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Nguyen V, Dolendo I, Uloko M, Hsieh TC, Patel D. Male delayed orgasm and anorgasmia: a practical guide for sexual medicine providers. Int J Impot Res 2024; 36:186-193. [PMID: 37061617 PMCID: PMC11035123 DOI: 10.1038/s41443-023-00692-7] [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: 09/21/2022] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 04/17/2023]
Abstract
Delayed orgasm (DO) is defined as increased latency of orgasm despite adequate sexual stimulation and desire. Anorgasmia (AO) is characterized as the absence of orgasm. Etiologies of DO/AO include medication-induced, psychogenic, endocrine, and genitopelvic dysesthesia. Given the multifactorial complex nature of this disorder, a thorough history and physical examination represent the most critical components of patient evaluation in the clinical setting. Treating DO/AO can be challenging due to the lack of standardized FDA-approved pharmacotherapies. There is no standardized treatment plan for DO/AO, though common treatments plans are often multidisciplinary and may include adjustment of offending medications and sex therapy. In this review, we summarize the etiology, diagnosis, and treatment of DO/AO.
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Affiliation(s)
- Vi Nguyen
- Department of Urology, University of California, San Diego, CA, USA
| | - Isabella Dolendo
- Department of Urology, University of California, San Diego, CA, USA
| | - Maria Uloko
- Department of Urology, University of California, San Diego, CA, USA
| | - Tung-Chin Hsieh
- Department of Urology, University of California, San Diego, CA, USA
| | - Darshan Patel
- Department of Urology, University of California, San Diego, CA, USA.
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2
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Wang W, Qiu D, Mei Y, Bai X, Yuan Z, Zhang X, Xiong Z, Tang H, Zhang P, Zhang Y, Yu X, Wang Z, Ge Z, Sui B, Wang Y. Altered functional connectivity of brainstem nuclei in new daily persistent headache: Evidence from resting-state functional magnetic resonance imaging. CNS Neurosci Ther 2024; 30:e14686. [PMID: 38516817 PMCID: PMC10958407 DOI: 10.1111/cns.14686] [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: 07/03/2023] [Revised: 02/16/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVES The new daily persistent headache (NDPH) is a rare primary headache disorder. However, the underlying mechanisms of NDPH remain incompletely understood. This study aims to apply seed-based analysis to explore the functional connectivity (FC) of brainstem nuclei in patients with NDPH using resting-state functional magnetic resonance imaging (MRI). METHODS The FC analysis from the region of interest (ROI) to whole brain voxels was used to investigate 29 patients with NDPH and 37 well-matched healthy controls (HCs) with 3.0 Tesla MRI. The 76 nuclei in the brainstem atlas were defined as ROIs. Furthermore, we explored the correlations between FC and patients' clinical characteristics and neuropsychological evaluations. RESULTS Patients with NDPH exhibited reduced FC in multiple brainstem nuclei compared to HCs (including right inferior medullary reticular formation, right mesencephalic reticular formation, bilateral locus coeruleus, bilateral laterodorsal tegmental nucleus-central gray of the rhombencephalon, median raphe, left medial parabrachial nucleus, periaqueductal gray, and bilateral ventral tegmental area-parabrachial pigmented nucleus complex) and increased FC in periaqueductal gray. No significant correlations were found between the FC of these brain regions and clinical characteristics or neuropsychological evaluations after Bonferroni correction (p > 0.00016). CONCLUSIONS Our results demonstrated that patients with NDPH have abnormal FC of brainstem nuclei involved in the perception and regulation of pain and emotions.
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Affiliation(s)
- Wei Wang
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Dong Qiu
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yanliang Mei
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xiaoyan Bai
- Tiantan Neuroimaging Center of ExcellenceChina National Clinical Research Center for Neurological DiseasesBeijingChina
- Department of Radiology, Beijing Neurosurgical Institute, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Ziyu Yuan
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xue Zhang
- Tiantan Neuroimaging Center of ExcellenceChina National Clinical Research Center for Neurological DiseasesBeijingChina
- Department of Radiology, Beijing Neurosurgical Institute, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zhonghua Xiong
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Hefei Tang
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Peng Zhang
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yaqing Zhang
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Xueying Yu
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Zhe Wang
- Department of NeurologyThe First Affiliated Hospital of Dalian Medical UniversityDalianLiaoningChina
| | - Zhaoli Ge
- Department of NeurologyShenzhen Second People's HospitalShenzhenGuangdongChina
| | - Binbin Sui
- Tiantan Neuroimaging Center of ExcellenceChina National Clinical Research Center for Neurological DiseasesBeijingChina
| | - Yonggang Wang
- Department of Neurology, Headache Center, Beijing Tiantan HospitalCapital Medical UniversityBeijingChina
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3
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Blumenthal SA, Young LJ. The Neurobiology of Love and Pair Bonding from Human and Animal Perspectives. BIOLOGY 2023; 12:844. [PMID: 37372130 PMCID: PMC10295201 DOI: 10.3390/biology12060844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023]
Abstract
Love is a powerful emotional experience that is rooted in ancient neurobiological processes shared with other species that pair bond. Considerable insights have been gained into the neural mechanisms driving the evolutionary antecedents of love by studies in animal models of pair bonding, particularly in monogamous species such as prairie voles (Microtus ochrogaster). Here, we provide an overview of the roles of oxytocin, dopamine, and vasopressin in regulating neural circuits responsible for generating bonds in animals and humans alike. We begin with the evolutionary origins of bonding in mother-infant relationships and then examine the neurobiological underpinnings of each stage of bonding. Oxytocin and dopamine interact to link the neural representation of partner stimuli with the social reward of courtship and mating to create a nurturing bond between individuals. Vasopressin facilitates mate-guarding behaviors, potentially related to the human experience of jealousy. We further discuss the psychological and physiological stress following partner separation and their adaptive function, as well as evidence of the positive health outcomes associated with being pair-bonded based on both animal and human studies.
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Affiliation(s)
- Sarah A. Blumenthal
- Silvio O. Conte Center for Oxytocin and Social Cognition, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
- Center for Translational Social Neuroscience, Emory University, Atlanta, GA 30329, USA
| | - Larry J. Young
- Silvio O. Conte Center for Oxytocin and Social Cognition, Emory National Primate Research Center, Emory University, Atlanta, GA 30329, USA
- Center for Translational Social Neuroscience, Emory University, Atlanta, GA 30329, USA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA
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4
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Blyuss KB, Kyrychko YN. Sex, ducks, and rock "n" roll: Mathematical model of sexual response. CHAOS (WOODBURY, N.Y.) 2023; 33:043106. [PMID: 37097948 DOI: 10.1063/5.0143190] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 03/10/2023] [Indexed: 06/19/2023]
Abstract
In this paper, we derive and analyze a mathematical model of a sexual response. As a starting point, we discuss two studies that proposed a connection between a sexual response cycle and a cusp catastrophe and explain why that connection is incorrect but suggests an analogy with excitable systems. This then serves as a basis for derivation of a phenomenological mathematical model of a sexual response, in which the variables represent levels of physiological and psychological arousal. Bifurcation analysis is performed to identify stability properties of the model's steady state, and numerical simulations are performed to illustrate different types of behavior that can be observed in the model. Solutions corresponding to the dynamics associated with the Masters-Johnson sexual response cycle are represented by "canard"-like trajectories that follow an unstable slow manifold before making a large excursion in the phase space. We also consider a stochastic version of the model, for which spectrum, variance, and coherence of stochastic oscillations around a deterministically stable steady state are found analytically, and confidence regions are computed. Large deviation theory is used to explore the possibility of stochastic escape from the neighborhood of the deterministically stable steady state, and the methods of an action plot and quasi-potential are employed to compute most probable escape paths. We discuss implications of the results for facilitating better quantitative understanding of the dynamics of a human sexual response and for improving clinical practice.
