MedicalResearch.com Interview with:
Marilyn Cyr, Ph.D., Psy.D.
Postdoctoral Research Scientist
Division of Child and Adolescent Psychiatry
New York State Psychiatric Institute
Columbia University Medical Center
New York, NY 10032
MedicalResearch.com: What is the background for this study?
Response: A hallmark feature of problematic substance use is compulsive drug-seeking long after the drug is no longer experienced as pleasurable and despite the associated adverse consequences of this behavior. Disturbances in cognitive control—an ensemble of processes by which the mind governs behaviors, regulates impulses and guides decisions based on goals—are believed to be involved in the initiation and maintenance of the compulsive drug-seeking that characterizes problematic substance use. Most adults with problematic substance use began having problems with drugs and alcohol in adolescence, a developmental period during which the neural circuits underlying cognitive control processes continue to mature.
As such, the adolescent brain may be particularly vulnerable to the effects of substance use, and particularly cannabis, the most commonly used recreational drug by teenagers worldwide.
MedicalResearch.com: What are the main findings?
Response: Using functional magnetic resonance imaging (fMRI) data acquired from 28 adolescents and young adults (aged 14-23 years) with significant cannabis use and 32 age and sex-matched non-using healthy controls during their performance of a task known to engage cognitive control processes (the Simon Spatial Incompatibility Task), we found that youth who frequently use cannabis show alterations in the functioning of neural circuits that support these processes. We also found that these brain alterations were less robust with recent cannabis use abstinence, which may suggest that the effects of cannabis escalate with recent use. Some of the study findings may also point to greater and more persistent alterations with earlier cannabis use initiation, while the brain is still developing.
MedicalResearch.com: What should readers take away from your report?
Response: The present findings are a first step towards identifying brain-based targets for early interventions that reduce addiction behaviors by enhancing self-regulatory capacity and support the mission of large-scale initiatives, such as the Adolescent Brain and Cognitive Development (ABCD) study, a longitudinal study aimed at understanding the developmental trajectory of brain circuits in relation to cannabis use. Given that substance use and relapse rates are associated with control processes, interventions based on neural stimulation, such as transcranial magnetic stimulation (TMS), and behavioral interventions, such as cognitive training, that specifically target the brain circuits underlying these control processes may be helpful as adjunct intervention strategies to complement standard treatment programs for cannabis use disorder’.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: This study underscores the importance of cognitive control brain processes in cannabis-using youth. Future large-scale longitudinal studies should determine whether cognitive control-related neural alterations represent a consequence of cannabis use, a preexisting risk factor, or a combination of both. A careful characterization of the specific nature of brain–cannabis use relationships and of individual differences will ultimately lead to individualized prevention and treatment strategy (precision medicine) and inform public decision-making.
Marilyn Cyr et al. Deficient Functioning of Frontostriatal Circuits During the Resolution of Cognitive Conflict in Cannabis-Using Youth, Journal of the American Academy of Child & Adolescent Psychiatry(2018). DOI: 10.1016/j.jaac.2018.09.436
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