Adolescents show differential dysfunctions related to Alcohol and Cannabis Use Disorder severity in emotion and executive attention neuro-circuitries

Abstract

Alcohol and cannabis are two substances that are commonly abused by adolescents in the United States and which, when abused, are associated with negative medical and psychiatric outcomes across the lifespan. These negative psychiatric outcomes may reflect the detrimental impact of substance abuse on neural systems mediating emotion processing and executive attention. However, work indicative of this has mostly been conducted either in animal models or adults with Alcohol and/or Cannabis Use Disorder (AUD/CUD). Little work has been conducted in adolescent patients. In this study, we used the Affective Stroop task to examine the relationship in 82 adolescents between AUD and/or CUD symptom severity and the functional integrity of neural systems mediating emotional processing and executive attention. We found that AUD symptom severity was positively related to amygdala responsiveness to emotional stimuli and negatively related to responsiveness within regions implicated in executive attention and response control (i.e., dorsolateral prefrontal cortex, anterior cingulate cortex, precuneus) as a function of task performance. In contrast, CUD symptom severity was unrelated to amygdala responsiveness but positively related to responsiveness within regions including precuneus, posterior cingulate cortex, and inferior parietal lobule as a function of task performance. These data suggest differential impacts of alcohol and cannabis abuse on the adolescent brain.

Adolescent Substance Use and the Brain: Behavioral, Cognitive and Neuroimaging Correlates

“…Despite limited evidence for differences in amygdalar morphology between adolescent cannabis users and non-users, amygdalar hypersensitivity in response to angry faces has been reported in adolescent cannabis users, which could predispose individuals to future mood disorders (Spechler et al, 2015). However, these results are conflicted by a more recent study that showed no differences in amygdalar responsivity to emotional stimuli in adolescents with CUD (Aloi et al, 2018). Psychiatric comorbidity may have masked any association between CUD symptomology and amygdala responsiveness in the latter study.…”

“…For instance, heavy-drinking adolescents exhibited attenuated activation in the left supplementary motor area, bilateral parietal lobule, right hippocampus, bilateral middle frontal gyrus, left superior temporal gyrus, and the ACC compared to light drinkers during a response inhibition task (Ahmadi et al, 2013). Similarly, Aloi et al (2018) reported an association between increasing AUD severity and reduced BOLD responses within the ACC and the dorsomedial PFC during the affective Stroop task assessing emotional interference on cognitive functioning. Effects on inhibitory control may be dose-dependent as a longitudinal study of adolescents with low alcohol use did not find any impairments in the development of inhibitory control across adolescence and activation in related networks, such as the dorsal ACC, DLPFC, pre-supplementary motor area, and the posterior parietal cortex (Jurk et al, 2018).…”

“…Self-reported alcohol use in adolescence has also been prospectively associated with hypomanic/manic symptoms at age 23 (Fasteau et al, 2017 ); however, these results solely relied on self-reported alcohol intake and problematic use and will need to be confirmed in future studies with more robust designs. Although the neural basis for the association between adolescent alcohol use and mood disorders has been largely unexplored, AUD symptom severity in adolescents was associated with increased amygdala responses to emotional compared to neutral stimuli (Aloi et al, 2018 ). However, the directional implications of these findings on the relationship between alcohol use and mood disorders are unclear, highlighting the need for more studies to identify neural markers to help characterize their comorbidity.…”

The Association Between Alcohol Consumption and Pain Interference in a Nationally Representative Sample: The Moderating Roles of Gender and Alcohol Use Disorder Symptomatology

“…Our findings also highlight the important role of AUD‐symptom severity in the relation from earlier drinking behavior to later reports of pain‐related disability. Recent research has indicated that severity of AUD symptomatology indexed by the Alcohol Use Disorder Identification Test (AUDIT) and DSM‐5 symptom count is associated with the degree of neurological dysregulation that has developed in response to disordered drinking (Aloi et al, ; Joyner et al, ). Our findings further support the hypothesis that this dysregulation is central to the comorbidity of AUD and pain‐related disability.…”

“…Given that recent neurocognitive studies have shown a positive association between AUD severity and alcohol‐related neurological dysregulation (e.g., Aloi et al, ; Joyner et al, ), it is reasonable to suspect that alcohol’s pain sensitization effects would become increasingly pronounced with increasing AUD severity (e.g., as indexed by AUD‐symptom count). Further, in addition to increased pain sensitization, other addiction‐related neurological impairments (e.g., compromised self‐regulatory capacities) would likely exacerbate other negative pain‐related outcomes such as pain‐related distress and functional disability/interference.…”