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Affiliation(s)
- K B Blyuss
- Department of Mathematics, University of Sussex, Brighton BN1 9QH, United Kingdom
| | - Y N Kyrychko
- Department of Mathematics, University of Sussex, Brighton BN1 9QH, United Kingdom
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5
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Batista LL, Koga RDCR, Teixeira AVTDL, Teixeira TA, de Melo EL, Carvalho JCT. Clinical Safety of a Pharmaceutical Formulation Containing an Extract of Acmella oleracea (L.) in Patients With Premature Ejaculation: A Pilot Study. Am J Mens Health 2023; 17:15579883231167819. [PMID: 37081737 PMCID: PMC10126617 DOI: 10.1177/15579883231167819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/22/2023] Open
Abstract
Acmella oleracea (L.) R. K. Jansen (Asteraceae) is a plant species widely used in traditional Amazonian medicine to treat sexual dysfunction. The use of this plant has gained popularity because of its sensory properties, such as a tingling sensation. In this study on patients with premature ejaculation, we evaluated the clinical action of a nano-formulation containing an ethanolic extract of A. oleracea inflorescences. Major constituents in the extracts were identified based on gas chromatographic analysis. Participants used a spray preparation based on the A. oleracea extract for 12 weeks, during which they were instructed to apply the product 5 min prior to sexual intercourse. To assess therapeutic efficacy, participants were required to record the mean intravaginal latency time for ejaculation (IELT). During the period of spray treatment, the nano-formulation of A. oleracea increased participant IELT values (M = 293 s) compared with the baseline values (193 s). This nano-formulation reported clinical action in patients with premature ejaculation. It is accordingly considered to have potential application as a therapeutic alternative with benefits for both patients and their partners. Given the small number of participants in this study, further multicenter studies involving a larger number of participants are needed to confirm these observations.
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Affiliation(s)
- Lecildo Lira Batista
- Pharmaceutical Innovation Program, Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá, Brazil
- Research Laboratory of Drugs, Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá, Brazil
- Division of Urology, University Hospital, Federal University of Amapá, Macapá, Brazil
| | | | | | - Thiago Afonso Teixeira
- Division of Urology, University Hospital, Federal University of Amapá, Macapá, Brazil
- Men's Health Study Group, Institute for Advanced Studies, University of São Paulo, São Paulo, Brazil
- Postgraduate Program in Tropical Biodiversity, Federal University of Amapá, Macapá, Brazil
| | - Ester Lopes de Melo
- Research Laboratory of Drugs, Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá, Brazil
- Postgraduate Program in Tropical Biodiversity, Federal University of Amapá, Macapá, Brazil
| | - José Carlos Tavares Carvalho
- Pharmaceutical Innovation Program, Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá, Brazil
- Research Laboratory of Drugs, Department of Biological and Health Sciences, Universidade Federal do Amapá, Macapá, Brazil
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6
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Chen J, Wang Q, Huang X, Xu Y, Xiang Z, Liu S, Yang J, Chen Y. Potential biomarkers for distinguishing primary from acquired premature ejaculation: A diffusion tensor imaging based network study. Front Neurosci 2022; 16:929567. [PMID: 36340794 PMCID: PMC9626512 DOI: 10.3389/fnins.2022.929567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Premature ejaculation (PE) is classified as primary and acquired and may be facilitated by different pathophysiology. Brain plays an important role in PE, however, differences in the central neuropathological mechanisms among subtypes of PE are unknown. Materials and methods We acquired diffusion tensor imaging (DTI) data from 44 healthy controls (HC) and 47 PE patients (24 primary PE and 23 acquired PE). Then, the whole-brain white matter (WM) structural networks were constructed and between-group differences of nodal segregative parameters were identified by the method of graph theoretical analysis. Moreover, receiver operating characteristic (ROC) curves were performed to determine the suitability of the altered parameters as potential neuroimaging biomarkers for distinguishing primary PE from acquired PE. Results PE patients showed significantly increased clustering coefficient C(i) in the left inferior frontal gyrus (triangular part) (IFGtriang.L) and increased local efficiency Eloc(i) in the left precental gyrus (PreCG.L) and IFGtriang.L when compared with HC. Compared to HC, primary PE patients had increased C(i) and Eloc(i) in IFGtriang.L and the left amygdala (AMYG.L) while acquired PE patients had increased C(i) and Eloc(i) in IFGtriang.L, and decreased C(i) and Eloc(i) in AMYG.L. Compared to acquired PE, primary PE patients had increased C(i) and Eloc(i) in AMYG.L. Moreover, ROC analysis revealed that PreCG.L, IFGtriang.L and AMYG.L might be helpful for distinguishing different subtypes of PE from HC (PE from HC: sensitivity, 61.70–78.72%; specificity, 56.82–77.27%; primary PE from HC: sensitivity, 66.67–87.50%; specificity, 52.27–77.27%; acquired PE from HC: sensitivity, 34.78–86.96%; specificity, 54.55–100%) while AMYG.L might be helpful for distinguishing primary PE from acquired PE (sensitivity, 83.33–91.70%; specificity, 69.57–73.90%). Conclusion These findings improved our understanding of the pathophysiological processes that occurred in patients with ejaculatory dysfunction and suggested that the abnormal segregation of left amygdala might serve as a useful marker to help clinicians distinguish patients with primary PE from those with acquired PE.
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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
| | - 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
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of 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
| | - Shaowei Liu
- Department of Radiology, 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, Xinjiang, China
- Jie Yang,
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yun Chen,
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7
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Kourosh-Arami M, Gholami M, Alavi-Kakhki SS, Komaki A. Neural correlates and potential targets for the contribution of orexin to addiction in cortical and subcortical areas. Neuropeptides 2022; 95:102259. [PMID: 35714437 DOI: 10.1016/j.npep.2022.102259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 05/14/2022] [Accepted: 05/15/2022] [Indexed: 02/01/2023]
Abstract
The orexin (hypocretin) is one of the hypothalamic neuropeptides that plays a critical role in some behaviors including feeding, sleep, arousal, reward processing, and drug addiction. This variety of functions can be described by a united function for orexins in translating states of heightened motivation, for example during physiological requirement states or following exposure to reward opportunities, into planned goal-directed behaviors. An addicted state is characterized by robust activation of orexin neurons from the environment, which triggers downstream circuits to facilitate behavior directed towards obtaining the drug. Two orexin receptors 1 (OX1R) and 2 (OX2R) are widely distributed in the brain. Here, we will introduce and describe the cortical and subcortical brain areas involved in addictive-like behaviors and the impact of orexin on addiction.
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Affiliation(s)
- Masoumeh Kourosh-Arami
- Department of Neuroscience, School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Masoumeh Gholami
- Department of Physiology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
| | - Seyed Sajjad Alavi-Kakhki
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Alireza Komaki
- Neurophysiology Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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8
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Zhang X, Guan M, Chen X, Zhang P, Wu J, Zhang X, Dong M. Identifying neuroimaging biomarkers for psychogenic erectile dysfunction by fusing multi‐level brain information: a resting‐state fMRI study. Andrology 2022; 10:1398-1410. [PMID: 35869867 DOI: 10.1111/andr.13238] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Xiaoyan Zhang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education School of Life Science and Technology Xidian University Xi'an Shaanxi 710071 China
- Xian Key Laboratory of Intelligent Sensing and Regulation of tran‐Scale Life Information Xi'an Shaanxi 710071 China
| | - Min Guan
- Department of Cerebrovascular Disease Henan Provincial People's Hospital Zhengzhou 450003 China
| | - Xin Chen
- Department of Andrology Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zheng Zhou Henan 450003 China
| | - Peiming Zhang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education School of Life Science and Technology Xidian University Xi'an Shaanxi 710071 China
- Xian Key Laboratory of Intelligent Sensing and Regulation of tran‐Scale Life Information Xi'an Shaanxi 710071 China
| | - Jia Wu
- School of Foreign Languages Northwestern Polytechnical University Xi'an Shaanxi China
| | - Xiangsheng Zhang
- Department of Andrology Henan Provincial People's Hospital, People's Hospital of Zhengzhou University Zheng Zhou Henan 450003 China
| | - Minghao Dong
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education School of Life Science and Technology Xidian University Xi'an Shaanxi 710071 China
- Xian Key Laboratory of Intelligent Sensing and Regulation of tran‐Scale Life Information Xi'an Shaanxi 710071 China
- Key Laboratory of Intelligent Perception and Image Understanding of Ministry of Education, School of Artificial Intelligence Xidian University Xi'an China
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9
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A review of the neural control of micturition in dogs and cats: neuroanatomy, neurophysiology and neuroplasticity. Vet Res Commun 2022; 46:991-998. [PMID: 35802232 DOI: 10.1007/s11259-022-09966-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 06/22/2022] [Indexed: 10/17/2022]
Abstract
This article discusses the current knowledge on the role of the neurological structures, especially the cerebellum and the hypothalamus, and compares the information with human medicine. Micturition is a complex voluntary and involuntarily mechanism. Its physiological completion strictly depends on the hierarchical organisation of the central nervous system pathways in the peripheral nervous system. Although the role of the peripheral nervous system and subcortical areas, such as brainstem centres, are well established in veterinary medicine, the role of the cerebellum and hypothalamus have been poorly investigated and understood. Lower urinary tract dysfunction is often associated with neurological diseases that cause neurogenic bladder (NB). The neuroplasticity of the nervous system in the developmental changes of the mechanism of micturition during the prenatal and postnatal periods is also analysed.
