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White\u2010matter microstructure was examined using primary\u2010fiber orientations anisotropy, which may reflect white\u2010matter integrity, modeled separately from other fiber orientations in the same voxels. Analyses were conducted on regions of interest previously associated with childhood stress and substance use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Lower perceived stress and presence of substance\u2010use initiation were related to greater right cingulum primary\u2010fiber measures. Substance\u2010use\u2010initiation status moderated the association between perceived stress and right cingulum primary\u2010fiber measures, such that higher perceived stress was associated with lower right cingulum primary\u2010fiber anisotropy in adolescents without substance\u2010use initiation, but not in those with substance\u2010use initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Scientific Significance<\/jats:title><jats:p>Findings in primary\u2010fiber anisotropy suggest differences in right cingulum white\u2010matter integrity is associated with substance\u2010use initiation in higher\u2010stress adolescents. This reflects a possible pre\u2010existing risk factor, an impact of early substance use, or a combination thereof. Examination of potential markers associated with substance\u2010use initiation in white\u2010matter microstructure among stress\u2010exposed youth warrant additional investigation as such biomarkers may inform efforts relating to tailored interventions. 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