the independent or combined effects of these additional use disorders due to insufficient statistical power. Instead, as a post-hoc analysis, we tested whether our effect remained after a binary covariate indexing other SUDs was used. A similar covariate approach was made to account for the fact that participants with AUD were much more likely to be male than female. While our results remained significant, this approach is imperfect, and additional studies are warranted to determine the impact of other SUDs and effects of biological sex. Future studies should aim to recruit more females with AUD as, although males have a higher rate of AUD than females, this gender gap appears to be closing47. Third, our study utilized AUDIT/CUDIT measures to derive additional information on amount/frequency of use, but was limited in details such as concurrent versus simultaneous use, time of last use, and tobacco use, and future study is needed to assess these variables. Finally, our task probed visual-spatial processing, which was largely limited to neural activity in the occipital cortices. Further studies are needed to understand how these changes affect and interact with more frontally-mediated executive function deficits that can occur in substance use disorders.