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10
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Singh K, García-Gomar MG, Cauzzo S, Staab JP, Indovina I, Bianciardi M. Structural connectivity of autonomic, pain, limbic, and sensory brainstem nuclei in living humans based on 7 Tesla and 3 Tesla MRI. Hum Brain Mapp 2022; 43:3086-3112. [PMID: 35305272 PMCID: PMC9188976 DOI: 10.1002/hbm.25836] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 02/09/2022] [Accepted: 03/06/2022] [Indexed: 11/18/2022] Open
Abstract
Autonomic, pain, limbic, and sensory processes are mainly governed by the central nervous system, with brainstem nuclei as relay centers for these crucial functions. Yet, the structural connectivity of brainstem nuclei in living humans remains understudied. These tiny structures are difficult to locate using conventional in vivo MRI, and ex vivo brainstem nuclei atlases lack precise and automatic transformability to in vivo images. To fill this gap, we mapped our recently developed probabilistic brainstem nuclei atlas developed in living humans to high‐spatial resolution (1.7 mm isotropic) and diffusion weighted imaging (DWI) at 7 Tesla in 20 healthy participants. To demonstrate clinical translatability, we also acquired 3 Tesla DWI with conventional resolution (2.5 mm isotropic) in the same participants. Results showed the structural connectome of 15 autonomic, pain, limbic, and sensory (including vestibular) brainstem nuclei/nuclei complex (superior/inferior colliculi, ventral tegmental area‐parabrachial pigmented, microcellular tegmental–parabigeminal, lateral/medial parabrachial, vestibular, superior olivary, superior/inferior medullary reticular formation, viscerosensory motor, raphe magnus/pallidus/obscurus, parvicellular reticular nucleus‐alpha part), derived from probabilistic tractography computation. Through graph measure analysis, we identified network hubs and demonstrated high intercommunity communication in these nuclei. We found good (r = .5) translational capability of the 7 Tesla connectome to clinical (i.e., 3 Tesla) datasets. Furthermore, we validated the structural connectome by building diagrams of autonomic/pain/limbic connectivity, vestibular connectivity, and their interactions, and by inspecting the presence of specific links based on human and animal literature. These findings offer a baseline for studies of these brainstem nuclei and their functions in health and disease, including autonomic dysfunction, chronic pain, psychiatric, and vestibular disorders.
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Affiliation(s)
- Kavita Singh
- Brainstem Imaging Laboratory, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - María Guadalupe García-Gomar
- Brainstem Imaging Laboratory, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Escuela Nacional de Estudios Superiores, Juriquilla, Universidad Nacional Autónoma de México, Querétaro, Mexico
| | - Simone Cauzzo
- Brainstem Imaging Laboratory, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Life Sciences Institute, Sant'Anna School of Advanced Studies, Pisa, Italy.,Research Center E. Piaggio, University of Pisa, Pisa, Italy
| | - Jeffrey P Staab
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.,Department of Otorhinolaryngology - Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA
| | - Iole Indovina
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Italy.,Laboratory of Neuromotor Physiology, IRCCS Santa Lucia Foundation, Rome, Italy
| | - Marta Bianciardi
- Brainstem Imaging Laboratory, Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Division of Sleep Medicine, Harvard University, Boston, Massachusetts, USA
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11
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Zhang T, Yuan P, Cui Y, Yuan W, Jiang D. Convergent and Divergent Structural Connectivity of Brain White Matter Network Between Patients With Erectile Dysfunction and Premature Ejaculation: A Graph Theory Analysis Study. Front Neurol 2022; 13:804207. [PMID: 35273555 PMCID: PMC8902049 DOI: 10.3389/fneur.2022.804207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Sexual dysfunction, namely, erectile dysfunction (ED) and premature ejaculation (PE), has been found to be associated with abnormal structural connectivity in the brain. Previous studies have mainly focused on a single disorder, however, convergent and divergent structural connectivity patterns of the brain network between ED and PE remain poorly understood. Methods T1-weighted structural data and diffusion tensor imaging data of 28 patients with psychological ED, 28 patients with lifelong PE (LPE), and 28 healthy controls (HCs) were obtained to map the white matter (WM) brain networks. Then, the graph-theoretical method was applied to investigate the differences of network properties (small-world measures) of the WM network between patients with ED and LPE. Furthermore, nodal segregative and integrative parameters (nodal clustering coefficient and characteristic path length) were also explored between these patients. Results Small-world architecture of the brain networks were identified for both psychological ED and LPE groups. However, patients with ED exhibited increased average characteristic path length of the brain network when compared with patients with LPE and HCs. No significant difference was found in the average characteristic path length between patients with LPE and HCs. Moreover, increased nodal characteristic path length was found in the right middle frontal gyrus (orbital part) of patients with ED and LPE when compared with HCs. In addition, patients with ED had increased nodal characteristic path length in the right middle frontal gyrus (orbital part) when compared with patients with LPE. Conclusion Together, our results demonstrated that decreased integration of the right middle frontal gyrus (orbital part) might be a convergent neuropathological basis for both psychological ED and LPE. In addition, patients with ED also exhibited decreased integration in the whole WM brain network, which was not found in patients with LPE. Therefore, altered integration of the whole brain network might be the divergent structural connectivity patterns for psychological ED and LPE.
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Affiliation(s)
- Tielong Zhang
- Department of Urology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Peng Yuan
- Department of Intervention, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Yonghua Cui
- Department of Neurosurgery, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Weibiao Yuan
- Department of Radiology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Daye Jiang
- Department of Urology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
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12
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Ramezani M, Ryan F, Sahraian MA, Simani L. The impact of brain lesions on sexual dysfunction in patients with multiple sclerosis: A systematic review of magnetic resonance imaging studies. Mult Scler Relat Disord 2022; 57:103336. [PMID: 35158464 DOI: 10.1016/j.msard.2021.103336] [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: 07/17/2021] [Revised: 09/19/2021] [Accepted: 10/14/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Sexual dysfunction is common but underestimated clinical symptom in MS patients. A growing body of evidence has been suggested the link between brain lesions and sexual dysfunction (SD) in patients with multiple sclerosis (MS). However, the clinical research investigating this relationship have shown inconsistent results. Here, we aimed to systematically review the magnetic resonance imaging (MRI) studies evaluating the association between the brain lesions and SD in MS patients. METHODS This study was provided according to the recommendations of the preferred reporting items for systematic reviews and meta-analyses statement. A comprehensive systematic search of online databases was performed to find eligible studies up to December 2020. The quality of studies was methodologically assessed using Newcastle-Ottawa Scale score. RESULTS We identified eight articles regarding MS brain lesions and SD through the search strategy. Seven studies showed significant associations between SD and brain lesions. Three studies investigated the brain stem, two studies the insular and occipital region, one study the frontal lobe, prefrontal cortex, and temporal lobe and one study the parietal area. CONCLUSION The results of this systematic review showed that lesions in different brain areas are correlated with SD in MS patients. Plaques in the occipital and hippocampus areas, as well as left insula appear to be related to dysfunction of sexual arousability or lubrication/erection in MS patients. Orgasmic dysfunction in MS patients may be associated with brain lesions in pons, left temporal periventricular, and right occipital areas.
