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From neurons to brain networks, pharmacodynamics of stimulant medication for ADHD
Open accessAbstract
Stimulants represent the first line pharmacological treatment for attention-deficit/hyperactivity disorder (ADHD) and are among the most prescribed psychopharmacological treatments. Their mechanism of action at synaptic level has been extensively studied. However, it is less clear how their mechanism of action determines clinically observed benefits. To help bridge this gap, we provide a comprehensive review of stimulant effects, with an emphasis on nuclear medicine and magnetic resonance imaging (MRI) findings. There is evidence that stimulant-induced modulation of dopamine and norepinephrine neurotransmission optimizes engagement of task-related brain networks, increases perceived saliency, and reduces interference from the default mode network. An acute administration of stimulants may reduce brain alterations observed in untreated individuals in fronto-striato-parieto-cerebellar networks during tasks or at rest. Potential effects of prolonged treatment remain controversial. Overall, neuroimaging has fostered understanding on stimulant mechanism of action. However, studies are often limited by small samples, short or no follow-up, and methodological heterogeneity. Future studies should address age-related and longer-term effects, potential differences among stimulants, and predictors of treatment response.
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“Studies using acute administration of stimulants demonstrated that neural activity in adults with ADHD can be modulated towards similar levels as those of adults without ADHD in various tasks (Parlatini et al., 2024).”
From Are prediction error modifications domain specific in autism but domain general in ADHD? (2025) · cites this paper as Parlatini et al., 2024
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- Parlatini, 2023, White matter alterations in Attention-Deficit/Hyperactivity Disorder (ADHD): a systematic review of 129 diffusion imaging studies with meta-analysis, Mol. Psychiatry, 10.1038/s41380-023-02173-1 · DOI
- Parlatini, 2024, A state-of-the-art overview of candidate diagnostic biomarkers for Attention-deficit/hyperactivity disorder (ADHD), Expert Rev. Mol. Diagn., 24, 259, 10.1080/14737159.2024.2333277 · DOI
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Metadata
- Authors
- Parlatini, V., Bellato, A., Murphy, D., & Cortese, S.
- Affiliations
- King's College London (GB)
- University of Nottingham (GB)
- Corresponding author
- Parlatini, Valeria
- Venue
- Neuroscience & Biobehavioral Reviews
- Publisher
- Elsevier BV
- Published
- 2024-09
- Volume
- 164
- Pages
- 105841
- ISSN
- 0149-7634 (ISSN-L)
- OpenAlex
- W4401306218
- Cited by
- 26
- References
- 230
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 1
- FWCI
- 2.08
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Neuroscience & Biobehavioral Reviews (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- iMinds
- British Association for Psychopharmacology
- Aims2Cure (AIMS-2-TRIALS, 115300, 777394)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- attention deficit hyperactivity disorder, stimulant medication, pharmacodynamics, dopamine signaling, brain networks, default mode network, salience, long-term treatment outcomes, predictors of treatment response
- MeSH terms
- Central Nervous System Stimulants, Attention Deficit Disorder with Hyperactivity, Brain, Humans, Nerve Net, Neurons
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