Structural brain recovery following reductions in adolescent and young adult binge drinking: A longitudinal NCANDA study

Adolescence through young adulthood is a sensitive neurodevelopmental window characterized by ongoing maturation of gray and white matter and heightened vulnerability to alcohol's neurotoxic effects. Although prior studies link binge drinking with disrupted brain development, the potential for recovery with reduced alcohol use remains underexplored. Using data from 690 participants (ages 12-29) in the National Consortium on Alcohol and NeuroDevelopment in Adolescence to Adulthood (NCANDA-A), we examined the longitudinal impact of binge drinking episodes, and reductions in binge drinking episodes, on regional gray and white matter volumes. Linear mixed-effects models assessed (1) past-year binge drinking frequency, (2) reductions below personal mean binge drinking across time, and (3) transitions in frequency of binge drinking across 10 annual neuroimaging assessments. Results showed that higher binge drinking frequency was associated with decreases in gray matter across frontal, parietal, temporal, and occipital cortices, as well as white matter reductions in frontolimbic and frontostriatal pathways. Reductions below personal mean drinking frequency were also associated with attenuated shrinkage in gray matter volumes. Participants who transitioned from frequent to infrequent binge drinking had significantly larger corpus callosum volumes compared to those with sustained frequent binge episodes. This longitudinal analysis demonstrates consistent negative effects of binge drinking on gray and white matter regions. Importantly, reductions in binge drinking provide evidence for neuroanatomical recovery, particularly in the corpus callosum, and suggest that the degree of recovery may vary by brain region and extent of alcohol use reduction during this key developmental period.