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Affiliation(s)
- Mahtab Ramezani
- Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fari Ryan
- Centre for Research in Neuroscience, The Research Institute of the McGill University Health Center, 1650 Cedar Ave., Montreal, Quebec, Canada
| | - Mohammad Ali Sahraian
- Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Simani
- Skull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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13
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Haghighi M, Jahangard L, Meybodi AM, Shayganfard M, Ahmadpanah M, Faryadres M, Dürsteler KM, Brühl AB, Sadeghi-Bahmani D, Brand S. Influence of modafinil on early ejaculation - Results from a double-blind randomized clinical trial. J Psychiatr Res 2022; 146:264-271. [PMID: 34799125 DOI: 10.1016/j.jpsychires.2021.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 10/16/2021] [Accepted: 11/05/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND For men, early ejaculation is a serious health concern. Here, we tested the influence of modafinil (Profinil®) on early ejaculation. To this end, we performed a double-blind randomized clinical trial among men with early ejaculation. METHODS A total of 46 men with early ejaculation (mean age: 37.35 years) and in stable marital relationships with regular weekly penile-vaginal intercourse were randomly assigned either to the modafinil (100 mg) or to the placebo condition. Compounds were taken about 4-6h before intended penile-vaginal intercourse. At baseline and four weeks later at the end of the study, participants completed a series of self-rating questionnaires covering early ejaculation. Female partners also rated their male partners' early ejaculation profile. RESULTS Dimensions of early ejaculation improved over time, but only so in the modafinil condition, while no improvements were observed in the placebo condition. CONCLUSIONS Among male adults in stable marital relationships with regular weekly penile-vaginal intercourse modafinil improved dimensions of early ejaculation, always compared to placebo. Given the strong effect of modafinil on cognitive-executive processes, it is conceivable, that modafinil acted both via physiological and cognitive-executive pathways.
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Affiliation(s)
- Mohammad Haghighi
- Behavioral Disorder and Substance Abuses Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Leila Jahangard
- Behavioral Disorder and Substance Abuses Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Azadeh Mazahri Meybodi
- Taleghani Hospital Research Development Committee and Department of Psychiatry, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehran Shayganfard
- Department of Psychiatry, Arak University of Medical Sciences, Arak, Iran
| | - Mohammad Ahmadpanah
- Behavioral Disorder and Substance Abuses Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mohammad Faryadres
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Kenneth M Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002, Basel, Switzerland; Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8001, Zurich, Switzerland
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland
| | - Dena Sadeghi-Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland; Department of Psychology, Stanford University, Stanford, CA, USA; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 67146, Iran
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002, Basel, Switzerland; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, 67146, Iran; Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, 67146, Iran; Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052, Basel, Switzerland; School of Medicine, Tehran University of Medical Sciences, Tehran, 25529, Iran.
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14
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Kayama T, Ikegaya Y, Sasaki T. Phasic firing of dopaminergic neurons in the ventral tegmental area triggers peripheral immune responses. Sci Rep 2022; 12:1447. [PMID: 35087155 PMCID: PMC8795439 DOI: 10.1038/s41598-022-05306-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 01/11/2022] [Indexed: 01/07/2023] Open
Abstract
Dopaminergic neurons in the ventral tegmental area (VTA) play a crucial role in the processing of reward-related information. Recent studies with pharmacological manipulations of VTA neuronal activity demonstrated a VTA-induced immunoenhancement in peripheral organs. Here, to examine the detailed physiological dynamics, we took an optogenetic approach in which VTA dopaminergic neurons were selectively activated with millisecond precision. Optogenetic phasic, rather than tonic, stimulation of VTA dopaminergic neurons increased serum cytokine levels, such as IL-2, IL-4 and TNF-α. These results provide direct evidence to link dopaminergic neuronal phasic firing to peripheral immunity. Next, we tested whether cytokine induction in male mice was boosted by female encounters, a natural condition that induces increased active VTA neurons and gamma power. Female encounters increased serum IL-2 levels, which were abolished by pharmacological inhibition of VTA neuronal activity. Taken together, our results highlight the importance of the brain reward system in the treatment and management of immune-related disorders.
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Affiliation(s)
- Tasuku Kayama
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan.,Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai, 980-8578, Japan
| | - Yuji Ikegaya
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan.,Institute for AI and Beyond, The University of Tokyo, Tokyo, 113-0033, Japan.,Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita City, Osaka, 565-0871, Japan
| | - Takuya Sasaki
- Graduate School of Pharmaceutical Sciences, The University of Tokyo, Tokyo, 113-0033, Japan. .,Department of Pharmacology, Graduate School of Pharmaceutical Sciences, Tohoku University, 6-3 Aramaki-Aoba, Aoba-Ku, Sendai, 980-8578, Japan.
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15
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Chen J, Wu J, Huang X, Sun R, Xiang Z, Xu Y, Chen S, Xu W, Yang J, Chen Y. Differences in structural connectivity between diabetic and psychological erectile dysfunction revealed by network-based statistic: A diffusion tensor imaging study. Front Endocrinol (Lausanne) 2022; 13:892563. [PMID: 35966068 PMCID: PMC9365033 DOI: 10.3389/fendo.2022.892563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) has been found to be associated with abnormalities of the central and peripheral vascular nervous system, which were considered to be involved in the development of cognitive impairments and erectile dysfunction (ED). In addition, altered brain function and structure were identified in patients with ED, especially psychological ED (pED). However, the similarities and the differences of the central neural mechanisms underlying pED and T2DM with ED (DM-ED) remained unclear. METHODS Diffusion tensor imaging data were acquired from 30 T2DM, 32 ED, and 31 DM-ED patients and 47 healthy controls (HCs). Then, whole-brain structural networks were constructed, which were mapped by connectivity matrices (90 × 90) representing the white matter between 90 brain regions parcellated by the anatomical automatic labeling template. Finally, the method of network-based statistic (NBS) was applied to assess the group differences of the structural connectivity. RESULTS Our NBS analysis demonstrated three subnetworks with reduced structural connectivity in DM, pED, and DM-ED patients when compared to HCs, which were predominantly located in the prefrontal and subcortical areas. Compared with DM patients, DM-ED patients had an impaired subnetwork with increased structural connectivity, which were primarily located in the parietal regions. Compared with pED patients, an altered subnetwork with increased structural connectivity was identified in DM-ED patients, which were mainly located in the prefrontal and cingulate areas. CONCLUSION These findings highlighted that the reduced structural connections in the prefrontal and subcortical areas were similar mechanisms to those associated with pED and DM-ED. However, different connectivity patterns were found between pED and DM-ED, and the increased connectivity in the frontal-parietal network might be due to the compensation mechanisms that were devoted to improving erectile function.
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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
| | - Jindan Wu
- Department of Endocrinology, Nanjing First Hospital, 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
| | - Rui Sun
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shi Chen
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Weilong Xu
- Department of Endocrinology, 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, Artux, Xinjiang, China
- *Correspondence: Yun Chen, ; Jie Yang,
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yun Chen, ; Jie Yang,
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16
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van 't Hof SR, Van Oudenhove L, Janssen E, Klein S, Reddan MC, Kragel PA, Stark R, Wager TD. The Brain Activation-Based Sexual Image Classifier (BASIC): A Sensitive and Specific fMRI Activity Pattern for Sexual Image Processing. Cereb Cortex 2021; 32:3014-3030. [PMID: 34905775 PMCID: PMC9290618 DOI: 10.1093/cercor/bhab397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 09/27/2021] [Accepted: 09/28/2021] [Indexed: 11/19/2022] Open
Abstract
Previous studies suggest there is a complex relationship between sexual and general affective stimulus processing, which varies across individuals and situations. We examined whether sexual and general affective processing can be distinguished at the brain level. In addition, we explored to what degree possible distinctions are generalizable across individuals and different types of sexual stimuli, and whether they are limited to the engagement of lower-level processes, such as the detection of visual features. Data on sexual images, nonsexual positive and negative images, and neutral images from Wehrum et al. (2013) (N = 100) were reanalyzed using multivariate support vector machine models to create the brain activation-based sexual image classifier (BASIC) model. This model was tested for sensitivity, specificity, and generalizability in cross-validation (N = 100) and an independent test cohort (N = 18; Kragel et al. 2019). The BASIC model showed highly accurate performance (94–100%) in classifying sexual versus neutral or nonsexual affective images in both datasets with forced choice tests. Virtual lesions and tests of individual large-scale networks (e.g., visual or attention networks) show that individual networks are neither necessary nor sufficient to classify sexual versus nonsexual stimulus processing. Thus, responses to sexual images are distributed across brain systems.
