A systematic review of 18 fMRI studies found that regular cannabis users consistently show heightened brain activity in reward, executive control, and memory regions when exposed to cannabis-related cues.
Addiction researchers, neuroimaging scientists, substance use treatment developers
Cannabis cues consistently activated the striatum, prefrontal cortex, and parietal cortex across 18 studies
What the researchers found
Across 18 studies involving 918 participants, cannabis users showed greater brain activation to cannabis cues versus neutral stimuli in the striatum, prefrontal cortex (anterior cingulate, middle frontal), and parietal cortex (posterior cingulate/precuneus), with preliminary links between craving and activity in the amygdala, striatum, and orbitofrontal cortex.
Why it matters
Understanding which brain regions respond to cannabis cues helps explain why regular users experience cravings and may have difficulty quitting, and could point to neurobiological targets for addiction treatment.
The numbers in context
18 studies; 918 participants (340 female); aged 16-38; 603 regular cannabis users; 315 controls; consistent activation in striatum, prefrontal cortex, and parietal cortex.
How the study worked
PRISMA-guided systematic review of 18 fMRI cue-reactivity studies (pre-registered in PROSPERO) examining brain function in cannabis users exposed to cannabis versus neutral stimuli.
What this study cannot tell us
Heterogeneity in study designs and cannabis use definitions; relatively small individual study samples; limited longitudinal data on whether cue-reactivity predicts relapse.
How to read the evidence
Well-conducted systematic review with pre-registered protocol, limited by heterogeneity across individual studies.
When this study was published
Review of studies published through 2021.
The bigger picture
The pattern of heightened cue-reactivity in reward and executive control regions mirrors what has been observed in other substance use disorders, suggesting shared neurobiological mechanisms of addiction across different substances.
Questions still open
- Could interventions targeting cue-reactivity (like neurofeedback) help reduce cannabis cravings? Does cue-reactivity normalize after sustained abstinence?
Common questions
What happens in the brain when a cannabis user sees cannabis cues?
Does this brain activity relate to cravings?
Read the original research
Patterns of brain function associated with cannabis cue-reactivity in regular cannabis users: a systematic review of fMRI studies.
Psychopharmacology, 238(10), 2709-2728
Citation
Sehl, Hannah; Terrett, Gill; Greenwood, Lisa-Marie; Kowalczyk, Magdalena; Thomson, Hannah; Poudel, Govinda; Manning, Victoria; Lorenzetti, Valentina. (2021). Patterns of brain function associated with cannabis cue-reactivity in regular cannabis users: a systematic review of fMRI studies.. Psychopharmacology, 238(10), 2709-2728. https://doi.org/10.1007/s00213-021-05973-x
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