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Macrì R, Maiuolo J, Scarano F, Musolino V, Fregola A, Gliozzi M, Carresi C, Nucera S, Serra M, Caminiti R, Cardamone A, Coppoletta AR, Ussia S, Ritorto G, Mazza V, Bombardelli E, Palma E, Muscoli C, Mollace V. Evaluation of the Potential Beneficial Effects of Ferula communis L. Extract Supplementation in Postmenopausal Discomfort. Nutrients 2024; 16:2651. [PMID: 39203788 PMCID: PMC11357168 DOI: 10.3390/nu16162651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2024] [Revised: 08/05/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Peri-menopausal discomfort can have a detrimental effect on the physical health of women due to physiological and behavioral changes. Estrogen and progesterone-based hormone therapy can alleviate menopausal symptoms, but estrogen supplementation may have negative health effects. The effectiveness of hormone replacement therapy using natural compounds for peri-menopausal disorders is still uncertain. Evidence from in vivo experiments indicates that Ferula L. extract in ovariectomized rats leads to better sexual behavior. The effect seems to be linked to the phytoestrogenic properties of ferutinin, the primary bioactive compound in the extract. The purpose of this study was to assess the clinical impact of Ferula communis L. extract (titrated at 20% ferutinin, and given at doses of 100 mg/die for 90 days) on the quality of life of 64 menopausal women. The clinical trial was randomized, double-blind, and placebo controlled. Our data showed that Ferula communis L. extract reduced by 67 + 9% all symptoms associated to postmenopausal discomfort and enhanced significantly sexual behavior. In addition, the supplement led to a significant improvement of BMI and oxidative stress decrease in the women who received it, while also keeping platelet aggregation within normal levels. Overall, these results could point to the potential use of supplementation with Ferula communis L. extract to revert or mitigate menopause dysfunction.
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Affiliation(s)
- Roberta Macrì
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Jessica Maiuolo
- Laboratory of Pharmaceutical Biology, IRC-FSH Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (J.M.); (V.M.)
| | - Federica Scarano
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Vincenzo Musolino
- Laboratory of Pharmaceutical Biology, IRC-FSH Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (J.M.); (V.M.)
| | - Annalisa Fregola
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Micaela Gliozzi
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Cristina Carresi
- Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (C.C.); (E.P.)
| | - Saverio Nucera
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Maria Serra
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Rosamaria Caminiti
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Antonio Cardamone
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Anna Rita Coppoletta
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Sara Ussia
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Giovanna Ritorto
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Valeria Mazza
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Ezio Bombardelli
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Ernesto Palma
- Veterinary Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (C.C.); (E.P.)
| | - Carolina Muscoli
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
| | - Vincenzo Mollace
- Pharmacology Laboratory, Institute of Research for Food Safety and Health IRC-FSH, Department of Health Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (F.S.); (A.F.); (M.G.); (S.N.); (M.S.); (R.C.); (A.C.); (A.R.C.); (S.U.); (G.R.); (V.M.); (E.B.); (C.M.)
- Renato Dulbecco Institute, 88046 Lamezia Terme, Italy
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Pinto J, Comprido C, Moreira V, Maccarone MT, Cogoni C, Faustino R, Pignatelli D, Cera N. The Complex Role Played by the Default Mode Network during Sexual Stimulation: A Cluster-Based fMRI Meta-Analysis. Behav Sci (Basel) 2024; 14:570. [PMID: 39062393 PMCID: PMC11273531 DOI: 10.3390/bs14070570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/14/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
The default mode network (DMN) is a complex network that plays a significant and active role during naturalistic stimulation. Previous studies that have used naturalistic stimuli, such as real-life stories or silent or sonorous films, have found that the information processing involved a complex hierarchical set of brain regions, including the DMN nodes. The DMN is not involved in low-level features and is only associated with high-level content-related incoming information. The human sexual experience involves a complex set of processes related to both external context and inner processes. Since the DMN plays an active role in the integration of naturalistic stimuli and aesthetic perception with beliefs, thoughts, and episodic autobiographical memories, we aimed at quantifying the involvement of the nodes of the DMN during visual sexual stimulation. After a systematic search in the principal electronic databases, we selected 83 fMRI studies, and an ALE meta-analysis was calculated. We performed conjunction analyses to assess differences in the DMN related to stimulus modalities, sex differences, and sexual orientation. The results show that sexual stimulation alters the topography of the DMN and highlights the DMN's active role in the integration of sexual stimuli with sexual schemas and beliefs.
