Role and Functions of the Human Orbitofrontal Cortex

The orbitofrontal cortex (OFC) plays a pivotal role in integrating sensory, emotional, and cognitive signals to support flexible, goal-directed behavior. This review synthesizes converging evidence from lesion studies, neuroimaging, intracranial recordings and stimulations to elucidate the OFC's contribution to emotional regulation, social behavior, and value-based decision making. Lesions in the OFC are associated with affective disturbances, social disinhibition, and impaired behavioral adaptation to feedback. The OFC evaluates the hedonic valence of stimuli across sensory modalities-visual, gustatory, olfactory, somatosensory, and auditory-thereby contributing to subjective affective experience. Intracranial and neuroimaging data further underscore the OFC's involvement in processing emotional facial expressions, tactile pleasure, and social cues such as attractiveness and vocal identity. Stimulation studies provide causal evidence for the OFC's role in modulating emotional perception and mood. Structural and functional alterations of the OFC are consistently observed across multiple neuropsychiatric conditions, including major depressive disorder, obsessive-compulsive disorder, borderline personality disorder, and addiction. These abnormalities manifest as impaired reward processing, increased impulsivity, and affective dysregulation, and may be ameliorated by targeted neuromodulatory interventions such as deep brain stimulation and repetitive transcranial magnetic stimulation. Collectively, findings highlight the OFC as a central hub for affective-cognitive integration and as a promising target for therapeutic modulation in psychiatric disorders.