In this meta-analysis, we aimed to assess the evidence from neuroimaging studies for chronic alterations in the brains of MDMA users. The databases PubMed, Embase, and Web of Science were searched for studies published from inception to August 24, 2018, without any language restriction. Sixteen independent studies comprising 356 MDMA users and 311 controls were included. Of these, five studies investigated frontal and occipital N-acetylaspartate/creatine and myo-inositol/creatine ratios, three studies assessed basal ganglia blood flow and ten studies investigated serotonin transporter (SERT) density in various regions. We found significantly decreased SERT density in eight of 13 investigated regions. Meta-regression indicated a positive association with abstinence, but none with lifetime episodes of use. Therefore, other variables (such as doses taken per occasion) might be more important determinants. Positive associations between time of abstinence and SERT density might indicate that these alterations are reversible to some extent. Furthermore, there were no significant differences between user and control groups in terms of neurochemical ratios in the frontal and occipital lobes and blood flow in the basal ganglia. Overall, MDMA user groups showed heavy use patterns and study quality was poor.

在这项荟萃分析中，我们旨在评估神经影像研究对MDMA使用者大脑中慢性变化的证据。搜索PubMed，Embase和Web of Science数据库，查找从开始到2018年8月24日发布的研究，没有任何语言限制。包括16个独立研究，包括356个MDMA用户和311个对照。其中，有五项研究调查了额叶和枕叶N-乙酰天门冬氨酸/肌酸和肌醇/肌酸的比率，三项研究评估了基底神经节血流量，十项研究研究了各个区域的血清素转运蛋白（SERT）密度。我们发现13个调查区域中的8个区域的SERT密度显着降低。元回归表明节制与禁欲成正相关，但与终生使用无关。因此，其他变量（例如每次使用的剂量）可能是更重要的决定因素。禁欲时间与SERT密度之间的正相关可能表明这些改变在一定程度上是可逆的。此外，就额叶和枕叶的神经化学比率以及基底神经节的血流而言，使用者和对照组之间没有显着差异。全面的，