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Affiliation(s)
- Joana Pinto
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Camila Comprido
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
| | - Vanessa Moreira
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
| | | | - Carlotta Cogoni
- Instituto de Biofísica e Engenharia Biomédica, Faculty of Sciences, University of Lisbon, 1749-016 Lisbon, Portugal;
| | - Ricardo Faustino
- Research Unit in Medical Imaging and Radiotherapy, Cross I&D Lisbon Research Center, Escola Superior de Saúde da Cruz Vermelha Portuguesa, 1300-125 Lisbon, Portugal;
| | - Duarte Pignatelli
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Endocrinology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Nicoletta Cera
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
- Research Unit in Medical Imaging and Radiotherapy, Cross I&D Lisbon Research Center, Escola Superior de Saúde da Cruz Vermelha Portuguesa, 1300-125 Lisbon, Portugal;
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Ågmo A. Neuroendocrinology of sexual behavior. Int J Impot Res 2024; 36:305-311. [PMID: 36481796 DOI: 10.1038/s41443-022-00654-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
One of the consequences of sexual behavior is reproduction. Thus, this behavior is essential for the survival of the species. However, the individual engaged in sexual behavior is rarely aware of its reproductive consequences. In fact, the human is probably the only species in which sexual acts may be performed with the explicit purpose of reproduction. Most human sexual activities as well as sex in other animals is performed with the aim of obtaining a state of positive affect. This makes sexual behavior important for wellbeing as well as for reproduction. It is not surprising, then, that sexual health has become an increasingly important issue, and that knowledge of the basic mechanisms controlling that behavior are urgently needed. The endocrine control of sexual behavior has been extensively studied, and although it is established that gonadal hormones are necessary, some controversy still exists concerning which hormone does what in which species. The brain areas necessary for sexual behavior have been determined in almost all vertebrates except the human. The medial preoptic area is crucial in males of all non-human vertebrates, whereas the ventromedial nucleus of the hypothalamus is important in females. Modulatory functions have been ascribed to several other brain areas.
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Moon CM, Heo SH, Yoon W, Baek BH, Shin SS, Kim SK, Lee YY. Altered Sexual Response-Related Functional Connectivity and Morphometric Changes Influenced by Sex Hormones across Menopausal Status. J Clin Med 2024; 13:387. [PMID: 38256520 PMCID: PMC10816754 DOI: 10.3390/jcm13020387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 12/29/2023] [Accepted: 01/09/2024] [Indexed: 01/24/2024] Open
Abstract
Our study retrospectively investigated differential patterns of the functional connectivity (FC) of core brain regions synchronous with morphometric changes associated with sexual dysfunction in menopausal women, and their correlations with sexual hormones. Twenty-three premenopausal women (mean age: 41.52 ± 7.38 years) and 21 menopausal women (mean age: 55.52 ± 2.80 years) underwent sex hormone level measurements with high-resolution T1 and functional magnetic resonance imaging (MRI) during rest, neutral, and sexual arousal conditions. Analysis of covariance adjusted for age was used to compare the FC and gray matter (GM) volume between the two groups. Menopausal women showed lower GM volumes in the superior frontal gyrus (SFG), superior temporal pole, parahippocampal gyrus (PHG), hippocampus (Hip), amygdala (Amg), and cerebellum (Cb) compared to premenopausal women (p < 0.05). In addition, compared to premenopausal women, menopausal women showed decreased FC of seed regions involved in the SFG, frontal eye fields, and Amg, as well as target regions involved in the PHG, Hip, inferior frontal gyrus, Cb, and vermis (p < 0.005). Furthermore, the FC between the right Amg and right Cb and between the left Amg and right Cb during sexual arousal in both groups was positively correlated with total estrogen and estradiol levels, respectively (p < 0.01). The GM volume values in the right Amg and right Cb were positively correlated with total estrogen and estradiol levels (p < 0.05). Our study demonstrated an association between menopause-related differential FC and GM volume variations and fluctuating sex hormones. Our findings highlight that overlapping brain regions with functional alterations and morphometric changes are closely linked with menopausal symptom-related decreases in sexual arousal and hormone levels.
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Affiliation(s)
- Chung Man Moon
- Research Institute of Medical Sciences, Chonnam National University, 264 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Woong Yoon
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Byung Hyun Baek
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Sang Soo Shin
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Seul Kee Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun 58128, Jeollanam-do, Republic of Korea
- Department of Radiology, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
| | - Yun Young Lee
- Department of Radiology, Chonnam National University Hospital, 42 Jebong-ro, Dong-gu, Gwangju 61469, Gyeonggi-do, Republic of Korea
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Kim GW, Park K, Jeong GW. Early Detection of Alzheimer's Disease in Postmenopausal Women Using Thalamic Subnuclear Volumetry. J Clin Med 2023; 12:6844. [PMID: 37959308 PMCID: PMC10648434 DOI: 10.3390/jcm12216844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 10/24/2023] [Accepted: 10/26/2023] [Indexed: 11/15/2023] Open
Abstract
Alzheimer's disease (AD) and aging are intrinsically interconnected with each other and are mediated by molecular, cellular, and biological systems. In particular, a specific pattern of brain volume atrophy is the most profound risk factor for cognitive impairment, including AD, that is directly linked to aging. Thus, this study aimed to investigate knowledge on the early detection of AD in postmenopausal women, focusing on the volume changes of the subcortical regions, including the thalamic subnuclei, in women with AD vs. postmenopausal women. Twenty-one women with AD and twenty-one postmenopausal women without AD underwent magnetic resonance imaging (MRI). Women with AD showed significantly reduced volumes in the hippocampus, thalamus, and amygdala compared with postmenopausal women (p < 0.05, FWE-corrected). After adjustments for age, the right hippocampal volume was found to be significantly lower in the women with AD, but the volumes of the thalamus and amygdala were relatively unaffected. The women with AD exhibited significantly reduced volume in the right laterodorsal nucleus of the thalamus compared with the postmenopausal women (p < 0.05, Bonferroni-corrected). Our findings suggest that the reduced volume of both the right laterodorsal thalamic nucleus and right hippocampus may serve as a potential biomarker for the early detection of AD in postmenopausal women.
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Affiliation(s)
- Gwang-Won Kim
- Advanced Institute of Aging Science, Chonnam National University, Gwangju 61186, Republic of Korea; (G.-W.K.); (K.P.)
| | - Kwangsung Park
- Advanced Institute of Aging Science, Chonnam National University, Gwangju 61186, Republic of Korea; (G.-W.K.); (K.P.)
