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Meta-analysis of executive functioning in ecstasy/polydrug users

Roberts, CA, Jones, A and Montgomery, C (2016) Meta-analysis of executive functioning in ecstasy/polydrug users. Psychological Medicine, 46 (8). pp. 1581-1596. ISSN 0033-2917

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Abstract

Ecstasy/3,4-methylenedioxymethamphetamine (MDMA) use is proposed to cause damage to serotonergic (5-HT) axons in humans. Therefore, users should show deficits in cognitive processes that rely on serotonin-rich, prefrontal areas of the brain. However, there is inconsistency in findings to support this hypothesis. The aim of the current study was to examine deficits in executive functioning in ecstasy users compared with controls using meta-analysis. We identified k = 39 studies, contributing 89 effect sizes, investigating executive functioning in ecstasy users and polydrug-using controls. We compared function-specific task performance in 1221 current ecstasy users and 1242 drug-using controls, from tasks tapping the executive functions – updating, switching, inhibition and access to long-term memory. The significant main effect demonstrated overall executive dysfunction in ecstasy users [standardized mean difference (SMD) = −0.18, 95% confidence interval (CI) −0.26 to −0.11, Z = 5.05, p < 0.001, I2 = 82%], with a significant subgroup effect (χ2 = 22.06, degrees of freedom = 3, p < 0.001, I2 = 86.4%) demonstrating differential effects across executive functions. Ecstasy users showed significant performance deficits in access (SMD = −0.33, 95% CI −0.46 to −0.19, Z = 4.72, p < 0.001, I2 = 74%), switching (SMD = −0.19, 95% CI −0.36 to −0.02, Z = 2.16, p < 0.05, I2 = 85%) and updating (SMD = −0.26, 95% CI −0.37 to −0.15, Z = 4.49, p < 0.001, I2 = 82%). No differences were observed in inhibitory control. We conclude that this is the most comprehensive analysis of executive function in ecstasy users to date and provides a behavioural correlate of potential serotonergic neurotoxicity.

Item Type: Article
Uncontrolled Keywords: 1701 Psychology, 1117 Public Health And Health Services, 1109 Neurosciences
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Natural Sciences & Psychology (closed 31 Aug 19)
Publisher: Cambridge University Press
Related URLs:
Date Deposited: 09 Feb 2017 12:07
Last Modified: 04 Sep 2021 11:57
DOI or ID number: 10.1017/S0033291716000258
URI: https://researchonline.ljmu.ac.uk/id/eprint/5492
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