There appears to be a distinct pattern of anatomical asymmetry, particularly in the OFC, that is functionally important in behavioral and emotional regulation. Unilateral right hemisphere damage to the ventrolateral prefrontal cortex (PFC) is associated with severe deficits in social/emotional and descision-making processes (Tranel et al. 2005). Greater involvement of the right than left prefrontal cortex is seen in tasks involving response selection and inhibition, with suboptimal response inhibition in children and adolescents is related to insufficient recruitment of the right ventrolateral PFC (Rubia et al. 2001). This is consistent with a subsequent study that found that boys with conduct disorder had lower activation of the right orbitofrontal cortex compared with healthy controls subjects and those with ADHD (Rubia et al. 2008). Moreover, volumetric differences in adolescents at high risk for AUD appear to be limited to the right OFC (Hill et al. 2009).
