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Study breakdown

Brain activity before treatment predicted cannabis abstinence during and after therapy

Prospective CohortModerate evidence
The takeaway

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?
This small study found that greater pre-treatment brain activity in cognitive control regions predicted less cannabis use during treatment, while activity in reward regions predicted better one-year outcomes. Larger studies are needed to confirm.
Do cannabis users have different brain activity during thinking tasks?
Yes. Cannabis-dependent participants showed diminished activity in brain regions responsible for cognitive control and reward processing compared to healthy controls during a color-word interference task.

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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