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Study breakdown

Adolescent cannabis use was linked to cortical thinning, especially in males, and some brain differences existed before use began

Longitudinal CohortStrong evidence
The takeaway

A longitudinal neuroimaging study of 136 adolescents found that cannabis use was associated with reduced cortical thickness, with males showing a 0.005 mm reduction per weekly use increase, and pre-existing brain signatures predicted which males were more likely to use cannabis.

Neuroscientists, adolescent health researchers, parents of teens

Each weekly increase in cannabis use equivalent to 17.9% of annual cortical thinning in males

What the researchers found

In years when adolescents used more cannabis than their personal average, cortical thickness was lower (p = 0.047). This effect was stronger in males, where each once-per-week increase in use was associated with a 0.005 mm reduction in cortical thickness, equivalent to about 17.9% of the annual rate of cortical thinning. The thinning was greatest in brain regions with highest CB1 receptor gene expression. Males also showed a pre-existing cortical thickness signature associated with cannabis use propensity, present before any cannabis exposure.

Why it matters

This study helps answer a long-standing question: do brain differences cause cannabis use or does cannabis cause brain differences? The answer appears to be both, at least in males, which has major implications for understanding adolescent vulnerability.

The numbers in context

136 adolescents; 74 female; 3 neuroimaging sessions ages 12-17; 90% follow-up; within-person effect: -0.0023 mm per weekly use increase (p = 0.047); males: -0.005 mm (p = 0.0017); 17.9% of annual cortical thinning rate; CB1 receptor gene correlation: rho = -0.33 (sample), rho = -0.5 (males)

How the study worked

Longitudinal study with 136 adolescents (74 female) completing three neuroimaging sessions and annual assessments from ages 12 to 17, with 90% follow-up. Cannabis use was disaggregated into between-person (vulnerability) and within-person (time-varying) components using multilevel modeling, controlling for age, sex, and alcohol use.

What this study cannot tell us

Relatively small sample (136 adolescents). Cannabis use was relatively low in this age group. Cannot fully rule out other substance use effects. Cortical thinning is a normal developmental process, making it challenging to determine clinical significance.

How to read the evidence

Strong: longitudinal design with repeated neuroimaging, high follow-up rate, and sophisticated statistical methods separating risk factors from consequences.

When this study was published

2026 publication following adolescents ages 12-17 with three neuroimaging sessions.

The bigger picture

This is one of the first studies to separate pre-existing brain risk factors from consequences of cannabis use using longitudinal data. The finding that both exist simultaneously, particularly in males, adds nuance to the debate about cannabis and the developing brain.

Questions still open

  • Why are males more affected than females? Do the pre-existing brain signatures in males reflect genetic or environmental factors? Does the cannabis-associated cortical thinning translate to cognitive or functional impairments?

Common questions

Does cannabis thin the brain in teens?
This study found that in years when teens used more cannabis, their cortex was thinner. In males, each once-per-week increase was associated with a reduction equivalent to about 18% of the normal annual thinning rate.
Were the brain differences caused by cannabis or did they exist before?
Both. Males showed pre-existing cortical thickness patterns that predicted cannabis use before it started, AND showed additional thinning in years of heavier use. This suggests brain vulnerability and cannabis effects work together.

Read the original research

Independent brain cortical signatures of risk for adolescent cannabis use and consequences of such use are moderated by sex.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 51(2), 497-505

Citation

Watts, Jeremy J; Navarri, Xavier; Conrod, Patricia J. (2026). Independent brain cortical signatures of risk for adolescent cannabis use and consequences of such use are moderated by sex.. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 51(2), 497-505. https://doi.org/10.1038/s41386-025-02249-2

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