Insights from a new study published in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging can play an important role in early prevention and intervention

Philadelphia, March 3, 2025 – Adolescent substance use is a significant predictor of future addiction and related disorders. Understanding neural mechanisms underlying substance use initiation and frequency during adolescence is critical for early prevention and intervention. A novel study in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, published by Elsevier, shows that by tracking year-to-year changes in brain connectivity underlying cognitive control, the ability to flexibly use goals to guide behavior and overcome habitual responses, data can predict when an adolescent is at high risk of starting to use substances, an important message for early prevention.

Lead investigator Jungmeen Kim-Spoon, PhD, Department of Psychology and School of Neuroscience, Virginia Tech, says, "Beginning to use substances at a young age can significantly increase the risk of developing serious substance use problems later in life. This may lead to major challenges in relationships, work, and overall well-being. By identifying the risk of early substance use, we can improve our chances of preventing it and helping individuals avoid these challenges.”

To clarify brain mechanisms that prospectively predict initiation and progression of substance use, the current study examined the trajectories of functional connectivity during cognitive control linked to substance use. For seven years researchers followed 91 adolescents from ages 14 to 21 who had never used substances at the start of this longitudinal study to identify potential neural precursors that predict substance use initiation and frequency. Cognitive control processes were examined using the Multi-Source Interference Task (MSIT) to assess functional neural connectivity; a questionnaire assessed substance use frequency.

Findings indicate that brain connectivity related to cognitive control predicted substance use initiation, whereas cognitive control behavior did not.

Co-investigator Tae-Ho Lee, PhD, Department of Psychology and School of Neuroscience, Virginia Tech, explains, "Our study revealed that neural recruitment from the salience network (brain regions for detecting and responding to stimuli) during the cognitive control process, specifically the dorsal anterior cingulate cortex (dACC) and anterior insula (aINS), can predict future substance use in adolescents before they actually begin using substances."

Co-investigator Ya-Yun Chen, MS, Department of Psychology, Virginia Tech, adds, "Specifically, stronger connectivity between the dACC and the dorsolateral prefrontal cortex was associated with delayed substance use onset, and this connectivity pattern showed a significant drop one year prior to substance use initiation. In contrast, lower connectivity of the dACC with the supplementary motor area, along with heightened connectivity of the aINS with the dorsal medial prefrontal cortex and angular gyrus, predicted greater severity of future substance use."

Editor-in-Chief of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging Cameron S. Carter, MD, University of California Irvine, comments, "Adolescence is an important period characterized by heightened susceptibility to risk-taking behaviors, which have implications for substance use. National data indicate that approximately 68% of individuals aged 12 to 17 in the United States reported initiating the use of substances such as cigarettes, alcohol, or marijuana in the past year. In light of these statistics, identifying neurodevelopmental precursors linked to the risk of early substance use and heavy use during adolescence becomes crucial. The current study paves the way for innovative early prevention and intervention strategies."

Dr. Kim-Spoon concludes, "Our study highlights the critical role of cognitive control-related neural connectivity in forecasting substance use initiation and frequency during adolescence. The results imply that efforts to strengthen and monitor the development of the top-down cognitive control system in the brain from early adolescence may serve as a protective factor, helping to deter progression into problematic substance use. Furthermore, for adolescents with heightened frequency of substance use, interventions may be more effective if they target interoceptive processes as part of cognitive control training."