title: The effect of alcohol consumption on the adolescent brain: A systematic review of MRI and fMRI studies of alcohol-using youth.
abstract: BACKGROUND
  A large proportion of adolescents drink alcohol, with many engaging in high-risk patterns of consumption, including binge drinking. Here, we systematically review and synthesize the existing empirical literature on how consuming alcohol affects the developing human brain in alcohol-using (AU) youth.
  
  
  METHODS
  For this systematic review, we began by conducting a literature search using the PubMED database to identify all available peer-reviewed magnetic resonance imaging (MRI) and functional magnetic resonance imaging (fMRI) studies of AU adolescents (aged 19 and under). All studies were screened against a strict set of criteria designed to constrain the impact of confounding factors, such as co-occurring psychiatric conditions.
  
  
  RESULTS
  Twenty-one studies (10 MRI and 11 fMRI) met the criteria for inclusion. A synthesis of the MRI studies suggested that overall, AU youth showed regional differences in brain structure as compared with non-AU youth, with smaller grey matter volumes and lower white matter integrity in relevant brain areas. In terms of fMRI outcomes, despite equivalent task performance between AU and non-AU youth, AU youth showed a broad pattern of lower task-relevant activation, and greater task-irrelevant activation. In addition, a pattern of gender differences was observed for brain structure and function, with particularly striking effects among AU females.
  
  
  CONCLUSIONS
  Alcohol consumption during adolescence was associated with significant differences in structure and function in the developing human brain. However, this is a nascent field, with several limiting factors (including small sample sizes, cross-sectional designs, presence of confounding factors) within many of the reviewed studies, meaning that results should be interpreted in light of the preliminary state of the field. Future longitudinal and large-scale studies are critical to replicate the existing findings, and to provide a more comprehensive and conclusive picture of the effect of alcohol consumption on the developing brain.
authors.affiliation: University of New Mexico, Department of Psychiatry, Albuquerque, NM 87131, USA.
authors.forename: Sarah W Feldstein
authors.initials: SW
authors.lastname: Ewing
authors.affiliation: UCL Institute of Cognitive Neuroscience, 17 Queen Square, London WC1N 3AR, UK.
authors.forename: Ashok
authors.initials: A
authors.lastname: Sakhardande
authors.affiliation: UCL Institute of Cognitive Neuroscience, 17 Queen Square, London WC1N 3AR, UK.
authors.forename: Sarah-Jayne
authors.initials: SJ
authors.lastname: Blakemore
mesh_terms: D000293:Adolescent; D000428:Alcohol Drinking / Q000473:pathology* / Q000523:psychology; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D012309:Risk-Taking
keywords: Adolescence; Alcohol; Brain; Diffusion tensor imaging; Functional magnetic resonance imaging; Magnetic resonance imaging