- Department of Urology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju 61469, Republic of Korea
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Bonsale R, Infantino R, Perrone M, Marabese I, Ricciardi F, Fusco A, Teweldemedhin MM, Boccella S, Guida F, Rinaldi B. The long-term exercise after traumatic brain injury: Reharmonizing brain by sound body. Brain Res 2023; 1816:148471. [PMID: 37356701 DOI: 10.1016/j.brainres.2023.148471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/15/2023] [Accepted: 06/21/2023] [Indexed: 06/27/2023]
Abstract
Traumatic brain injuries (TBI) refer to multiple acquired dysfunctions arising from damage to the brain caused by an external force, including rapid acceleration/deceleration and concussion. Among them, mild TBI (mTBI) accounts for most cases (up to 90%) of injuries. It is responsible for a variety of symptoms, including anxiety, depression, and cognitive impairments that remain difficult to be treated. It has been reported that regular physical activity, as well as, improving life quality, display a neuroprotective function, suggesting a possible role in post-traumatic rehabilitation. In this study, we investigated the effects of treadmill exercise in a mice mTBI model by behavioural, electrophysiological and neurochemical analysis. Daily exercise decreased anxiety, aggressive behavior, and depression in mTBI mice. Accordingly, electrophysiological and neurochemical maladaptive rearrangement occurring in the hippocampus of mTBI mice were prevented by the exercise.
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Affiliation(s)
- Roozbe Bonsale
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Rosmara Infantino
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Michela Perrone
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Ida Marabese
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Federica Ricciardi
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Antimo Fusco
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Milena Melake Teweldemedhin
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Serena Boccella
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Francesca Guida
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy
| | - Barbara Rinaldi
- Department of Experimental Medicine, Division of Pharmacology, University of Campania "L. Vanvitelli", Naples, Italy.
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Hassanein MM, Huri HZ, Abduelkarem AR, Baig K. Therapeutic Effects of Vitamin D on Vaginal, Sexual, and Urological Functions in Postmenopausal Women. Nutrients 2023; 15:3804. [PMID: 37686835 PMCID: PMC10490181 DOI: 10.3390/nu15173804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 08/22/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Recent years have witnessed the emergence of growing evidence concerning vitamin D's potential role in women's health, specifically in postmenopausal women. This evidence also includes its connection to various genitourinary disorders and symptoms. Numerous clinical studies have observed improvements in vulvovaginal symptoms linked to the genitourinary syndrome of menopause (GSM) with vitamin D supplementation. These studies have reported positive effects on various aspects, such as vaginal pH, dryness, sexual functioning, reduced libido, and decreased urinary tract infections. Many mechanisms underlying these pharmacological effects have since been proposed. Vitamin D receptors (VDRs) have been identified as a major contributor to its effects. It is now well known that VDRs are expressed in the superficial layers of the urogenital organs. Additionally, vitamin D plays a crucial role in supporting immune function and modulating the body's defense mechanisms. However, the characterization of these effects requires more investigation. Reviewing existing evidence regarding vitamin D's impact on postmenopausal women's vaginal, sexual, and urological health is the purpose of this article. As research in this area continues, there is a potential for vitamin D to support women's urogenital and sexual health during the menopausal transition and postmenopausal periods.
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Affiliation(s)
- Mohammed M. Hassanein
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Hasniza Zaman Huri
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Universiti Malaya, Kuala Lumpur 50603, Malaysia;
| | - Abduelmula R. Abduelkarem
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, University of Sharjah, University City Road—University City, Sharjah P.O. Box 27272, United Arab Emirates;
- Research Institute for Medical and Health Sciences, University of Sharjah, University City Road—University City, Sharjah P.O. Box 27272, United Arab Emirates
| | - Kauser Baig
- Department of Obstetrics and Gynecology, University Hospital Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
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Lu W, Sun Y, Gao H, Qiu J. A review of multi-modal magnetic resonance imaging studies on perimenopausal brain: a hint towards neural heterogeneity. Eur Radiol 2023; 33:5282-5297. [PMID: 36977851 DOI: 10.1007/s00330-023-09549-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/05/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023]
Abstract
The population ageing process worldwide is leading to an increasing number of women in the perimenopausal phase. Many of the perimenopausal symptoms, such as headache, depression, insomnia, and cognitive decline, are neurological in nature. Therefore, the study of the perimenopausal brain is of great importance. In addition, relevant studies can also provide an imaging basis for multiple therapies to treat perimenopausal symptoms. Because of its non-invasive nature, magnetic resonance imaging (MRI) has now been widely applied to the study of perimenopausal brains, revealing alterations in the brain associated with symptoms during the menopause transition. In this review, we collected papers and works of literature on the perimenopausal brain using MRI techniques in the Web of Science database. We firstly described the general principles and analysis methods of different MRI modalities briefly and then reviewed the structural, functional, perfusion, and metabolic compounds changes in the brain of perimenopausal women respectively, and described the latest advances in probing the perimenopausal brain using MRI, resulting in summary diagrams and figures. Based on the summary of existing works of the literature, this review further provided a perspective on multi-modal MRI studies in the perimenopausal brain, suggesting that population-based, multi-center, and longitudinal studies will be beneficial to the comprehensive understanding of changes in the perimenopausal brain. In addition, we found a hint towards neural heterogeneity in the perimenopausal brain, which should be addressed by future MRI studies to provide more help for the precise diagnosis and personalized treatment of perimenopausal symptoms. KEY POINTS: • Perimenopause is not only a physiological transition but also a period of neurological transition. • Multi-modal MRI studies have revealed that perimenopause is accompanied by alterations in the brain, which is implicated in many perimenopausal symptoms. • The diversity in the multi-modal MRI findings may give a hint to neural heterogeneity in the perimenopausal brain.
