CUD-PRS: Predicting Cannabis Use and Neurostructural Impacts in Adolescents.

Xu W.; Zhou W.; Xie X. · Developmental psychobiology · 2026

**Background & Methods** This is a commentary review on Cupertino et al.'s 2025 study examining cannabis use disorder (CUD) development mechanisms in adolescents. The review synthesizes findings regarding genetic vulnerability, neurobiological changes, and behavioral factors contributing to cannabis use initiation during the critical adolescent period. **Key Findings** • Genetic vulnerability significantly influences early cannabis use initiation, with adolescence identified as a critical developmental window when genetic risk for CUD is most likely to manifest clinically. • White matter integrity abnormalities and impulsive behavior function as mediating factors in the pathway between genetic predisposition and cannabis use, suggesting these are potential intervention targets. • Early identification of individuals with high genetic risk could enable targeted prevention strategies, with potential interventions including behavioral therapy, cognitive interventions, and neuromodulation approaches to strengthen white matter integrity. **Dosage & Administration** Not reported. **Safety & Adverse Effects** Not reported. **Evidence Quality** This is a narrative commentary rather than a primary research study, representing a lower level of evidence (Level 5). The summary synthesizes findings from a single referenced study (Cupertino et al., 2025) without presenting original data or conducting systematic review methodology. Key limitations include: (1) reliance on a single source study not fully detailed in this abstract, (2) lack of systematic literature review, (3) absence of quantitative synthesis or meta-analysis, (4) no specification of sample sizes or effect sizes, and (5) preliminary nature of proposed screening and intervention recommendations without established validation. The proposed screening approach for genetic susceptibility and white matter abnormalities lacks clinical implementation evidence. While the conceptual framework linking genetics, neurobiological integrity, and behavioral outcomes is theoretically sound, the clinical applicability of these findings requires further validation through prospective studies and intervention trials before implementation in clinical practice. The commentary's value lies primarily in highlighting research directions rather than providing definitive clinical evidence.

More recent cannabis research