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Cerebellar Alteration in Resting-State Functional Connectivity Among Kratom ( Mitragyna speciosa ) Users: Insights from Functional MRI

Suzana Mat Isa, Aini Ismafairus Abd Hamid, Muhamad Zabidi Ahmad, Md Mahmudur Rahman, Mohammad Farris Iman Leong Abdullah, Darshan Singh

Journal of Psychoactive Drugs September 18, 2026 DOI: 10.1080/02791072.2026.2729619 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case-control study Peer reviewed
Sample size 43
Population 22 regular kratom users and 21 healthy controls
Intervention Kratom
Key findings Kratom users showed reduced low-frequency fluctuations in default mode network, cognitive control, and self-referential processing regions (precuneus, superior frontal gyrus, cerebellar and cingulate cortices) and increased functional connectivity between salience and cerebellar networks, specifically the posterior cerebellum and left rostral prefrontal cortex, compared with controls. The authors suggest these patterns may reflect altered brain activity and possible compensatory adaptations to chronic kratom use.

Abstract

), further studies are needed to measure its neurobiological impacts. This exploratory study employed resting-state functional magnetic resonance imaging (rs-fMRI) to examine alterations in brain activity and functional connectivity (FC) among kratom users. A total of 43 respondents were recruited (22 regular kratom users and 21 healthy controls). RS-fMRI data were acquired using a 1.5T GE Signa HDxt scanner. Preprocessing and analysis were performed with Statistical Parametric Mapping 12 (SPM 12) and CONN toolbox. Group differences in the low-frequency fluctuations (LFFs) and FC were examined. Kratom users exhibited reduced LFF in brain regions critical to the default mode network (DMN), cognitive control, and self-referential processing, including the precuneus, superior frontal gyrus, and cerebellar and cingulate cortices. They also showed increased FC between salience and cerebellar networks, specifically in the posterior cerebellum, and left rostral prefrontal cortex (RPFC). Chronic kratom consumption may alter brain activity, especially in areas linked to the DMN, cognition, and reward processing. Enhanced FC between salience and cerebellar networks may reflect compensatory mechanisms or adaptations to kratom's effects. Further research is crucial to elucidate the underlying mechanisms and potential implications for cognitive function and addictive behaviors.

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