Neurobehavioral correlates of inhibitory control in youth at-risk for early low-level alcohol use initiation: neuroimaging findings from the ABCD study.

Introduction: Adolescent alcohol experimentation is a rising concern given its links to future problematic drug use. Difficulty with inhibitory control (i.e., the ability to suppress unwanted behaviors) is a well-known risk factor for early alcohol use onset. Nevertheless, little is known about the neurobiology of inhibitory control during early development (i.e., preadolescence), especially in relation to minimal early low-level alcohol use. The current study will reveal neural and behavioral differences in inhibitory control that differentiate youth will go on to engage in low-level alcohol experimentation compared with youth who remain alcohol naïve. Methods: The current study examined 80 pairs of demographically and developmentally matched youth from the Adolescent Brain Cognitive Development Study to predict early alcohol experimentation, consuming at least one full drink, but no regular use, prospectively (ages 10-14 years old). To identify the underlying neural mechanisms differentiating youth who endorsed alcohol experimentation (AE) and those who did not (AN), we utilized impulsive personality trait markers and neurobehavioral markers from the Stop Signal Task. Results: AE and AN youth showed no difference in task performance nor in impulsive personality traits but differed in patterns of neural engagement during the Stop Signal task. When compared to AN youth, AE youth displayed significantly higher activation in the right paracentral lobule and the left isthmus gyrus during the correct stop versus correct go contrast (indexing inhibitory control). Moreover, our findings indicated that, unlike in AN, a greater lack of planning in AE youth was associated with lower inhibitory control-related activation in the fusiform gyrus. Discussion: This study demonstrates a possible role of neural correlates of inhibitory control that are associated with substance use initiation. Despite behavioral similarities, the study detects differential neural markers of inhibitory control between AE and AN youth, an effect potentially driven by impulsive personality trait markers. As these markers could be both constitutionally and environmentally based, our results suggest that early substance use is accompanied by detectable differences in brain activation in key regions, which may be similar to those in later stages of use, highlighting the importance of delaying the age of alcohol onset.