PROJECT SUMMARY / ABSTRACT Initiating excessive alcohol drinking during adolescence is known to disturb typical neurodevelopmental patterns, increase the risk of developing alcohol use disorder (AUD), and accelerate involutional processes in adulthood. In response to RFA-AA-21-007, this application proposes a Research Project Site of the National Consortium on Alcohol and Neurodevelopment in Adolescence - Adulthood (NCANDA-A) to follow for the next 5 years a diverse community sample of male and female participants recruited in three age bands (12-14, 15-17, 18-21 years old) when most were no-to-low drinkers and tracked over the last 8 years across 5 sites (N=831; 93% retention rate). Monitoring has involved annually acquired multimodal neuroimaging (MRI, DTI, resting state fMRI, task fMRI), cognitive, clinical, behavioral, and biological data, collected in person or remotely by computer and our mobile app. These measures will now be complemented with new advanced neuroimaging and sleep and physical activity tracking. This cohort sequential design uniquely positions NCANDA-A to quantify transient or enduring alcohol-related disturbances in specific adolescent and early adult neural system growth trajectories and functional concomitants. NCANDA-A proposes four consortium-wide specific aims and two specialty project aims. In Aim 1, NCANDA-A will investigate the impact of excessive alcohol drinking during adolescence and emerging adulthood on subsequent developmental trajectories of cognitive performance, brain structure and function, and psychopathology. Aim 2 analyses will identify neurodevelopment patterns describing the extent to which alcohol's effects on brain structure and function resolve or persist during desistance after binge drinking. Aim 3 will deploy data-driven analysis to identify adolescent biological, environmental, and behavioral factors (e.g., age of drinking onset) that forecast excessive drinking during early adulthood. In Aim 4, NCANDA-A will quantify the impact of the COVID pandemic on life stress and social, emotional, and economic wellbeing and their relations with alcohol use patterns. In Aim 5, the SRI and Pittsburgh sites will identify interactions among patterns of alcohol use, sleep, and cardiac function. In Aim 6, the UCSD, Duke and OHSU sites will determine the extent to which short-term (i.e., 4 weeks) alcohol use discontinuation results in acute improvement in cognition, affect, sleep and resting heart rate, and reversal of the adverse structural and functional brain effects of frequent binge alcohol use. For each aim, sex differences in development, alcohol use patterns and history, impact of alcohol use on the brain, and sex-differentiating psychosocial factors will be tested. With the longitudinal data collected into early adulthood during this renewal, NCANDA-A will provide novel information to the public on the enduring and transient effects of adolescent drinking on adult functioning by discovering elements an...