The effects of ‘ecstasy’ (MDMA) on visuospatial memory performance: findings from a systematic review with meta-analysis (Running head: Ecstasy and visuospatial memory: meta-analyses)

Objective. To review performance differences, with meta-analyses, between ecstasy (MDMA) users and non-users on a wider range of tasks requiring processing of visual/spatial information than in our previous narrative review of tasks requiring working memory executive resources. Method. Abstracting databases were searched using the United Kingdom NHS Evidence Health Information Resource. Inclusion criteria were publication in English language peer-reviewed journals, and to be reporting new findings regarding human ecstasy users' performance on visual/spatial tasks. Data extracted included specific task demands, to provide a basis for meta-analyses for categories of tasks making similar demands. Results. Fifty-two studies were identified for review, although not all were suitable for meta-analysis. Significant weighted mean effect sizes indicating poorer performance by ecstasy users compared to matched controls were found for tasks requiring recall of spatial stimulus elements, recognition of figures, and production/reproduction of figures. There was no evidence of a linear relationship between estimated ecstasy consumption and effect sizes. Conclusions. Given the networked nature of processing for spatial and non-spatial visual information, future scanning and imaging studies should focus on brain activation differences between ecstasy users and non-users in the context of specific tasks for the identification of loci of potentially compromised activity in users.