This study found that functional connectivity with reward/salience regions, specifically the NAcc, appears to represent a preexisting neurobiological characteristic of FH+ youth. Despite similar performance and NAcc activation, reward processing in the high-risk group involved positive striatal functional connectivity with attention, motor and DMN structures versus decoupling seen in FH− subjects, suggestive of inefficient inter-network communication. Importantly, NAcc-SSMA and NAcc-precuneus connectivity mediated the relationship between the personality trait of sensation-seeking and drinking in FH+ subjects, representing a potential model of vulnerability. Differences in accumbens connectivity with multiple functional networks, rather than strictly with control regions, may influence the reward system’s role in vulnerability for substance abuse.
