Altered brain developmental trajectories in adolescents after initiating drinking

Objective: The authors sought evidence for altered adolescent braingrowthtrajectory associatedwithmoderateand heavy alcohol use in a large national, multisite, prospective study of adolescents before and after initiation of appreciable alcohol use. Method: This study examined 483 adolescents (ages 12-21) before initiation of drinking and 1 and 2 years later. At the 2-year assessment, 356 participants continued to meet the study's no/low alcohol consumption entry criteria, 65 had initiatedmoderate drinking, and 62 had initiated heavy drinking. MRI was used to quantify regional cortical and white matter volumes. Percent change per year (slopes) in adolescents who continued to meet no/low criteria served as developmental control trajectories against which to compare those who initiated moderate or heavy drinking. Results: In no/low drinkers, gray matter volume declined throughout adolescence and slowed in many regions in later adolescence. Complementing gray matter declines, white matter regions grew at faster rates at younger ages and slowed toward young adulthood. Youths who initiated heavy drinking exhibited an accelerated frontal cortical gray matter trajectory, divergent from the norm. Although significant effects on trajectories were not observed in moderate drinkers, their intermediate position between no/lowand heavy drinkers suggests a dose effect. Neithermarijuana co-use nor baseline volumes contributed significantly to the alcohol effect. Conclusions: Initiation of drinking during adolescence, with or without marijuana co-use, disordered normal brain growth trajectories. Factors possibly contributing to abnormal cortical volume trajectories include peak consumption in the past year and family history of alcoholism. © 2018 American Psychiatric Association. All rights reserved.