Ventral–striatal responsiveness during reward anticipation in ADHD and its relation to trait impulsivity in the healthy population: A meta-analytic review of the fMRI literature
Open accessAbstract
A review of the existing functional magnetic resonance imaging (fMRI) studies on reward anticipation in patients with attention-deficit/hyperactivity disorder (ADHD) is provided. Meta-analysis showed a significant medium effect size (Cohen's d=0.48-0.58) in terms of ventral-striatal (VS)-hyporesponsiveness in ADHD. Studies on VS-responsiveness and trait impulsivity in the healthy population demonstrate the opposite relationship, i.e. impulsivity-scores positively correlated with VS activation during reward processing. Against the background that ADHD may represent an extreme on a continuum of normal variability, the question arises as to how these contrasting findings can be integrated. We discuss three theoretical approaches, each of which integrates the opposing findings: (1) an inverted-u-shape model; (2) a (genetic) moderator model; and (3) the "unrelated model". We conclude that at the present stage the number of existing studies in the healthy population as well as in ADHD groups is too small for a final answer. Therefore, our presented integrative approaches should be understood as an attempt to frame future research directions by generating testable hypotheses and giving practical suggestions for future studies.
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Impairment has been found in hot EF functions of motivation control and reward-related decision making, as measured in temporal discounting and gambling tasks, with more inconsistent findings.
“However, impairment has also been found in so-called “hot” EF functions of motivation control and reward-related decision making, as measured in temporal discounting and gambling tasks, with, however, more inconsistent findings (Willcutt et al., 2008; Noreika et al., 2013; Plichta and Scheres, 2014).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Plichta and Scheres, 2014
Section 2 (page unavailable) reports altered reward-related brain responses in ADHD during a delay-discounting task, supporting the reward-processing part of the claim. It does not establish impaired decision-making performance on gambling tasks or inconsistent behavioral findings; its meta-analysis instead describes the neural reward-anticipation effect as consistent across the tasks it examined. (LLM, conf=0.85)
Experimental — accuracy not yet measuredOne of the most consistent findings is reduced ventral striatum activation during reward anticipation, as shown in a recent meta-analysis of eight fMRI studies of a monetary reward anticipation task using region of interest analysis in 340 ADHD patients and healthy controls.
“One of the most consistent findings is reduced ventral striatum activation during reward anticipation, as shown in a recent meta-analysis of eight fMRI studies of a monetary reward anticipation task using region of interest analysis in 340 ADHD patients and healthy controls (Plichta and Scheres, 2014).”
From Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder (ADHD) and Its Clinical Translation (2018) · cites this paper as Plichta and Scheres, 2014
Split into 2 atoms — 0 confirmed, 2 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredDysfunction within this loop may underlie deficits in delay of gratification, reinforcement sensitivity, and effort-related decision making, which are characteristic of ADHD motivation and emotional regulation styles.
“Dysfunction within this loop may underlie deficits in delay of gratification, reinforcement sensitivity, and effort-related decision making, which are characteristic of ADHD motivation and emotional regulation styles (26).”
From Abnormal functional connectivity associated with emotional dysregulation in children with attention-deficit/hyperactivity disorder (2025) · cites this paper as [26]
Section 2 links altered dopamine-based reward processing in ADHD to preference for immediate rewards, abnormal reinforcement sensitivity, and a motivational style partly associated with negative emotions during waiting. It does not establish deficits in effort-related decision making or specifically attribute all three deficits to dysfunction within the cited loop. Page numbers are unavailable in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredNon-emotional trait impulsivity in the general population is related to increased striatal activation in the reward anticipation phase, in contrast to hypoactivation in ADHD.
“In line with this, non-emotional trait impulsivity in the general population is related to increased striatal activation in the reward anticipation phase in contrast to hypoactivation in ADHD (Plichta and Scheres, 2014).”
From Top-Down Dysregulation—From ADHD to Emotional Instability (2016) · cites this paper as Plichta and Scheres, 2014
The Background (page unavailable) reports a positive association between impulsivity-related traits and ventral-striatal response during reward anticipation in healthy people. Section 2 (page unavailable) reports relative ventral-striatal hypoactivation during reward anticipation in ADHD. The paper does not specifically establish the association for *non-emotional* impulsivity; it describes impulsivity as having cognitive, affective, and motor facets. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe monetary incentive delay task has been repeatedly shown to elicit a neural response in the ventral striatum to both reward anticipation and receipt.
“The MID task has been repeatedly shown to elicit a neural response in the VS to both reward anticipation and receipt (for review see 15,18-20).”