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Affiliation(s)
- Weizhao Lu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, 271000, China
| | - Yuanyuan Sun
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, No. 619 Changcheng Road, Taian, 271016, China
| | - Hui Gao
- Department of Gynaecology, Beijing Tian Tan Hospital, Beijing, China
| | - Jianfeng Qiu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No. 366 Taishan Street, Taian, 271000, China.
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van 't Hof SR, Cera N. Specific factors and methodological decisions influencing brain responses to sexual stimuli in women. Neurosci Biobehav Rev 2021; 131:164-178. [PMID: 34560132 DOI: 10.1016/j.neubiorev.2021.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 08/29/2021] [Accepted: 09/06/2021] [Indexed: 11/19/2022]
Abstract
Most of the neuroimaging studies on sexual behavior have been conducted with male participants, leading to men-based models of sexual arousal. Here, possible factors and methodological decisions that might influence brain responses to sexual stimuli, specifically for the inclusion of women, will be reviewed. Based on this review, we suggest that future studies consider the following factors: menstrual phase, hormonal contraception use, history of sexual or psychiatric disorders or diseases, and medication use. Moreover, when researching sexual arousal, we suggest future studies assess sexual orientation and preferences, that women should select visual sexual stimuli, and a longer duration than commonly used. This review is thought to represent a useful guideline for future research in sexual arousal, which hopefully will lead to a higher inclusion of women and therefore more accurate neurobiological models of sexual arousal.
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Affiliation(s)
| | - Nicoletta Cera
- Centre for Psychology at University of Porto -CPUP, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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10
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Xu Y, Zhang X, Xiang Z, Wang Q, Huang X, Liu T, Yang Z, Chen Y, Xue J, Chen J, Yang J. Abnormal Functional Connectivity Between the Left Medial Superior Frontal Gyrus and Amygdala Underlying Abnormal Emotion and Premature Ejaculation: A Resting State fMRI Study. Front Neurosci 2021; 15:704920. [PMID: 34421524 PMCID: PMC8375680 DOI: 10.3389/fnins.2021.704920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Premature ejaculation (PE) is a common sexual dysfunction and is found to be associated with abnormal emotion. The amygdala plays an important role in the processing of emotion. The process of ejaculation is found to be mediated by the frontal-limbic neural circuits. However, the correlations between PE and emotion are still unclear. Methods Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired in 27 PE patients with stable emotion (SPE), 27 PE patients with abnormal emotion (NPE), and 30 healthy controls (HC). We used rs-fMRI to explore the underlying neural mechanisms in SPE, NPE, and HC by measuring the functional connectivity (FC). Differences of FC values among the three groups were compared when choosing bilateral amygdala as the regions of interest (ROIs). We also explored the correlations between the brain regions showing altered FC values and scores of the premature ejaculation diagnostic tool (PEDT)/Eysenck Personality Inventory about neuroticism (EPQ-N) in the PE group. Results When the left amygdala was chosen as the ROI, the SPE group exhibited an increased FC between the left medial superior frontal gyrus (SFGmed) and amygdala compared with the NPE or HC group. When the right amygdala was chosen as the ROI, the NPE group exhibited a decreased FC between the left SFGmed and right amygdala compared with the HC group. In addition, FC values of the left SFGmed had positive correlations with PEDT and negative correlations with EPQ-N scores in the PE group. Moreover, FC values of the left superior temporal gyrus had positive correlations with EPQ-N scores in the PE group. Conclusion The increased FC values between the left SFGmed and amygdala could reflect a compensatory cortical control mechanism with the effect of stabilized emotion in the limbic regions of PE patients. Abnormal FC between these brain regions could play a critical role in the physiopathology of PE and could help us in dividing PE into more subtypes.
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Affiliation(s)
- Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing Zhang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,Department of Andrology, Yangzhou Traditional Chinese Medicine Hospital, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Tao Liu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhaoxu Yang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianguo Xue
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Department of Urology, People's Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture, Ürümqi, China
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11
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He L, Guo W, Qiu J, An X, Lu W. Altered Spontaneous Brain Activity in Women During Menopause Transition and Its Association With Cognitive Function and Serum Estradiol Level. Front Endocrinol (Lausanne) 2021; 12:652512. [PMID: 34046011 PMCID: PMC8146460 DOI: 10.3389/fendo.2021.652512] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 04/28/2021] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE Serum hormone deficiencies during menopause transition may affect spontaneous brain activity and global cognition. The purpose of this study was to explore the differences in spontaneous brain activity between premenopausal and perimenopausal women, and to investigate the associations between spontaneous brain activity, serum hormone levels and global cognition. METHODS Thirty-two premenopausal women (47.75 ± 1.55 years) and twenty-five perimenopausal women (51.60 ± 1.63 years) underwent resting-state functional MRI (fMRI) scan. Clinical information including Mini-Mental State Examination (MMSE), levels of estradiol (E2), free testosterone, progesterone, prolactin, follicle-stimulating hormone and luteinizing hormone were measured. Regional homogeneity (ReHo) was used to evaluate spontaneous brain activity alterations between perimenopausal and premenopausal women. Correlation analysis was used to investigate the associations between brain functional alterations and clinical measures in perimenopausal group. RESULTS The results demonstrated increased ReHo value in the right lingual gyrus (LG) and decreased ReHo value in the right superior frontal gyrus (SFG) in perimenopausal women compared with premenopausal women. In perimenopausal group, ReHo of the right LG showed a negative correlation with level of E2 (r = -0.586, p = 0.002), ReHo of the right SFG showed a positive correlation with level of E2 (r = 0.470, p = 0.018) and MMSE (r = 0.614, p = 0.001). CONCLUSIONS The results demonstrated that women approaching menopause suffered from altered functions in brain regions related to cognitive function, working memory, the results also revealed a direct association between levels of E2 and brain functions in perimenopausal women.