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Affiliation(s)
- Sophie R van 't Hof
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH 03755, USA.,Department of Psychiatry, Amsterdam Medical Centre, 1105 AZ, The Netherlands
| | - Lukas Van Oudenhove
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH 03755, USA.,Laboratory for Brain-Gut Axis Studies, Translational Research Center for Gastrointestinal Disorders, Department of Chronic Diseases and Metabolism, KU Leuven, Leuven 3000, Belgium
| | - Erick Janssen
- Institute for Family and Sexuality Studies, KU Leuven, Leuven 3000, Belgium
| | - Sanja Klein
- Bender Institute of Neuroimaging (BION), Justus Liebig University Giessen, Giessen 35390, Germany.,Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen 35390, Germany
| | - Marianne C Reddan
- Institute of Cognitive Science, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA.,Stanford University, Palo Alto, CA, USA
| | - Philip A Kragel
- Institute of Cognitive Science, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA.,Emory University, Atlanta, GA, USA
| | - Rudolf Stark
- Bender Institute of Neuroimaging (BION), Justus Liebig University Giessen, Giessen 35390, Germany.,Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen 35390, Germany
| | - Tor D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH 03755, USA.,Institute of Cognitive Science, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO 80309, USA
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17
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Newberg AB, Wintering NA, Hriso C, Vedaei F, Stoner M, Ross R. Alterations in Functional Connectivity Measured by Functional Magnetic Resonance Imaging and the Relationship With Heart Rate Variability in Subjects After Performing Orgasmic Meditation: An Exploratory Study. Front Psychol 2021; 12:708973. [PMID: 34858249 PMCID: PMC8631761 DOI: 10.3389/fpsyg.2021.708973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 10/15/2021] [Indexed: 12/21/2022] Open
Abstract
Background: We measured changes in resting brain functional connectivity, with blood oxygen level dependent (BOLD) functional magnetic resonance imaging (fMRI), associated with a creative meditation practice that is augmented by clitoral stimulation and is designed to not only achieve a spiritual experience but to help individuals manage their most intimate personal relationships. Briefly, the meditative state is attained by both the male and female participants while the male stimulates the woman’s clitoris. The goal of this practice, called orgasmic meditation (OM), according to the practitioners is not sexual, but to use the focus on clitoral stimulation to facilitate a meditative state of connectedness and calm alertness between the two participants. Methods: fMRI was acquired on 20 pairs of subjects shortly following one of two states that were randomized in their order – during the OM practice or during a neutral condition. The practice is performed while the female is lying down on pillows with the clitoris exposed. During the practice, the male performs digital stimulation of the clitoris for 15 min. Resting BOLD image acquisition was performed at completion of the practice to assess changes in functional connectivity associated with the performance of the practice. Results: The results demonstrated significant changes (p < 0.05) in functional connectivity associated with the OM compared to the neutral condition. For the entire group there was altered connectivity following the OM practice involving the left superior temporal lobe, the frontal lobe, anterior cingulate, and insula. In female subjects, there was altered connectivity involving the cerebellum, thalamus, inferior frontal lobe posterior parietal lobe, angular gyrus, amygdala and middle temporal gyrus, and prefrontal cortex. In males, functional connectivity changes involved the supramarginal gyrus, cerebellum, and orbitofrontal gyrus, cerebellum, parahippocampus, inferior temporal gyrus, and anterior cingulate. Conclusion: Overall, these findings suggest a complex pattern of functional connectivity changes occurring in both members of the couple pair that result from this unique meditation practice. The changes represent a hybrid of functional connectivity findings with some similarities to meditation based practices and some with sexual stimulation and orgasm. This study has broader implications for understanding the dynamic relationship between sexuality and spirituality.
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Affiliation(s)
- Andrew B Newberg
- Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA, United States.,Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Nancy A Wintering
- Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA, United States
| | - Chloe Hriso
- Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA, United States
| | - Faezeh Vedaei
- Department of Radiology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Marie Stoner
- Department of Integrative Medicine and Nutritional Sciences, Thomas Jefferson University, Philadelphia, PA, United States
| | - Reneita Ross
- Department of Obstetrics and Gynecology, Thomas Jefferson University, Philadelphia, PA, United States
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18
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Functional Connectivity of Nucleus Accumbens Is Associated with Lifelong Premature Ejaculation in Male Adults : A Resting-state fMRI Study. Clin Neuroradiol 2021; 32:655-663. [PMID: 34714363 DOI: 10.1007/s00062-021-01105-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Ejaculation represents a crucial component of sexual behavior in men, which is involved in reward functions of certain brain areas including the nucleus accumbens (NAcc). Lifelong premature ejaculation (PE) is one of the most prevalent sexual dysfunctions in men. It is suggested to be related to abnormal brain function. This study aimed to explore changes of the functional connectivity patterns of NAcc and possible correlations of the neuroimaging abnormalities with clinical features in lifelong PE patients. METHODS The sample consisted with 42 lifelong PE patients and 30 healthy controls. All participants underwent functional magnetic resonance imaging scans and clinical symptoms. The functional connectivity (FC) approach was applied to investigate differences of NAcc-seed intrinsic connectivity between two groups and correlation analysis was used to access possible relationships between the imaging findings and clinical features, such as premature ejaculation diagnostic tool (PEDT) or intravaginal ejaculatory latency time (IELT). RESULTS Results showed that lifelong PE patients had decreased FC between the NAcc and thalamus, superior temporal pole, superior temporal cortex (STC), inferior frontal gyrus (IFG), orbitofrontal cortex, caudate and putamen. A significantly negative correlation between the PEDT score and NAcc-STC connectivity (r = -0.46) was found in lifelong PE patients, while IELT score positively correlated with the NAcc-IFG connectivity (r = 0.48) and NAcc-thalamus connectivity (r = 0.46). CONCLUSION The findings may facilitate a more sophisticated understanding of neural mechanisms of lifelong PE, particularly associated with the NAcc-related intrinsic connectivity during the resting state.
