organic and psychotic syndrome caused by occassional use of low to moderate dose of MDMA. Serial neuroimaging ((18)F-FDG-PET and brain MRI) were correlated with severe cognitive impairment. After 16 months of intensive neuropsychological rehabilitation she showed significant improvement in hippocampal remodelling. This case report indicates that even non-chronic MDMA use may cause subacute toxic encephalopathy in which the clinical evolution is paralleled by neuroimaging changes in specific cerebral areas. The most relevant aspec is the reversibility of the volumetric changes , whic may be the structural correlate of an ongoing hippocampal remodeling