Background and Aims: Internet gaming disorder (IGD), as a relapse disease, has become a common mental health problem among Asian teenagers. Functional connections in the prefrontal lobo-striatum affect changes in impulsivity and inhibition. Therefore, exploration of the directional connections of the relevant brain regions in the prefrontal-striatal circuit and the synchronization level of the two hemispheres will help us to further understand the neural mechanism of IGD, which can provide guidance for the development of prevention and intervention strategies.Methods: Twenty-two adolescents with IGD, recruited through various channels, composed the IGD group. Twenty-six subjects, matching age, gender, and education level, were included in a recreational internet game users (RGUs) control group. Impulsivity and response inhibition were tested via general questionnaire, the Internet Addiction Test (IAT), the Barratt impulsivity scale-11 (BIS-11), and a Stroop color-word task. A Granger causality analysis (GCA) was used to calculate the directional connection between the prefrontal and striatum with the dorsolateral prefrontal cortex (DLPFC) as a region of interest (ROI). We chose voxel-mirrored homotopic connectivity (VMHC) to determine brain hemisphere functional connectivity in the prefrontal-striatal circuits.Results: We found significant differences in impulsivity between the IGD group and RGU group, with members of the IGD group exhibiting higher impulsivity. Additionally, the response inhibition of adolescents with IGD in the Stroop color-word task was impaired. There was a significant difference in the directed connection of the left DLPFC and dorsal striatum between the IGD group and the RGU group.Conclusions: This study confirmed the role of prefrontal-striatal circuits in the neural mechanism of IGD in adolescents. In the IGD group, bilateral cerebral medial orbitofrontal cortex (mOFC) synchronization was significantly reduced, which indicated that mOFC signal transmission in both hemispheres of the brain might be affected by impulse behavior and impaired response inhibition.