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19
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Lu J, Chen Q, Li D, Zhang W, Xing S, Wang J, Zhang X, Liu J, Qing Z, Dai Y, Zhang B. Reconfiguration of Dynamic Functional Connectivity States in Patients With Lifelong Premature Ejaculation. Front Neurosci 2021; 15:721236. [PMID: 34588948 PMCID: PMC8473781 DOI: 10.3389/fnins.2021.721236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Neuroimaging has demonstrated altered static functional connectivity in patients with premature ejaculation (PE), while studies examining dynamic changes in spontaneous brain activity in PE patients are still lacking. We aimed to explore the reconfiguration of dynamic functional connectivity (DFC) states in lifelong PE (LPE) patients and to distinguish LPE patients from normal controls (NCs) using a machine learning method based on DFC state features. Methods: Thirty-six LPE patients and 23 NCs were recruited. Resting-state functional magnetic resonance imaging (fMRI) data, the clinical rating scores on the Chinese Index of PE (CIPE), and intravaginal ejaculatory latency time (IELT) were collected from each participant. DFC was calculated by the sliding window approach. Finally, the Lagrangian support vector machine (LSVM) classifier was applied to distinguish LPE patients from NCs using the DFC parameters. Two DFC state metrics (reoccurrence times and transition frequencies) were introduced and we assessed the correlations between DFC state metrics and clinical variables, and the accuracy, sensitivity, and specificity of the LSVM classifier. Results: By k-means clustering, four distinct DFC states were identified. The LPE patients showed an increase in the reoccurrence times for state 3 (p < 0.05, Bonferroni corrected) but a decrease for state 1 (p < 0.05, Bonferroni corrected) compared to the NCs. Moreover, the LPE patients had significantly less frequent transitions between state 1 and state 4 (p < 0.05, uncorrected) while more frequent transitions between state 3 and state 4 (p < 0.05, uncorrected) than the NCs. The reoccurrence times and transition frequencies showed significant associations with the CIPE scores and IELTs. The accuracy, sensitivity, and specificity of the LSVM classifier were 90.35, 87.59, and 85.59%, respectively. Conclusion: LPE patients were more inclined to be in DFC states reinforced intra-network and inter-network connection. These features correlated with clinical syndromes and can classify the LPE patients from NCs. Our results of reconfiguration of DFC states may provide novel insights for the understanding of central etiology underlying LPE, indicate neuroimaging biomarkers for the evaluation of clinical severity of LPE.
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Affiliation(s)
- Jiaming Lu
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Qian Chen
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Danyan Li
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Radiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
| | - Wen Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Siyan Xing
- Department of Andrology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Junxia Wang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiani Liu
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhao Qing
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yutian Dai
- Department of Andrology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Radiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China.,Institute of Brain Science, Nanjing University, Nanjing, China
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20
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Addiction and the cerebellum with a focus on actions of opioid receptors. Neurosci Biobehav Rev 2021; 131:229-247. [PMID: 34555385 DOI: 10.1016/j.neubiorev.2021.09.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/12/2021] [Accepted: 09/12/2021] [Indexed: 01/19/2023]
Abstract
Increasing evidence suggests that the cerebellum could play a role in the higher cognitive processes involved in addiction as the cerebellum contains anatomical and functional pathways to circuitry controlling motivation and saliency. In addition, the cerebellum exhibits a widespread presence of receptors, including opioid receptors which are known to play a prominent role in synaptic and circuit mechanisms of plasticity associated with drug use and development of addiction to opioids and other drugs of abuse. Further, the presence of perineural nets (PNNs) in the cerebellum which contain proteins known to alter synaptic plasticity could contribute to addiction. The role the cerebellum plays in processes of addiction is likely complex, and could depend on the particular drug of abuse, the pattern of use, and the stage of the user within the addiction cycle. In this review, we discuss functional and structural modifications shown to be produced in the cerebellum by opioids that exhibit dependency-inducing properties which provide support for the conclusion that the cerebellum plays a role in addiction.
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Mascherek A, Reidick MC, Gallinat J, Kühn S. Is Ejaculation Frequency in Men Related to General and Mental Health? Looking Back and Looking Forward. Front Psychol 2021; 12:693121. [PMID: 34434144 PMCID: PMC8382266 DOI: 10.3389/fpsyg.2021.693121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 07/19/2021] [Indexed: 11/13/2022] Open
Abstract
Despite its relevance for human sexuality, literature on potential effects of ejaculation frequency and masturbation on general and mental health outcomes is sparse. Reasons for this knowledge gap include a general lack of interest, but also methodological challenges and still existing superstition. This paper reconciles literature from various fields to extract relevant information on how ejaculation frequency effects general and mental health outcomes. Culture-bound syndromes have been reported in countries still strictly tabooing or condemning masturbation. Masturbatory guilt describes a phenomenon in individuals experiencing a discrepancy between moral standards and own behavior with respect to masturbation. Abstinence is one aspect under study in the area of fertility treatment. Specific time frames and their respective implications on quality of sperm remain inconclusive. Limited temporal resolution capacities hamper the precise study of brain structures directly activated during ejaculation. The relation between ejaculation frequency and hormonal influences remains poorly understood. Future research that specifically addresses ejaculation frequency and potential mental and general health outcomes is needed. In contrast to extracting knowledge as a byproduct from other studies with a different focus, this enables sound study designs and could provide evidence-based results which could then be further discussed and interpreted.
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Affiliation(s)
- Anna Mascherek
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mirjam Christina Reidick
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simone Kühn
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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22
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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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23
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Wu J, Gao M, Piao R, Feng N, Geng B, Liu P. Magnetic Resonance Imaging-Based Structural Covariance Changes of the Striatum in Lifelong Premature Ejaculation Patients. J Magn Reson Imaging 2021; 55:443-450. [PMID: 34291847 DOI: 10.1002/jmri.27851] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The striatum has been reported to be implicated in various neurological diseases, including lifelong premature ejaculation (LPE). Altered striatum-related functional connectivity was investigated in LPE patients in previous studies; however, structural abnormalities in the striatum have been less studied in LPE. PURPOSE To identify the gray matter volume (GMV) and structural covariance patterns of the striatum between LPE patients and healthy controls (HCs). STUDY TYPE Prospective. SUBJECTS Forty-three LPE patients and 31 male HCs. FIELD STRENGTH/SEQUENCE 3.0 T magnetic resonance imaging (MRI) scanner; T1-weighted imaging using a spoiled gradient recalled echo sequence. ASSESSMENT Preprocessing of structural MRI data and the striatum-seeded GMV computation were conducted using SPM12. STATISTICAL TESTS Two sample t-test was used to compare differences in GMV of the striatum between patients and HCs. Regions showing altered between-group GMV were considered as seeds for structural covariance analysis in two groups. Additionally, correlations between GMV findings and clinical features were assessed with age and total intracranial volume (TIV) as covariates and with age, TIV, anxiety, and depression scores as covariates in the patient group, P < 0.05 was considered statistically significant. RESULTS Compared to HCs, LPE patients had significantly decreased GMV in four regions located in the bilateral caudate and putamen. Distinct striatum-based structural covariance patterns in the two groups were mainly related to the thalamus, amygdala, insula, anterior cingulate cortex, middle cingulate cortex, medial prefrontal cortex, primary motor cortex, and precuneus/cuneus. LPE patients showed that GMV in the bilateral caudate negatively correlated with the premature ejaculation diagnostic tool (PEDT) scores (r = -0.369, r = -0.377, respectively). DATA CONCLUSION Our findings indicated that LPE patients had altered GMV and structural covariance patterns in the striatum compared to HCs. The correlations between abnormal GMV and PEDT were also shown in the present findings. These findings may contribute to enhancing the understanding of the pathophysiology of LPE. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Jiayu Wu
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Ming Gao
- Xi'An DaXing Hospital of Shaanxi, University of Chinese Medicine, Xi'an, China.,Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China
| | - Ruiqing Piao
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Nana Feng
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Bowen Geng
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Peng Liu
- Life Sciences Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
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24
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Abnormal degree centrality in lifelong premature ejaculation patients: an fMRI study. Brain Imaging Behav 2021; 15:1412-1419. [PMID: 32767047 DOI: 10.1007/s11682-020-00340-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Lifelong premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions. It is still not well known about the possible neural mechanisms of lifelong PE. This study tried to investigate the abnormal characteristics of brain functional networks of lifelong PE and to assess relationships of PE-related functional abnormalities with clinical symptoms. Functional magnetic resonance imaging (fMRI) data and clinical symptoms were collected from 45 lifelong PE patients and 37 healthy controls (HCs) since 2016, including disease and sexual life history, intravaginal ejaculatory latency time measured by stopwatch and other scales. The degree centrality (DC) approach were applied to distinguish altered brain functions between the two groups (p < 0.05, false discovery rate corrected). Correlation analysis was then performed to examine relationships between the imaging findings and clinical symptoms (p < 0.05, Bonferroni corrected). Results showed that compared with HCs, lifelong PE patients had increased DC value in the medial prefrontal cortex (mPFC), precuneus and primary somatosensory cortex (SI) as well as decreased DC value in the insula and orbitofrontal cortex. After controlling for anxiety and depression levels, the significant difference in the mPFC was not found. The DC value in the SI positively correlated with premature ejaculation diagnostic tool (PEDT) score in the patients. The present findings indicate that lifelong PE patients have altered DC in brain regions involved in sensation, motivation and inhibitory control processing. Our study may improve our understanding and provide a new sight into the further research of lifelong PE.
