People with ADHD are often described as chasing rewards, and autistic people as less moved by them. Both descriptions are rough, and sometimes unfair. A meta-analysis published in Molecular Psychiatry in 2026 looked at what happens in the brain at the precise moment a reward arrives. Its answer is more interesting: ADHD and autism involve the same deep brain regions, but those regions seem to respond in opposite directions.
What "Hedonic Experience of Rewards" Means
Researchers usually split reward into phases. First comes anticipation: you know a reward might be coming and you work for it (often called "wanting"). Then comes receipt: the reward actually arrives and the brain registers how good it feels (often called "liking"). The "hedonic experience" of the study title is this second moment.
In a brain scanner, this is tested with simple games. A message tells you that you have just won a small sum of money, or a smiling face or a word of approval appears after a correct answer.
What the Researchers Did
The team, led by Chunhong Zhu, Ting Xu and Tingyong Feng at the Faculty of Psychology of Southwest University in Chongqing, China, did not scan anyone themselves. They ran a pre-registered meta-analysis: they gathered 29 earlier fMRI studies of reward receipt, covering 468 people with ADHD, 424 autistic people and 1,027 people without either condition, and pooled the brain differences those studies had reported. The rewards were either money or social rewards.
They then added three analyses: brain connectivity, based on an independent database of scans from healthy people; Neurosynth decoding, which links brain locations to the terms used in thousands of published studies; and PET-based maps showing where dopamine and serotonin receptors and transporters are concentrated in the brain.
Same Regions, Opposite Directions
According to the abstract, both conditions showed altered activity in two deep (subcortical) structures: the amygdala, which helps flag what is emotionally important, and the putamen, part of the striatum, a key hub of the reward system. The differences specific to each condition were mainly in the prefrontal cortex, at the front of the brain.
The full paper is behind a paywall, but according to a detailed summary published by PsyPost, the directions were opposite:
- ADHD: the amygdala and putamen were more active than in controls when the reward arrived, while prefrontal areas involved in self-control and decision-making were less active.
- Autism: the same deep regions were less active than in controls, while medial prefrontal regions that judge how valuable something is were more active.
The extra analyses fit this picture. In ADHD, the over-active regions were linked to intense emotion and to motivation circuits, while the under-active ones were linked to attention and executive control. In autism, the over-active prefrontal regions were linked to social and value-related terms, and the under-active deep regions to novelty and basic emotional processing. On the receptor maps, ADHD's over-active regions sat in areas rich in dopamine and serotonin receptors, while autism's over-active value regions sat in areas with very low serotonin transporter density.
What It Might Mean for Everyday Motivation
The authors suggest that in ADHD, a strong reaction in emotional and reward centres combined with weaker prefrontal "brakes" could help explain impulsivity, difficulty waiting for a later reward and intense emotional reactions. In daily life, that would fit with the pull of what is new, immediate and exciting, and with how hard it can be to stay with a task whose payoff is far away.
For autism, they propose that the muted subcortical response may reflect a general dampening of reward signals, and that the extra prefrontal activity might be a form of compensation, a more deliberate way of working out value. That could fit with the experience that generic social rewards, such as a polite smile or a quick "well done", do not always land as others expect. It does not mean that autistic people care less about others or feel less pleasure in general. The rewards in these experiments were chosen by researchers, and may not be the ones that matter most to a given person, such as time spent on a deep interest. All of this remains hypothetical: the study did not measure anyone's motivation in daily life.
Not Simply "Too Little Dopamine"
None of this shows that ADHD brains simply "lack dopamine". The receptor maps describe where dopamine and serotonin systems are concentrated in the brain in general; they were not measured in the participants. And in ADHD, the deep reward regions were more active, not less, when the reward arrived. As we explain in our article on the "low dopamine" myth, the real picture involves several systems and circuits, not a single chemical shortage.
What About People with Both (AuDHD)?
ADHD and autism often occur together. This meta-analysis compared separate ADHD and autism groups, so it cannot tell us what happens in people who have both. Both patterns might coexist, partly offset each other, or vary with the situation and the kind of reward. Many AuDHD people describe this kind of tug of war, for example craving novelty while also needing predictability. Our article on AuDHD and the overlap between autism and ADHD explores this further.
The Limits
- 29 studies is a moderate number.
- Money and social rewards were pooled, although they may engage partly different pathways, and there were too few autism studies to analyse each type of reward separately.
- The connectivity analysis relied on healthy brains, not on people with ADHD or autism. The authors see mapping these networks directly in patients as a next step.
- This is not a diagnostic tool. The results are group averages, and no brain scan can currently diagnose ADHD or autism; diagnosis relies on a clinical assessment.
What This Means for You
This study cannot tell you how your own brain works, but it supports a useful idea: differences in motivation are not a matter of laziness or lack of willpower. They may partly reflect how the brain registers rewards in the moment. Knowing what genuinely rewards you, quick visible wins or time on a deep interest, can be a better starting point than relying on willpower alone.
If you are wondering where you stand, our free Neurotype test looks at five dimensions of your profile at once, including attention and social and sensory traits. You can also take the ASRS-v1.1 adult ADHD screener (18 questions, about 10 minutes) or the AQ-10 autism screener (10 questions, about 3 minutes). Screening tests are not a diagnosis, but they can help you put words on your experience and prepare a conversation with a professional.
Source: Zhu C, Bore MC, Wang X, Xu T, Feng T. Distinct neurobiological alterations during hedonic experience of rewards in attention deficit hyperactivity disorder and autism spectrum disorder: Multimodal evidence from neuroimaging meta-analyses. Molecular Psychiatry 31, 3605-3617 (2026), published online 17 February 2026. DOI 10.1038/s41380-026-03495-6. Pre-registered coordinate-based meta-analysis of 29 task-based fMRI studies (468 people with ADHD, 424 autistic people, 1,027 controls), with brain connectivity, Neurosynth decoding and neurotransmitter map analyses. Reported by PsyPost, 7 October 2026.