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Affiliation(s)
- Lemin He
- Department of Biomedical Engineering, College of Precision Instruments and Optoelectronics Engineering, Tianjin University, Tianjin, China
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
| | - Wei Guo
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Xingwei An
- Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China
- *Correspondence: Xingwei An, ; Weizhao Lu,
| | - Weizhao Lu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Science and Technology Innovation Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
- *Correspondence: Xingwei An, ; Weizhao Lu,
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12
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Chen J, Yang J, Huang X, Wang Q, Lu C, Liu S, Chen Y, Ni L. Brain Functional Biomarkers Distinguishing Premature Ejaculation From Anejaculation by ALFF: A Resting-State fMRI Study. J Sex Med 2020; 17:2331-2340. [PMID: 33023837 DOI: 10.1016/j.jsxm.2020.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/24/2020] [Accepted: 09/09/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Premature ejaculation (PE) and anejaculation (AJ) are 2 opposite disorders of male ejaculatory dysfunction. Recent studies have demonstrated that the process of ejaculation is mediated by certain neural circuits in the brain. However, different mechanisms between PE and AJ are still unclear. AIM Therefore, we used resting-state functional magnetic resonance imaging (fMRI) to explore the underlying neural mechanisms in patients with PE and AJ by measuring the amplitude of low-frequency fluctuations (ALFF). METHODS Resting-state fMRI data were acquired in 17 PE, 20 AJ patients and 23 matched healthy controls (HC). MAIN OUTCOME MEASURE Differences of ALFF values among the 3 groups were compared. We also explored the correlations between brain regions showing altered ALFF values and scores of Premature Ejaculation Diagnostic Tool (PEDT) in the PE group. RESULTS There were widespread differences of ALFF values among the 3 groups, which included left anterior cingulate gyrus, precentral and postcentral gyrus, paracentral lobule, superior temporal gyrus, calcarine fissure, putamen; right postcentral gyrus, paracentral lobule, middle temporal gyrus, putamen. Compared with HC, PE patients had greater ALFF in the right inferior frontal gyrus (opercular part), AJ patients had greater ALFF in the left postcentral gyrus. In addition, PE patients exhibited greater ALFF in the left Rolandic operculum, anterior cingulate gyrus, inferior frontal gyrus (orbital part), putamen, and right putamen when compared with AJ patients, as well as decreased ALFF in the right postcentral gyrus. Moreover, positive correlations were found between ALFF of left postcentral gyrus, inferior frontal gyrus (orbital part), right inferior frontal gyrus (opercular part), and PEDT scores. CLINICAL IMPLICATIONS The differences in central pathophysiological mechanisms between PE and AJ might be useful for improving the clinical diagnosis of ejaculation dysfunction. STRENGTH & LIMITATIONS Our results showed that the method of fMRI could identify the differences of ALFF between PE and AJ and that these alterations in ALFF were related to clinical function. However, this was a relatively small sample study, and further multimodal neuroimaging studies with large samples were needed. CONCLUSION The findings demonstrated that altered ALFF of frontal, parietal cortex, and putamen might help distinguish premature ejaculation from anejaculation. Abnormal function of these brain regions might play a critical role in the physiopathology of ejaculatory dysfunction of patients. Chen J, Yang J, Huang X, et al. Brain Functional Biomarkers Distinguishing Premature Ejaculation From Anejaculation by ALFF: A Resting-State fMRI Study. J Sex Med 2020;17:2331-2340.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Lu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Liangyu Ni
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
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13
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Kim GW, Kim BC, Park KS, Jeong GW. A pilot study of brain morphometry following donepezil treatment in mild cognitive impairment: volume changes of cortical/subcortical regions and hippocampal subfields. Sci Rep 2020; 10:10912. [PMID: 32616841 PMCID: PMC7331573 DOI: 10.1038/s41598-020-67873-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/11/2020] [Indexed: 12/14/2022] Open
Abstract
The efficacy of donepezil is well known for improving the cognitive performance in patients with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Most of the recent neuroimaging studies focusing on the brain morphometry have dealt with the targeted brain structures, and thus it remains unknown how donepezil treatment influences the volume change over the whole brain areas including the cortical and subcortical regions and hippocampal subfields in particular. This study aimed to evaluate overall gray matter (GM) volume changes after donepezil treatment in MCI, which is a prodromal phase of AD, using voxel-based morphometry. Patients with MCI underwent the magnetic resonance imaging (MRI) before and after 6-month donepezil treatment. The cognitive function for MCI was evaluated using the questionnaires of the Korean version of the mini-mental state examination (K-MMSE) and Alzheimer’s disease assessment scale-cognitive subscale (ADAS-Cog). Compared with healthy controls, patients with MCI showed significantly lower GM volumes in the hippocampus and its subfields, specifically in the right subiculum and left cornu ammonis (CA3). The average scores of K-MMSE in patients with MCI improved by 8% after donepezil treatment. Treated patients showed significantly higher GM volumes in the putamen, globus pailldus, and inferior frontal gyrus after donepezil treatment (p < 0.001). However, whole hippocampal volume in the patients decreased by 0.6% after 6-month treatment, and the rate of volume change in the left hippocampus was negatively correlated with the period of treatment. These findings will be useful for screening and tracking MCI, as well as understanding of the pathogenesis of MCI in connection with brain morphometric change.
