Psychological dysregulation, white matter disorganization and substance use disorders in adolescence

Abstract

Aims Adolescents with substance use disorders (SUD) have difficulties with cognitive, behavioral and affective regulation. White matter (WM) disorganization has been observed in adolescents with SUD and may be related to psychological dysregulation. This study compared adolescents with SUD and control adolescents to investigate relationships among psychological dysregulation, WM disorganization, and SUD symptoms. Design Cross-sectional observation. Setting Adolescents with SUD were recruited from SUD treatment programs. Controls were recruited from the community. Participants The 55 participants were ages 14–19; 35 with SUD, 20 controls without SUD. Measurements Psychological dysregulation was characterized by the Behavior Rating Inventory of Executive Function. WM disorganization was measured by diffusion tensor imaging, and fractional anisotropy, radial diffusivity and axial diffusivity were examined within cortical regions of interest. Findings Compared to controls, SUD adolescents showed significantly greater psychological dysregulation and prefrontal and parietal WM disorganization. WM disorganization was positively correlated with psychological dysregulation and cannabis-related symptoms. In multivariate mediation models, the results were consistent with both the Neurodevelopmental Immaturity model, in which WM disorganization leads to psychological dysregulation and cannabis-related symptoms, and with the Substance Effects Model, in which cannabis-related symptoms lead to WM disorganization and psychological dysregulation. Conclusions In adolescents, substance use disorder and psychological dysregulation appear to be associated with reduced frontoparietal network white matter maturation.

Considering Cannabis: The Effects of Regular Cannabis Use on Neurocognition in Adolescents and Young Adults

“…However, in this sample, alcohol use during the interscan interval predicted reduced white matter integrity while cannabis did not. With only one exception (DeLisi et al, 2006), several studies have now reported reduced white matter quality in several PFC, limbic, parietal and cerebellar tracts in young cannabis users after controlling for alcohol use (Arnone et al, 2008; Ashtari et al, 2009; Bava et al, 2009; Clark et al, 2012; Gruber et al, 2011; 2013). Additional research disentangling the unique effects of alcohol versus cannabis on white matter integrity is needed.…”

“…Additional research disentangling the unique effects of alcohol versus cannabis on white matter integrity is needed. In a study examining the relationship between psychological dysregulation, white matter integrity and substance (including cannabis) use in teens, Clark et al, (2012) tested mediation models and concluded that poorer white matter quality in frontoparietal networks was both a risk factor for psychological dysregulation and CUD-related symptoms, and a result of cannabis use.…”

“…Most of the studies outlined in this review controlled for potentially confounding variables, such as family history of SUD and Axis I disorders, however, subclinical symptoms or neurocognitive correlates of risk factors (Clark et al, 2012; Hanson, et al, 2010; Hill, Muddasani et al, 2007; Nigg et al, 2004; Schweinsburg et al, 2004; Spadoni, et al, 2008; Ridenour et al, 2009; Tapert & Brown, 2000) may still explain at least a portion of the brain abnormalities reported in cross-sectional studies of cannabis users. For example, Cheetham and colleagues (2012) found that abnormalities in the orbitofrontal cortex, but not limbic and anterior cingulate areas, predated and predicted the onset of cannabis use in a four-year prospective longitudinal study.…”

Insula White Matter Volume Linked to Binge Drinking Frequency Through Enhancement Motives in Treated Adolescents

“…Youth who completed baseline were approached to participate in a neuroimaging protocol (Thatcher et al, 2010; Chung et al, 2011; Clark et al, 2012; Chung et al, 2013), which was approved by the university’s Institutional Review Board. Youth were excluded from imaging based on standard restrictions (e.g., unremovable metal in the body), and a history of brain injury or concussion.…”

“…Image processing has been detailed elsewhere (Clark et al, 2012; Chung et al, 2013). Briefly, FreeSurfer (Dale et al, 1999; Fischl et al, 2002, Fischl et al, 2004) was used to create gray and white matter regions of interest (ROIs) based on standard parcellation units (Desikan et al, 2006).…”