Neuroanatomical Variability and Substance Use Initiation in Late Childhood and Early Adolescence

In this cohort study of 9804 participants, variability in brain structure, including greater whole brain, cortical, and subcortical volumes, and thinner prefrontal cortex, but thicker cortex otherwise, was significantly associated with early (ie, age <15 years) substance use initiation (ie, alcohol, nicotine, cannabis, or other). The majority of brain structure features associated with substance use initiation were evident among substance-naive children at baseline who later initiated.