The Effects of Cognitive Behavioral Therapy on Intrinsic Functional Brain Networks in Adults with Attention Deficit Hyperactivity Disorder

The Effects of Cognitive Behavioral Therapy on Intrinsic Functional Brain Networks in Adults with Attention Deficit Hyperactivity Disorder 

Behavior Research and Therapy

Attention-deficit/hyperactivity disorder (ADHD) is a common condition characterized by symptoms of inattention, hyperactivity, and impulsivity. It is recognized as a developmental impairment of cognitive functions, with persisting impairments in academic, occupational, social, and emotional domains in adults with ADHD. This study provides valuable insights into non-pharmacological ADHD interventions.

ADHD is commonly treated with prescription stimulants. However, not all adults with ADHD can or want to use these medications. Cognitive Behavioral Therapy (CBT) is also an established treatment for ADHD. CBT is a form of therapy that focuses on changing negative thoughts and behaviors. It has been shown to be effective in treating ADHD in adults, with resulting symptom reductions comparable to medications.  

Despite CBT’s efficacy in treating ADHD, there is little known about the neural processes underlying the benefits of CBT for adults suffering from this disorder.  This study explored the effect CBT has on several brain networks associated with ADHD.  It did this by conducting resting-state fMRI scans of adults with ADHD before and after a 12-session CBT protocol.  These scans allowed researchers to identify if and how CBT changed regional functional connectivity (rFCS) between neural networks associated with CBT.   

Key Findings:

  • Increased Brain Connectivity: Adults receiving 12 weeks of CBT showed increased connectivity between brain regions associated with ADHD, specifically within the fronto-parietal network and cerebellum, areas also influenced by ADHD medications. 
  • Symptom Improvement: ADHD symptoms were assessed using the ADHD Rating Scale-IV (ADHD RS-IV) and the Behavior Rating Scale for Executive Functioning - Adult Version (BRIEF-A).  Scores on both measures improved, indicating improvements in ADHD symptoms 
  • Increased Connectivity and Symptom Improvement:  Analysis of the data revealed a positive correlation between increased brain connectivity measured post-CBT and the improvements in ADHD symptoms as measured by ADHD RS-IV and the BRIEF-A.


These findings suggest that CBT not only improves ADHD symptoms but may also promote neurophysiological changes in the brain.


Highlights from the Study

“...after a 12-session CBT, adults with ADHD showed increased whole-brain functional connectivity in the fronto-parietal network and cerebellum. These brain regions were also mostly affected by medication in ADHD.”

“The enhanced functional coupling between bilateral superior parietal gyrus was positively correlated with the improvement of ADHD symptoms following CBT”


At Feeling Good Institute, we specialize in evidence-based CBT for various conditions, including ADHD and disorders that affect executive functioning. This study provides evidence that CBT positively influences the same brain networks as commonly prescribed ADHD medications.  

Research Brief Author: Erik Wilkerson, Psy.D.

Citation: Wang, X., Cao, Q., Wang, J., Wu, Z., Wang, P., Sun, L., Cai, T., & Wang, Y. (2016). The effects of cognitive-behavioral therapy on intrinsic functional brain networks in adults with attention-deficit/hyperactivity disorder. Behaviour Research and Therapy, 76, 32-39.

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