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Affiliation(s)
- Gwang-Won Kim
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, 61186, Republic of Korea.,Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, 02129, USA
| | - Byeong-Chae Kim
- Department of Neurology, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Kwang Sung Park
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, 61186, Republic of Korea.,Department of Urology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, 42 Jebong-Ro, Donggu, Gwangju, 61469, Republic of Korea.
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14
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Brain Morphological Changes With Functional Deficit Associated With Sexual Arousal in Postmenopausal Women. Sex Med 2019; 7:480-488. [PMID: 31606354 PMCID: PMC6963119 DOI: 10.1016/j.esxm.2019.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 06/18/2019] [Accepted: 06/25/2019] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION We have not known how menopause synchronously influences brain morphology and function associated with visually stimulated sexual arousal in postmenopausal women. AIM This study used a combination of functional magnetic resonance imaging and voxel-based morphometry to evaluate menopause-related brain morphological and functional changes in postmenopausal women. METHODS Nineteen premenopausal women and 19 postmenopausal women underwent functional and structural magnetic resonance imaging. Brain function activity was measured while the subjects viewed an erotic video clip. MAIN OUTCOME MEASURES A 2-sample t-test was used for cross-analysis of the 2 groups for comparison of gray matter volumes (corrected P < .05) and brain activation (uncorrected P < .01). RESULTS Our study revealed a relationship between sexual function and morphological changes in postmenopausal women. Compared with premenopausal women, the postmenopausal group showed significantly lower brain activations in the major parts of the limbic system and basal ganglia, including the parahippocampal gyrus, head of caudate nucleus, insula, putamen, hippocampus, hypothalamus, amygdala, and globus pallidus, which are involved in sexual behavior and emotional responses. In morphometric analyses, postmenopausal women showed significantly decreased gray matter volumes of the insula, putamen, parahippocampal gyrus, amygdala, and anterior cingulate gyrus, most of which were associated with decreased functional activity during visual sexual arousal in postmenopausal women. In addition, the premenopausal group alone showed a positive correlation between the activity of the insula and the level of estradiol (Pearson correlation r = 0.588; P = .008). CONCLUSION This study demonstrates an association between menopause-related brain function and morphological changes in postmenopausal women. This finding provides insight into the neural mechanisms associated with the sexual functional deficit in postmenopausal women. Baek H-S, Kim G-W, Sundaram T, et al. Brain Morphological Changes with Functional Deficit Associated with Sexual Arousal in Postmenopausal Women. Sex Med 2019;7:480-488.
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15
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Scavello I, Maseroli E, Di Stasi V, Vignozzi L. Sexual Health in Menopause. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E559. [PMID: 31480774 PMCID: PMC6780739 DOI: 10.3390/medicina55090559] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 02/07/2023]
Abstract
Sexual function worsens with advancing menopause status. The most frequently reported symptoms include low sexual desire (40-55%), poor lubrication (25-30%) and dyspareunia (12-45%), one of the complications of genitourinary syndrome of menopause (GSM). Declining levels of sex steroids (estrogens and androgens) play a major role in the impairment of sexual response; however, psychological and relational changes related with aging and an increase in metabolic and cardiovascular comorbidities should also be taken into account. Although first-line therapeutic strategies for menopause-related sexual dysfunction aim at addressing modifiable factors, many hormonal and non-hormonal, local and systemic treatment options are currently available. Treatment should be individualized, taking into account the severity of symptoms, potential adverse effects and personal preferences.
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Affiliation(s)
- Irene Scavello
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy
| | - Elisa Maseroli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy
| | - Vincenza Di Stasi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, Department of Experimental, Clinical, and Biomedical Sciences "Mario Serio", University of Florence, 50139 Florence, Italy.
