Summary
There is a peculiar tendency I’ve noticed where people try to understand what ADHD is through the effects of stimulant medications and correspondingly there is an inverse tendency where they try to determine the scope of the appropriate clinical use of stimulants through the boundaries of ADHD as a diagnosis.
Highlights
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ADHD is not a disorder any specific brain network, but stimulants have specific effects on brain networks
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A recent blockbuster study in Cell provides a good starting point for this discussion. “Stimulant medications affect arousal and reward, not attention networks” by Benjamin Kay et al. (2025) is a rigorous study showing that stimulants change functional connectivity of brain in networks associated with arousal, in networks associated with salience and reward, but they do not affect canonical attention networks, regardless of whether the person has ADHD.
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Stimulant medications do not directly influence the canonical attention networks (dorsal and ventral attention networks and frontoparietal network), but neither is ADHD a disorder of attention networks. ADHD has no special relationship to attention networks. Or to reward/salience networks, for that matter. In fact, ADHD is not definable as a disorder of any specific brain network at all, even though it involves subtle, distributed connectivity differences across the whole brain.