What Do Thirty Years of Neuroimaging Research Tell Us About Recreational Cannabis Use and Brain Integrity? A Narrative Review of the Multimodal Neuroimaging Evidence to Date.
Substance abuse and rehabilitation January 1, 2026 Ethan Murphy, Chao Suo, Govinda Poudel et al.
Acute intoxication with delta-9-tetrahydrocannabinol (THC) is consistently associated with greater brain activity in fronto-striatal pathways. Regular cannabis users, compared to non-users, show lower hippocampal volume, reduced white matter microstructure in the superior longitudinal fasciculus, and altered fronto-striatal activity and connectivity during cue-reactivity tasks and at rest. Emerging evidence from Positron Emission Tomography studies indicates lower N-acetyl aspartate, reduced glucose metabolism in the frontal cortex, and lower density of cannabinoid receptors in fronto-striatal pathways, which may reverse with abstinence. Longitudinal multimodal neuroimaging studies are needed to determine whether these brain differences precede or follow cannabis use and whether they dissipate with abstinence.