Adolescent Cannabis Users Showed Abnormal Risk-Taking and Reward Brain Patterns Even After Quitting

Abstinent adolescents who had cannabis use disorder showed hyperactivation during risky decisions and reduced reward response in the orbitofrontal cortex, with patterns persisting after treatment remission.

De Bellis, Michael D et al.·Drug and alcohol dependence·2013·Preliminary EvidenceCross-Sectional
RTHC-00670Cross SectionalPreliminary Evidence2013RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Cross-Sectional
Evidence
Preliminary Evidence
Sample
N=15

What This Study Found

Three groups of male adolescents were compared during a decision-making fMRI task: 15 with cannabis use disorder in remission, 23 controls with other psychiatric conditions, and 18 healthy controls. Abstinent cannabis users showed hyperactivation in parietal/visual regions during risky decisions involving uncertainty, and hypoactivation in the orbitofrontal cortex to rewarded outcomes.

Both control groups differed significantly from the cannabis group (but not from each other) in both decision-making and reward processing. The number of different drug classes tried correlated negatively with orbitofrontal reward response, and cannabis use duration correlated negatively with orbitofrontal response to non-reward.

Key Numbers

15 CUD remission, 23 psychiatric controls, 18 healthy controls. CUD group: hyperactivation in parietal/occipital during risky decisions. Hypoactivation in OFC to reward. Number of drug classes negatively correlated with OFC reward response. CUD duration negatively correlated with OFC no-reward response.

How They Did This

Cross-sectional fMRI study comparing three groups of male adolescents during the Decision-Reward Uncertainty Task. CUD group in full remission (n=15), psychiatric controls (n=23), healthy controls (n=18). Post-hoc ROI analyses examined correlations between brain activation and substance use variables.

Why This Research Matters

The persistence of abnormal brain activation patterns after remission from cannabis use disorder suggests that either cannabis caused lasting brain changes or these patterns represent pre-existing vulnerabilities. Either interpretation has implications for understanding adolescent addiction and predicting relapse risk.

The Bigger Picture

This study demonstrates that adolescent cannabis use disorder involves brain circuits beyond the traditional reward system. The abnormal decision-making patterns persisting after remission suggest that vulnerability or lasting effects may predispose adolescents to continued risk-taking and relapse.

What This Study Doesn't Tell Us

Small sample sizes, especially the CUD group (15). Cross-sectional design cannot determine whether brain differences preceded or resulted from cannabis use. Only males were studied. The CUD group was in remission, which means some recovery may have already occurred. Other substance exposure could have contributed.

Questions This Raises

  • ?Do these brain patterns predict relapse?
  • ?Would they normalize with longer abstinence?
  • ?Are they present before cannabis use begins?
  • ?Could they serve as biomarkers for adolescent addiction vulnerability?

Trust & Context

Key Stat:
Brain activation differences persisted after remission from cannabis use disorder
Evidence Grade:
Small cross-sectional fMRI study; preliminary evidence for lasting neural effects.
Study Age:
Published in 2013. Research on adolescent addiction neuroscience and brain recovery has expanded.
Original Title:
Neural mechanisms of risky decision-making and reward response in adolescent onset cannabis use disorder.
Published In:
Drug and alcohol dependence, 133(1), 134-45 (2013)
Database ID:
RTHC-00670

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

A snapshot of a population at one point in time.

What do these levels mean? →

Frequently Asked Questions

Do brain changes from adolescent cannabis use persist after quitting?

This study found that brain activation patterns during decision-making and reward processing remained abnormal in adolescents who had recovered from cannabis use disorder. However, the study cannot determine whether these patterns were caused by cannabis use or existed before use began as a vulnerability factor.

What parts of the brain were affected?

The orbitofrontal cortex, which is critical for evaluating rewards and making decisions, showed reduced activation in response to rewards. This brain region is one of the last to mature during adolescent development, which may make it particularly vulnerable to disruption from substance use during this period.

Read More on RethinkTHC

Cite This Study

RTHC-00670·https://rethinkthc.com/research/RTHC-00670

APA

De Bellis, Michael D; Wang, Lihong; Bergman, Sara R; Yaxley, Richard H; Hooper, Stephen R; Huettel, Scott A. (2013). Neural mechanisms of risky decision-making and reward response in adolescent onset cannabis use disorder.. Drug and alcohol dependence, 133(1), 134-45. https://doi.org/10.1016/j.drugalcdep.2013.05.020

MLA

De Bellis, Michael D, et al. "Neural mechanisms of risky decision-making and reward response in adolescent onset cannabis use disorder.." Drug and alcohol dependence, 2013. https://doi.org/10.1016/j.drugalcdep.2013.05.020

RethinkTHC

RethinkTHC Research Database. "Neural mechanisms of risky decision-making and reward respon..." RTHC-00670. Retrieved from https://rethinkthc.com/research/de-2013-neural-mechanisms-of-risky

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.