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25
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Haghighi M, Doostizadeh M, Jahangard L, Soltanian A, Faryadres M, Dürsteler KM, Beatrix Brühl A, Sadeghi-Bahmani D, Brand S. Influence of Lisdexamfetamine Dimesylate on Early Ejaculation-Results from a Double-Blind Randomized Clinical Trial. Healthcare (Basel) 2021; 9:859. [PMID: 34356237 PMCID: PMC8303163 DOI: 10.3390/healthcare9070859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Among male sexual dysfunctions, erectile dysfunction and early ejaculation have the highest prevalence rates. Here, we tested the influence of lisdexamfetamine dimesylate (Vyas®) on early ejaculation. To this end, we performed a double-blind randomized clinical trial among males with early ejaculation. METHODS A total of 46 males with early ejaculation (mean age: 35.23 years) and in stable marital relationships with regular weekly penile-vaginal intercourse were randomly assigned either to the lisdexamfetamine dimesylate condition (30 mg) or to the placebo condition. Compounds were taken about six hours before intended penile-vaginal intercourse. At baseline and four weeks later at the end of the study, participants completed a series of self-rating questionnaires covering early ejaculation. Female partners also rated participants' early ejaculation profile. RESULTS Compared to the placebo condition, dimensions of early ejaculation improved over time in the lisdexamfetamine condition, though improvements were also observed in the placebo condition. CONCLUSIONS Among male adults in stable marital relationships with regular weekly penile-vaginal intercourse, lisdexamfetamine dimesylate improved dimensions of early ejaculation. Given that improvements were also observed in the placebo condition, psychological factors such as increased attention to early ejaculation and favorable expectations of the compound should be considered.
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Affiliation(s)
- Mohammad Haghighi
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Mona Doostizadeh
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Leila Jahangard
- Behavioral Disorders and Substance Abuse Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran; (M.H.); (M.D.); (L.J.)
| | - Alireza Soltanian
- Modeling of Non-Communicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
| | - Mohammad Faryadres
- Department of Biostatistics and Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan 6516848741, Iran;
| | - Kenneth M. Dürsteler
- Psychiatric Clinics, Division of Substance Use Disorders, University of Basel, 4002 Basel, Switzerland;
- Center for Addictive Disorders, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8001 Zurich, Switzerland
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
| | - Dena Sadeghi-Bahmani
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
| | - Serge Brand
- Center for Affective, Stress and Sleep Disorders (ZASS), Psychiatric University Hospital Basel, 4002 Basel, Switzerland; (A.B.B.); (D.S.-B.)
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 67146, Iran
- Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Department of Sport, Exercise and Health, Division of Sport Science and Psychosocial Health, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Tehran 25529, Iran
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26
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Huang Y, Peng D, Geng H, Dai Y, Jiang H, Zhang X. Expression of brain-derived neurotrophic factor in rapid ejaculator rats: A further study. Andrologia 2021; 53:e14134. [PMID: 34101873 DOI: 10.1111/and.14134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 05/11/2021] [Accepted: 05/14/2021] [Indexed: 11/27/2022] Open
Abstract
Limited evidence has indicated that brain-derived neurotrophic factor (BDNF) may be involved in the neurobiology of premature ejaculation (PE). This study aimed to investigate BDNF levels in the central and peripheral nervous systems of a rapid ejaculation model. Eighteen male rats were selected and classified as 'sluggish', 'normal' and 'rapid' ejaculators on the basis of ejaculation frequency during copulatory behavioural tests. BDNF levels in specific brain regions, spinal cord and serum were determined by enzyme-linked immunosorbent assay (ELISA). Consistent with the results in PE patients, the concentration of serum BDNF decreased significantly from the sluggish rats to normal and rapid rats. Besides, in both brain regions and spinal cord, the sluggish group had the highest BDNF levels, while the rapid group had the lowest BDNF levels. Regression analyses of the expression of BDNF presented positive correlations between serum and brain (r = 0.958, p < .001), and between serum and spinal cord (r = 0.967, p < .001) respectively. Our findings suggested insufficient BDNF in the nervous system and serum may lead to rapid ejaculation. The current study adds to the evidence that BDNF is involved in the regulation of ejaculation.
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Affiliation(s)
- Yuanyuan Huang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dangwei Peng
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hao Geng
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yutian Dai
- Department of Andrology, Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, China
| | - Hui Jiang
- Department of Andrology, Peking University Third Hospital, Beijing, China.,Department of Human Sperm Bank, Peking University Third Hospital, Beijing, China
| | - Xiansheng Zhang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Hefei, China
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27
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Park JH, Kim E, Cho H, Park DW, Choi J, Jang SH. Brain activation in response to visual sexual stimuli in male patients with right middle cerebral artery infarction: The first case-control functional magnetic resonance imaging study. Medicine (Baltimore) 2021; 100:e25823. [PMID: 34032696 PMCID: PMC8154462 DOI: 10.1097/md.0000000000025823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 04/13/2021] [Indexed: 01/04/2023] Open
Abstract
Sexual dysfunction is a common problem after cerebral infarction; however, little is known about sexual arousal in poststroke patients. Thus, this study aimed to investigate brain activation in response to visual sexual stimuli in patients with right middle cerebral artery (MCA) territory infarction using functional magnetic resonance imaging (fMRI). Using fMRI in 20 participants (11 right MCA infarction patients and 9 age-matched healthy controls), we assessed brain activation elicited by visual sexual stimuli (erotic images) and visual nonsexual stimuli (landscape images). In right MCA infarction patients, the left dorsolateral prefrontal cortex and the left frontal subgyral area were more strongly activated by visual sexual stimuli than by nonvisual sexual stimuli. Brain areas that were more activated by visual sexual stimuli in right MCA infarction patients than in controls included the right parahippocampal gyrus and the bilateral frontal subgyral area. These fMRI results suggest that brain activation patterns in response to visual sexual stimuli might be influenced by right MCA infarction. Further research is needed to explore the association between sexual dysfunction and brain activation in poststroke patients.
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Affiliation(s)
- Jae Hyeon Park
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Gyeonggi-do
| | - Eunkyung Kim
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul
| | - Hyungpil Cho
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Gyeonggi-do
| | | | - Joonho Choi
- Department of Psychiatry, Hanyang University Guri Hospital, Gyeonggi-do, Republic of Korea
| | - Seong Ho Jang
- Department of Rehabilitation Medicine, Hanyang University Guri Hospital, Gyeonggi-do
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28
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Geng B, Gao M, Wu J, Yang G, Liu C, Piao R, Zhang S, Xu K, Yuan J, Liu P. Smaller volume and altered functional connectivity of the amygdala in patients with lifelong premature ejaculation. Eur Radiol 2021; 31:8429-8437. [PMID: 33928418 DOI: 10.1007/s00330-021-08002-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/04/2021] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To analyze the abnormal amygdala structure and function in lifelong premature ejaculation (PE) patients compared with healthy controls (HCs). METHODS Forty-four lifelong PE patients and thirty-one HCs were enrolled in this study. Each subject was diagnosed with PE using a Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculation latency time (IELT) score. Based on t-tests and Pearson correlation analysis, the voxel-based morphometry and functional connectivity (FC) analyses were applied to evaluate brain structural and functional changes by using T1-weighted and resting-state functional magnetic resonance imaging scans. RESULTS Lifelong PE patients had decreased gray matter volume in the bilateral amygdala and increased FC between the amygdala and precuneus, posterior cingulate cortex (PCC), and middle temporal cortex (MTC), as well as decreased FC between the amygdala and precentral gyrus, insula, and inferior frontal gyrus. Moreover, significantly negative correlations between the IELT score and the mean z-score from amygdala-MTC (r = -0.49) and amygdala-PCC (r = -0.48) FC were found in lifelong PE patients. CONCLUSIONS Our study investigated the abnormal amygdala-related structure and connectivity patterns in PE patients, which might provide novel perspective for understanding the crucial role of the amygdala in the neural mechanism of PE. KEY POINTS • As one of the most common diseases in men, PE may be related to abnormal brain mechanisms. • Functional and structural magnetic resonance imaging used to explore amygdala abnormalities in PE patients. • The correlation between clinical scores and functional connectivity was used to assess the reasonability of the results.
