Cannabis-dependent men showed diminished cognitive control brain activity compared to healthy individuals, and those with greater pre-treatment activation in specific regions used less cannabis during treatment and one-year follow-up.
Read this if you are interested in how brain function relates to cannabis treatment success.
Pre-treatment brain activity predicted cannabis use during treatment and at 1-year follow-up
What the researchers found
Twenty cannabis-dependent men completed an fMRI cognitive control task before starting a 12-week treatment trial. Compared to 20 healthy controls, the cannabis-dependent group showed diminished brain activity during the Stroop task in regions critical for cognitive control and reward processing, including the dorsolateral prefrontal cortex and ventral striatum.
Within the cannabis group, greater pre-treatment activity in the dorsal anterior cingulate cortex (a cognitive control region) predicted less cannabis use during the 12-week treatment. Greater pre-treatment activity in the ventral striatum (a reward region) predicted less cannabis use during the subsequent one-year follow-up.
These findings suggest that the brain's capacity for cognitive control before treatment influences treatment outcomes.
Why it matters
If brain imaging can predict who will respond to treatment, it could help personalize treatment approaches. The finding also suggests that treatments enhancing cognitive control might improve cannabis outcomes.
The numbers in context
20 cannabis-dependent and 20 healthy comparison participants. 12-week treatment followed by 1-year follow-up (n=18). Dorsal anterior cingulate activity predicted treatment response. Ventral striatum activity predicted long-term outcomes.
How the study worked
Prospective study combining pre-treatment fMRI (Stroop color-word task) with outcomes from a 12-week randomized trial of cognitive behavioral therapy and/or contingency management, followed by one-year post-treatment assessment. 20 cannabis-dependent males and 20 healthy controls.
What this study cannot tell us
Very small sample (20 per group, 18 at follow-up). Only male participants. Pre-treatment brain activity is correlational and may not be causal. The cannabis group may have had pre-existing brain differences unrelated to cannabis use.
How to read the evidence
Prospective study linking brain imaging to treatment outcomes. Novel and important but limited by very small sample.
When this study was published
Published in 2014.
The bigger picture
This study connected neuroscience to clinical treatment outcomes. The different brain regions predicting short-term (during treatment) vs. long-term (follow-up) outcomes suggests that cognitive control and reward processing contribute differently to the phases of recovery.
Questions still open
- Could cognitive training interventions boost pre-treatment brain activation and improve outcomes? Would these brain predictors work in female cannabis users? Can less expensive measures (neuropsychological tests) substitute for fMRI in predicting outcomes?
Common questions
Can brain scans predict who will succeed in cannabis treatment?
Do cannabis users have different brain activity during thinking tasks?
Read the original research
Cannabis abstinence during treatment and one-year follow-up: relationship to neural activity in men.
Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 39(10), 2288-98
Citation
Kober, Hedy; DeVito, Elise E; DeLeone, Cameron M; Carroll, Kathleen M; Potenza, Marc N. (2014). Cannabis abstinence during treatment and one-year follow-up: relationship to neural activity in men.. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 39(10), 2288-98. https://doi.org/10.1038/npp.2014.82
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