Does Stimulant Therapy Normalise Imaging Differences in ADHD? 

Research indicates that ADHD stimulant therapy brain imaging does show signs of structural changes and functional recovery, suggesting a degree of neuroplasticity in treated individuals versus untreated ADHD. In children especially, stimulants appear to help some brain structures and functions move closer to typical ranges.  

A recent large‑scale study of children aged 9‑11 found that those with ADHD on stimulant medication (with low symptom levels) had brain structure measures, like cortical thickness in the insula and volume of the nucleus accumbens, that were comparable to typically developing children, whereas unmedicated children with high ADHD symptoms showed reduced thickness or volume in these regions. Also, long‑term morphometry studies in adults suggest that stimulant treatment is associated with increased gyrification and surface complexity in some cortical regions compared to medication‑naive adults. Reviews of multiple MRI/fMRI studies further show that therapeutic oral doses of stimulants tend to attenuate many of the structural and functional abnormalities found in untreated ADHD, functional activation in attention and executive networks improves, for example.  

How Imaging Normalisation Relates to Symptoms 

Below are common symptom changes linked to these imaging findings, and how treatment helps: 

Better Focus, Less Distractibility 

Unmedicated ADHD often shows under‑activation in frontoparietal attention networks in imaging. When treated with stimulants, those activations become stronger, helping individuals sustain attention and reduce distractibility. Behavioural therapies can further support these changes by reinforcing attention practices over time. 

Improved Reward Processing & Control 

Some imaging studies show that untreated ADHD has reduced structural volume in reward circuits (e.g. nucleus accumbens) or weaker functional engagement. Stimulant therapy seems to help partially restore or “normalise” these areas, aligning reward response with non‑ADHD patterns. Therapeutic approaches that combine medication with reward‑based behavioural training may amplify these effects. 

Stimulant therapy does not make all imaging measures “normal,” and differences remain. But the accumulating evidence supports the idea that treatment can lead to measurable brain changes in structure and function.  

Visit providers like ADHD Certify for personal consultations considering these imaging insights. 

For a deeper dive into the science, diagnosis, and full treatment landscape, read our complete guide to ADHD stimulant therapy.