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16
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Lu W, Guo W, Cui D, Dong K, Qiu J. Effect of Sex Hormones on Brain Connectivity Related to Sexual Function in Perimenopausal Women: A Resting-State fMRI Functional Connectivity Study. J Sex Med 2019; 16:711-720. [PMID: 30956108 DOI: 10.1016/j.jsxm.2019.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 02/21/2019] [Accepted: 03/02/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Perimenopause is associated with increased risk of depression, vasomotor symptoms, and sexual dysfunction. AIMS To explore the effect of sex hormones on the functional connectivity (FC) of different brain regions related to sexual function in perimenopausal women. METHODS 32 premenopausal women (mean age, 47.75 ± 1.55 years) and 25 perimenopausal women (mean age, 51.60 ± 1.63 years) underwent sex hormone level measurements and resting-state fMRI. MAIN OUTCOME MEASURES Serum levels of sex hormones, including prolactin (PRL), follicle-stimulating hormone (FSH), luteotropic hormone (LH), estradiol (E2), free testosterone (free-T), and progesterone (P), were measured. 10 brain regions related to sexual function were selected according to a meta-analysis, and FCs of the selected regions of interest were calculated as Pearson's correlation coefficient. RESULTS Compared with premenopausal women, perimenopausal women showed increased FC between the right area 13 (A13_r) and the right medial superior frontal gyrus (mSFG), between the left dorsal granular insula (dIg_L) and the right superior frontal gyrus (SFG) (Gaussian random field-corrected at the voxel level, P < .001, and cluster level, P < .025). Furthermore, the PRL level was negatively correlated with the FC of A13_R with the right mSFG and the FC of dIg_L with the right SFG. CLINICAL TRANSLATION These findings may be applicable to assessing brain dysfunction with FC changes in women approaching menopause. STRENGTHS & LIMITATIONS This study is the first to evaluate a direct relationship between sex hormone levels and brain FC changes in women approaching menopause. Sexual function was not assessed, which may weaken the conclusions related to sexual function. CONCLUSIONS The results show that women approaching menopause suffered from aberrant intrinsic FC in regions related to sexual function, and reveal a direct relationship between serum sex hormone levels and FC changes related to sexual function. Lu W, Guo W, Cui D, et al. Effect of Sex Hormones on Brain Connectivity Related to Sexual Function in Perimenopausal Women: A Resting-State fMRI Functional Connectivity Study. J Sex Med 2019;16:711-720.
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Affiliation(s)
- Weizhao Lu
- Medical Engineering and Technical Center, Taishan Medcial University, Tai'an, China; Department of Radiology, Taishan Medical University, Tai'an, China
| | - Wei Guo
- Affiliated Hospital of Taishan Medical University, Tai'an, China
| | - Dong Cui
- Department of Radiology, Taishan Medical University, Tai'an, China
| | - Kejiang Dong
- Department of Radiology, Taishan Medical University, Tai'an, China
| | - Jianfeng Qiu
- Medical Engineering and Technical Center, Taishan Medcial University, Tai'an, China; Department of Radiology, Taishan Medical University, Tai'an, China.
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17
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Kim GW, Kim YH, Park K, Jeong GW. A comparative study of white matter volume between postoperative female-to-male transsexuals and healthy female. Int J Impot Res 2019; 31:432-438. [PMID: 30679768 DOI: 10.1038/s41443-019-0111-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 08/14/2018] [Accepted: 12/03/2018] [Indexed: 12/21/2022]
Abstract
Cross-sex hormones in female-to-male (FtM) transsexuals play a crucial role in brain plasticity. Morphological study associated with white matter (WM) volume in postoperative FtM transsexuals receiving cross-sex hormones has not been published yet. This study was performed to discriminate the regional WM volume differences between postoperative FtM transsexuals and female controls using voxel-based morphometry (VBM) and further to assess the correlations between regional volume variations and cross-sex hormones. WM volume was assessed in 12 postoperative FtM transsexuals receiving cross-sex hormones with 16 age-matched female controls. WM volume was processed using SPM8 software with diffeomorphic anatomical registration via an exponentiated Lie algebra (DARTEL) algorithm. Serum sex hormones, including estriol, free testosterone (free-T), estradiol, follicle-stimulating hormone, and luteinizing hormone were measured. Postoperative FtM transsexuals showed significantly (p < 0.05) larger WM volumes in the inferior parietal lobule, postcentral gyrus, and middle temporal gyrus compared with female controls. However, there were no brain areas with larger WM volume in female controls compared with FtM transsexuals. WM volumes of the inferior parietal lobule and middle temporal gyrus in FtM transsexuals were positively correlated with the levels of free-T. This study revealed WM volume change and its correlation with free-T level in postoperative FtM transsexuals. These findings will improve our understanding of the morphometric changes in FtM transsexuals under cross-sex hormone therapy.
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Affiliation(s)
- Gwang-Won Kim
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Yun-Hyeon Kim
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Kwangsung Park
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, 61186, Republic of Korea.,Department of Urology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, 61469, Republic of Korea.
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18
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Lu W, Guo W, Hou K, Zhao H, Shi L, Dong K, Qiu J. Grey matter differences associated with age and sex hormone levels between premenopausal and perimenopausal women: A voxel-based morphometry study. J Neuroendocrinol 2018; 30:e12655. [PMID: 30372794 DOI: 10.1111/jne.12655] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 09/22/2018] [Accepted: 10/24/2018] [Indexed: 11/30/2022]
Abstract
The present study aimed to explore brain morphological alterations associated with age and sex hormone levels between premenopausal and perimenopausal women using magnetic resonance imaging (MRI) T1 -weighted structural images. Thirty-two premenopausal women aged (mean ± SD) 47.75 ± 1.55 years and twenty-five recently perimenopausal women aged 51.60 ± 1.63 years were evaluated for sex hormone levels, including prolactin, follicle-stimulating hormone, luteinising hormone, oestradiol, free testosterone and progesterone. A 3.0-Tesla MRI scanner was utilised to acquire T1 images. Voxel-based morphometry (VBM) was used to evaluate changes in grey matter volume between the two groups. The general linear model was applied with false discovery rate correction for between group voxel-wise statistics. Spearman partial correlation analyses were conducted between age, sex hormone levels and regions of grey matter volume showing significant differences between the two groups. The VBM analysis revealed that age and menopause per se lead to grey matter volume reduction in certain brain structures. These structural changes might be potential causes of sexual dysfunction, nervous system degeneration and depression, which need to be examined in future studies. Our findings might provide evidence and guide future research in understanding the menopausal transition.
