The third conclusion from this systematic review is that, consistent with existing human reviews (Jacobus & Tapert, 2013; Lisdahl et al., 2013a), adolescent AU females may be at heightened vulnerability for alterations in brain structure and function. This is relevant because gender differences have been found in MRI studies of typical brain development, with GM volume in the frontal and parietal lobes peaking later in boys relative to girls during late childhood/early adolescence (Giedd et al., 1999; Gogtay et al., 2004). The greater deviation from expected developmental patterns suggests a more deleterious effect of alcohol on young female brain development. To that end, some have proposed that AU interferes with normal NMDA-mediated synaptic pruning (Squeglia et al., 2012b). In terms of broader psychosocial impact, the differential neurodevelopmental impact of AU for females is particularly relevant given the greater alcohol-related consequences observed for females in epidemiological studies (Healey et al., 2014). Yet, the nature of this pattern − whether it reflects a premorbid constellation of risk, a correlate, or a consequence of adolescent AU − is far from fully understood. The potential role of sex hormones in this equation provides an area for future investigation (Paus, 2010; Spear, 2014).