From Increased neural responses to reward in adolescents and young adults with attention-deficit/hyperactivity disorder and their unaffected siblings (2015) · cites this paper as [15]
Section 2 describes the MID task as measuring reward anticipation and feedback, including the monetary outcome, and reports ventral-striatal responses during anticipation. It does not establish that the task repeatedly elicits a ventral-striatal response at reward receipt; its feedback finding concerns the absence of a difference between ADHD and control groups. (LLM, conf=0.84)
Experimental — accuracy not yet measured
In reward-processing paradigms, most studies report lower activation of the ventral striatum of patients with ADHD in anticipation of reward than in controls.
“In rewardprocessing paradigms, most studies report lower activation of the ventral striatum of patients with ADHD in anticipation of reward than in controls 75 .”
From Attention-deficit/hyperactivity disorder (2015) · cites this paper as [75]
The study's data are in contrast with reports of decreased responsiveness of the VS in anticipation of reward in adults with ADHD and with one study with adolescents with ADHD.
“However, they are in contrast with reports of decreased responsiveness of the VS in anticipation of reward in adults with ADHD,15 as well as with one study with adolescents with ADHD.16”
From Increased neural responses to reward in adolescents and young adults with attention-deficit/hyperactivity disorder and their unaffected siblings (2015) · cites this paper as [15]
Studies using a monetary incentive delay task have found alterations in ventral striatum signaling in both healthy populations and participants with ADHD.
“studies investigating reward processing using a monetary incentive delay (MID) task have found alterations in VS signaling in both healthy populations and participants with ADHD (for review see 15).”
From Increased neural responses to reward in adolescents and young adults with attention-deficit/hyperactivity disorder and their unaffected siblings (2015) · cites this paper as [15]
In the healthy population, impulsivity is associated with increases in sensitivity to reward.
“Moreover, impulsivity is in the healthy population associated with increases in sensitivity to reward 15.”
From Increased neural responses to reward in adolescents and young adults with attention-deficit/hyperactivity disorder and their unaffected siblings (2015) · cites this paper as [15]
ADHD network abnormalities are only part of the pathophysiology of ADHD, not the only factors responsible.
“However, these network abnormalities are not the only factors responsible for ADHD; instead, they are only part of the pathophysiology of ADHD [36].”
From A translational neuroscience perspective on mindfulness meditation as a prevention strategy (2016) · cites this paper as [36]
A meta-analysis found ventral-striatal hyporesponsiveness during reward anticipation in ADHD individuals compared to healthy individuals.
“A meta-analysis also showed a ventral-striatal hyporesponsiveness (decreased response) on reward anticipation in ADHD individuals compared to healthy individuals [36].”
From A translational neuroscience perspective on mindfulness meditation as a prevention strategy (2016) · cites this paper as [36]
Impulsivity and impairments in reward processing are core features of many disorders, including ADHD and addiction.
“This relationship is of high clinical relevance because impulsivity and impairments in reward processing are core features of many disorders, including ADHD (19, 20) and addiction (21).”
From Understanding heterogeneity in clinical cohorts using normative models: Beyond case-control studies (2016) · cites this paper as [20]
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“…of the most consistent findings is reduced ventral striatum activation during reward anticipation, as shown in a recent meta-analysis of eight fMRI studies of a monetary reward anticipation task using region of interest analysis in 340 ADHD patients and healthy controls (Plichta and Scheres, 2014).”
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“…non-emotional trait impulsivity in Frontiers in Behavioral Neuroscience | www.frontiersin.org 16 May 2016 | Volume 10 | Article 70 the general population is related to increased striatal activation in the reward anticipation phase in contrast to hypoactivation in ADHD (Plichta and Scheres, 2014).”
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- Authors
- Plichta, M. M., & Scheres, A.
- Affiliations
- Heidelberg University (DE)
- Radboud University Nijmegen (NL)
- Corresponding author
- Plichta, Michael M.
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2014-01
- Volume
- 38
- Pages
- 125-134
- ISSN
- 0149-7634 (ISSN-L)
- PMC
- PMC3989497
- OpenAlex
- W2128368278
- Cited by
- 424
- References
- 113
- Citations by year
- 2026: 23 · 2025: 22 · 2024: 26 · 2023: 24 · 2022: 29 · 2021: 38 · 2020: 44 · 2019: 42 · 2018: 33 · 2017: 39 · 2016: 42 · 2015: 41 · 2014: 17 · 2013: 2
- FWCI
- 4.52
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Funders
- Beijing Normal University
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Universität Mannheim
- Institut de recherche en santé mentale
- National Institute of Mental Health (R03MH080930)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Keywords
- attention deficit hyperactivity disorder, reward anticipation, ventral striatum, trait impulsivity, reward processing
- MeSH terms
- Adolescent, Adult, Attention Deficit Disorder with Hyperactivity, Basal Ganglia, Female, Humans, Impulsive Behavior, Magnetic Resonance Imaging, Male, Models, Neurological, Reward, Young Adult, Anticipation, Psychological
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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