Neuroimaging Correlates of Adolescent Substance Use: A Systematic Review of the Adolescent Brain Cognitive Development Study

Background: Neuroimaging may help characterize brain and contextual factors associated with substance use during development. The ABCD study supports investigation of developmental pathways relevant to substance use [1]. Objective: To synthesize original ABCD publications examining MRI measures in relation to substance use and substance-related exposures. Methods: The authors screened all 2,700 publications in the ABCD corpus. Original empirical articles reporting an MRI measure of any modality and a substance use variable were eligible; methodological, conceptual, review, and commentary articles were excluded. Imaging modality, brain measures, substances, design, and association direction were extracted for descriptive synthesis. Results: The evidence considered spans morphology, white matter microstructure, resting-state connectivity, and task activation. Findings concerning youth initiation, prenatal exposure, and familial liability address distinct developmental questions. Family history and stressful life events feature in the white matter literature [2]. Findings vary by modality, exposure definition, and temporal direction, and include null associations. Conclusions: The literature suggests distributed and context-dependent neuroimaging associations. Observational designs, overlapping participants, confounding, and analytic heterogeneity limit causal interpretation and assessment of independent replication. The findings support further longitudinal investigation but do not establish a validated MRI screening tool.