Neurocognitive Correlates of Adolescent Cannabis Use: an Overview of Neural Activation Patterns in Task-Based Functional MRI Studies

Abstract

Alcohol and cannabis use are highly prevalent among adolescents and associated with negative consequences. Understanding motivations behind substance use in youth is important for informing prevention and intervention efforts. The present study aims to examine negative reinforcement principles of substance use among adolescent cannabis and alcohol users by pairing a cue reactivity paradigm with an aversive interoceptive stimulus. Adolescents (ages 15-17), classified as controls (CTL; n = 18), cannabis and/or alcohol experimenters (CAN+ALC-EXP; n = 16), or individuals meeting clinical criteria for cannabis and/or alcohol use disorder (CAN+ALC-SUD; n = 13) underwent functional magnetic resonance imaging during which they experienced an aversive interoceptive probe delivered via breathing load while simultaneously performing a cue reactivity paradigm. Participants also provided self-report ratings of how their substance use is positively or negatively reinforced. While experiencing the breathing load, CAN+ALC-SUD exhibited greater (p < 0.05) deactivation in the right amygdala, the left inferior frontal gyrus, and the left parahippocampal gyrus than CAN+ALC-EXP and CTL, who did not differ. Across all substance users, activation during the breathing load within the left parahippocampal gyrus negatively correlated with cannabis and alcohol lifetime use episodes and the left inferior frontal gyrus activity negatively correlated with lifetime alcohol use episodes. CAN+ALC-SUD reported experiencing more positive and negative reinforcement of using their substance of choice than CAN+ALC-EXP; both user groups reported higher levels of positive than negative reinforcement. Adolescents with a cannabis/alcohol use disorder demonstrate an altered response to interoceptive perturbations. However, adolescent cannabis/alcohol use does not appear to be driven by negative reinforcement, as viewing substance images did not dampen this response. Based on self-report data, the experience of positive reinforcement may be stronger for adolescents. Future studies should examine whether positive reinforcement contributes to adolescent substance use.

Young Adult E-Cigarette and Combustible Tobacco Users Attitudes, Substance Use Behaviors, Mental Health, and Neurocognitive Performance

“…Further, prior research indicates cannabis users may be particularly vulnerable to cognitive control and affective processing deficits, including when identifying emotional faces [ 59 ]. Cannabis users may have to use more neural resources to achieve the same level of performance [ 60 ], though this may not happen as readily on a less demanding task, such as on a congruent processing task. Future research should continue to investigate socioaffective response in cannabis users.…”

The brain in social context: A systematic review of substance use and social processing from adolescence to young adulthood

“…This review largely does not cover studies of domain-general risk-taking (see Sherman et al, 2018 ), non-human animal models (see Belin et al, 2016 ), brain structure (see Squeglia and Cservenka, 2017 ), or findings in adults over the age of 25 ( see Moeller and Paulus, 2017 ). Instead, this review builds upon previous discussions of adolescent neural function and substance use (e.g., Coronado et al, 2020 ; Courtney et al, 2019 ; Gray and Squeglia, 2017 ; Squeglia and Gray, 2016 ), contributing a new perspective about the importance of social and emotional information when understanding adolescent substance use. After applying exclusion criteria, the number of studies reviewed was 28 (see Table 2 ).…”

A Meta-Analysis of fMRI Studies of Youth Cannabis Use: Alterations in Executive Control, Social Cognition/Emotion Processing, and Reward Processing in Cannabis Using Youth

“…Taken together, although findings are mixed, these studies consistently show functional impairments in various brain regions, from the frontal cortical engagement in executive processing to that of the limbic system in emotional regulation, with long term adolescent cannabis use. One recent review of fMRI studies in adolescent cannabis users reported results suggesting that cannabis users may require the recruitment of more neural resources than non-using peers to achieve compatible performance on tasks across domains [ 28 ]. The authors stipulate that the frontal and parietal lobes were often identified as key regions engaged across tasks [ 17 , 18 , 19 , 24 , 27 , 29 , 30 , 31 ].…”

“…The authors stipulate that the frontal and parietal lobes were often identified as key regions engaged across tasks [ 17 , 18 , 19 , 24 , 27 , 29 , 30 , 31 ]. Another important observation relates to results from a few preliminary longitudinal studies indicating that there may be pre-existing activation differences, especially in prefrontal cortical (PFC) regions, in teens who will initiate cannabis use [ 28 ]. However, quantitative assessments (e.g., meta-analyses) of existing reports with respect to activation patterns during distinct cognitive processes (e.g., executive control vs. reward vs. emotion paradigms), severity of use and the contribution of developmentally sensitive factors such as age and childhood comorbid disorders and the implications of possible findings to clinical presentations are presently lacking.…”