The intersection between response inhibition and substance use among adolescents

Problems related to the capacity to successfully engage response inhibition are considered a risk factor for the development of substance use disorders (SUDs), but the evidence has been predominantly cross-sectional. In this commentary, we argue that recent longitudinal studies with multi-modal measures of response inhibition can improve understanding of how response inhibition may intersect with substance use among adolescents. Most Stop-Signal studies suggest that slower response inhibition predicts substance use progressions, with one multi-site study showing greater fronto-parietal activity indicative of risk. Most Go-NoGo studies suggest that blunted activation of prefrontal cortical areas during response inhibition predicts substance use progressions, while commission errors are less effective in identifying adolescents at risk. Studies differ in subject populations, outcome measures, statistical methods, and BOLD response contrasts, which challenge the capacity to compare and generalize findings. We encourage research teams throughout the globe to undertake multi-modal, longitudinal studies to assess brain functioning with large sample sizes, and when possible, before significant substance use potentially obscures interpretation of findings. Systematic review and meta-analysis of this growing literature are also important goals for future research.