Novel Research Shows Brain Connections Can Predict Future Substance Use in Adolescents

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 opens in new tab/window in Biological Psychiatry: Cognitive Neuroscience and Neuroimaging opens in new tab/window, 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."

Notes for editors

The article is "Neural Signatures of Cognitive Control Predict Future Adolescent Substance Use Onset and Frequency," by Ya-Yun Chen, MS, Morgan Lindenmuth, MS, Tae-Ho Lee, PhD, Jacob Lee, MS, Brooks Casas, PhD, and Jungmeen Kim-Spoon, PhD (https://doi.org/10.1016/j.bpsc.2024.11.020 opens in new tab/window). It appears online in advance of volume 10, issue 5 (May 2025) of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging opens in new tab/window, published by Elsevier.

The article is openly available athttps://www.biologicalpsychiatrycnni.org/article/S2451-9022(24)00357-4/fulltext opens in new tab/window.

Copies of this paper are also available to credentialed journalists upon request; please contact Rhiannon Bugno at [email protected] opens in new tab/window. Journalists wishing to interview the study’s authors should contact Jungmeen Kim-Spoon, PhD, at [email protected] opens in new tab/window, or Margaret Ashburn, Virginia Tech Associate Director of Media Relations, at +1 540 529 0814 or [email protected] opens in new tab/window.

The authors’ affiliations and disclosures of financial and conflicts of interest are available in the article.

Cameron S. Carter, MD, is Chair of the Department of Psychiatry & Human Behavior at the University of California, Irvine School of Medicine. His disclosures of financial and conflicts of interest are available here opens in new tab/window.

Research reported in this publication was supported by the grants from the National Institute on Drug Abuse at the National Institutes of Health under NIH Grant R01 DA036017 and the Virginia Tech Institute for Society, Culture, and Environment (ISCE).

About Biological Psychiatry: Cognitive Neuroscience and Neuroimaging

Biological Psychiatry: Cognitive Neuroscience and Neuroimaging opens in new tab/window is an official journal of the Society of Biological Psychiatry opens in new tab/window, whose purpose is to promote excellence in scientific research and education in fields that investigate the nature, causes, mechanisms and treatments of disorders of thought, emotion, or behavior. In accord with this mission, this peer-reviewed, rapid-publication, international journal focuses on studies using the tools and constructs of cognitive neuroscience, including the full range of non-invasive neuroimaging and human extra- and intracranial physiological recording methodologies. It publishes both basic and clinical studies, including those that incorporate genetic data, pharmacological challenges, and computational modeling approaches. The 2023 Journal Impact Factor^TM score, from Clarivate, for Biological Psychiatry: Cognitive Neuroscience and Neuroimaging is 5.7. www.sobp.org/bpcnni opens in new tab/window

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