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Affiliation(s)
- Weizhao Lu
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Wei Guo
- Affiliated Hospital of Taishan Medical University, Taian, China
| | - Kun Hou
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Huihui Zhao
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Liting Shi
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
| | - Kejiang Dong
- Department of Radiology, Taishan Medical University, Taian, China
| | - Jianfeng Qiu
- Medical Engineering and Technical Center, Taishan Medcial University, Taian, China
- Department of Radiology, Taishan Medical University, Taian, China
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19
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Kim GW, Park K, Jeong GW. Effects of Sex Hormones and Age on Brain Volume in Post-Menopausal Women. J Sex Med 2018; 15:662-670. [PMID: 29628218 DOI: 10.1016/j.jsxm.2018.03.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 03/07/2018] [Accepted: 03/11/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND Investigation of the effect of sex hormones on the brain volume in women provides a unique opportunity to examine menopause-related morphometric alterations. AIM To evaluate brain morphological alterations in post-menopausal women using voxel-based morphometry and its correlations with sex hormone levels. METHODS 20 Pre-menopausal women and 20 post-menopausal women underwent structural MRI. OUTCOMES T1-weighted magnetic resonance data were acquired and serum sex hormones including total estrogen, estriol, estradiol (E2), follicle-stimulating hormone, free testosterone, SHBG, and luteinizing hormone were measured. RESULTS Post-menopausal women showed decreased gray matter (GM) in the supplementary motor area (SMA), inferior frontal gyrus, olfactory cortex, and superior temporal gyrus as contrasted with pre-menopausal women using analysis of covariance (P < .05). The GM volume (GMV) values of the SMA, inferior frontal gyrus, and superior temporal gyrus were positively correlated with the levels of E2 in the pre-menopausal and post-menopausal women, in which the volume of the SMA was negatively correlated with the duration of time after menopause in post-menopausal women. CLINICAL TRANSLATION This finding is potentially applicable to assess the brain dysfunction with morphological changes in post-menopausal women. CONCLUSIONS Our study is the first to evaluate a direct relationship between the level of E2 and GMV change. We directly compared pre-menopausal and menopausal women un-matched in age. This study highlights the menopause-related morphological alterations in post-menopausal women, suggesting that the reduced GMV were closely associated with the symptoms of menopause caused by the decreased levels of E2. Kim G-W, Park K, Jeong G-W. Effects of Sex Hormones and Age on Brain Volume in Post-Menopausal Women. J Sex Med 2018;15:662-670.
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Affiliation(s)
- Gwang-Won Kim
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Republic of Korea
| | - Kwangsung Park
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Republic of Korea; Department of Urology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
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Kim GW, Yoon W, Jeong GW. Whole-brain volume alteration and its correlation with anxiety severity in patients with obsessive-compulsive disorder and generalized anxiety disorder. Clin Imaging 2018; 50:164-170. [PMID: 29567629 DOI: 10.1016/j.clinimag.2018.03.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 01/25/2018] [Accepted: 03/09/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the differential gray matter (GM) and white matter volume alterations between healthy controls and patients with obsessive-compulsive disorder (OCD) and generalized anxiety disorder (GAD) using voxel-based morphometry (VBM). METHOD Patients with OCD and GAD, and healthy controls underwent MR. RESULTS Patients with GAD showed significantly decreased GM volume in the medial prefrontal cortex (mPFC) compared with patients with OCD (p < 0.001). The GM volumes of the mPFC in patients with GAD were negatively correlated with Hamilton Anxiety Rating Scales. CONCLUSION Our findings indicate that the mPFC volume abnormality may be associated with anxiety disorder in patients with GAD rather than OCD.
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Affiliation(s)
- Gwang-Won Kim
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Republic of Korea
| | - Woong Yoon
- Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwangju, Republic of Korea.
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Whole brain volume changes and its correlation with clinical symptom severity in patients with schizophrenia: A DARTEL-based VBM study. PLoS One 2017; 12:e0177251. [PMID: 28520743 PMCID: PMC5435302 DOI: 10.1371/journal.pone.0177251] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 04/21/2017] [Indexed: 11/23/2022] Open
Abstract
The purpose of this study was to evaluate gray matter (GM) and white matter (WM) volume alterations in whole-brain structures in patients with schizophrenia and healthy controls using voxel-based morphometry (VBM), and further to assess the correlation between GM and WM volume variations and symptom severity in schizophrenia. A total of 22 patients with schizophrenia and 22 age-matched healthy controls participated. Magnetic resonance image data were processed using SPM8 software with diffeomorphic anatomical registration via an exponentiated Lie algebra (DARTEL) algorithm. Patients with schizophrenia exhibited significantly decreased GM volumes of the insula, superior temporal gyrus (STG), gyrus rectus, and anterior cingulate cortex (ACC) compared with healthy controls. The GM volumes of the STG and gyrus rectus were negatively correlated with the positive scales on the Positive and Negative Syndrome Scale (PANSS) and those of the STG and ACC were negatively correlated with the negative scales. The durations of illness in schizophrenia were negatively correlated with the GM volumes of the insula, STG, and ACC. Patients with schizophrenia exhibited significantly decreased WM volumes of the superior frontal gyrus, inferior temporal gyrus, and STG. The WM volumes of the STG were negatively correlated with the duration of illness. Our findings suggest that GM and WM volume abnormalities in the STG are associated with the psychopathology of schizophrenia.
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