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Affiliation(s)
- Bowen Geng
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ming Gao
- Xi'An DaXing Hospital of Shaanxi University of Chinese Medicine, Xi'an, China.,Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China
| | - Jiayu Wu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Guang Yang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Chengxiang Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ruiqing Piao
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Shuming Zhang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ke Xu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China. .,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China.
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29
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Abstract
Gender identity development is complex and involves several key processes. Transgender people experience incongruence between their biological and identified gender. This incongruence can cause significant impairment in overall functioning and lead to gender dysphoria (GD). The pathophysiology of GD is complex and is poorly understood. A PubMed search based on predetermined eligibility criteria was conducted to review neuropsychiatric articles focused on neurological, biological and neuroimaging aspects of gender development, transgender identity and GD. The information obtained from the literature was then used to formulize a GD model. Distinct gray matter volume and brain activation and connectivity differences were found in individuals with GD compared to controls, suggesting a neurobiological basis of GD; which leads to the concept of brain gender. Individuals with GD encounter a recurrent conflict between their brain gender and the societal feedback; which causes recurrent and ongoing cognitive dissonance, finally leading to GD and functional connectivity and activation changes in the transgender brain. GD has neurobiological basis, but it is closely associated with the individuals' interaction with the external world, their self-perception and the feedback received in return. We propose a novel model where the development of GD includes cognitive dissonance, involving anterior cingulate cortex and ventral striatum as the key brain structures. This model can be used to generate testable hypotheses using behavioral and neuroimaging techniques to understand the neuropsychobiology of GD.
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Affiliation(s)
- Murat Altinay
- Center for Behavioral Health, Cleveland Clinic, 9500 Euclid Avenue/P57, Cleveland, OH, 44195, USA.
| | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic, 9500 Euclid Avenue/P57, Cleveland, OH, 44195, USA
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30
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Xia JD, Chen F, Zhang QJ, Wang YM, Dai YT, Song NH, Wang ZJ, Zhang B, Yang J. Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation. J Sex Med 2020; 18:275-283. [PMID: 33358559 DOI: 10.1016/j.jsxm.2020.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/22/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although some recent neuroimaging studies have indicated the abnormal brain structure or function in patients with lifelong premature ejaculation (LPE), whether and how the abnormal thalamic function participates in processing sexual behavioral information are still unclear in patients with LPE. AIM The aim of this study was to assess the changes in the thalamus metabolism and structural integrity in patients with LPE. METHODS We performed a multimodal magnetic resonance approach in a 3.0 T system, including proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging, and volumetric analysis to detect the differences in thalamic metabolism and structure between 20 patients with LPE and 15 healthy controls. OUTCOMES We analyzed and correlated the clinical symptoms of the subjects with significant 1H-MRS-based features. Peak areas of N-acetylaspartate, choline, creatine (Cr), and glutamate/glutamine (Glu) were calculated with the LCModel software. RESULTS Diffusion tensor imaging and volumetric analysis of thalami showed no differences between the 2 groups. On the contrary, 1H-MRS study disclosed that both Glu concentrations and Glu/Cr ratio values in the thalami of patients with LPE were remarkably increased when compared with healthy controls (P < .01 for both variables). In addition, both the intravaginal ejaculatory latency time score and Chinese Index of Sexual Function for Premature Ejaculation-5 score were negatively related to increased Glu concentrations and Glu/Cr ratio values. CLINICAL IMPLICATIONS Glutamatergic activity changes of thalamus may be an underlying indicator for evaluating sensory conduction efficiency in patients with LPE. STRENGTHS & LIMITATIONS The present study first found the abnormal thalamic metabolism in patients with LPE and contributed to a better understanding of the LPE etiology. Limitations include a cross-sectional study design with small samples and no examination of other brain areas. CONCLUSION Our findings show that the increase in glutamatergic activity of thalamus is related to LPE, suggesting that the increased Glu neurotransmission in the thalamus may contribute to the development of premature ejaculation. Xia J-D, Chen F, Zhang Q-J, et al. Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation. J Sex Med 2021;18:275-283.
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Affiliation(s)
- Jia-Dong Xia
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Fei Chen
- Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, Jiangsu, China
| | - Qi-Jie Zhang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ya-Min Wang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yu-Tian Dai
- Department of Andrology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Ning-Hong Song
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zeng-Jun Wang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bing Zhang
- Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Jie Yang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
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31
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Chen J, Yang J, Xiang Z, Huang X, Lu C, Liu S, Chen Y, Hu J. Graph theory analysis reveals premature ejaculation is a brain disorder with altered structural connectivity and depressive symptom: A DTI‐based connectome study. Eur J Neurosci 2020; 53:1905-1921. [PMID: 33217076 DOI: 10.1111/ejn.15048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/15/2020] [Accepted: 11/15/2020] [Indexed: 01/05/2023]
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 HospitalFirst Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Ziliang Xiang
- 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
| | - 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
| | - Jun Hu
- Department of Radiology Nanjing Brain HospitalAffiliated Hospital of Nanjing Medical University Nanjing China
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Chen J, Wu W, Xiang Z, Wang Q, Huang X, Lu C, Liu S, Chen Y, Yang J. Aberrant default mode network and auditory network underlying the sympathetic skin response of the penis (PSSR) of patients with premature ejaculation: A resting-state fMRI study. Andrology 2020; 9:277-287. [PMID: 32996293 DOI: 10.1111/andr.12914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Hyperactivity of the sympathetic nervous system is considered as an important component involved in the pathological mechanisms of premature ejaculation (PE). However, the neural mechanisms of PE with high sympathetic activity are still not well understood. METHODS The activity of the sympathetic innervations in the penis was evaluated by the sympathetic skin response of the penis (PSSR) with an electromyograph and evoked potential equipment. Resting-state functional magnetic resonance imaging (fMRI) data were acquired from 18 PE patients with high sympathetic activity (sPE), 17 PE patients with normal sympathetic activity (nsPE), and 24 healthy controls (HC). We investigated the neural basis of sPE based on the measure of regional homogeneity (ReHo). Moreover, the correlations between brain regions with altered ReHo and PEDT scores and PSSR latencies in the patient group were explored. RESULTS Altered ReHo values among three groups were found in the temporal, cingulated, and parietal cortex in the default mode network (DMN), as well as the temporal cortex in the auditory network (AUD). Compared with HC, Patients with sPE had increased ReHo values of brain regions in DMN, AUD, and decreased ReHo values of brain regions in DMN. In addition, increased ReHo values were found in DMN of patients with nsPE, while decreased ReHo values were found in DMN and the attention network (AN). Moreover, sPE patients had increased ReHo values in AUD and decreased ReHo values in DMN when compared with nsPE patients. Finally, altered ReHo values of brain regions in DMN and AUD were associated with PEDT scores and PSSR latencies in the patient group. CONCLUSION Our results suggested that PE patients had abnormal ReHo values in DMN, AUD, and AN. Patients with sPE were characterized by increased neuronal activity in AUD and decreased activity in DMN. This highlighted the significances of DMN, AUD, and AN in the pathophysiology of PE and also provided potential neuroimaging biomarkers for distinguishing sPE from nsPE and HC.
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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
| | - Wanke Wu
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, 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
| | - 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
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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Waqar M, Omar K, Moubasher A, Brunckhorst O, Ahmed K. Painful Ejaculation - An Ignored Symptom. Cureus 2020; 12:e11253. [PMID: 33269171 PMCID: PMC7707127 DOI: 10.7759/cureus.11253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/29/2020] [Indexed: 11/30/2022] Open
Abstract
The purpose of this review is to summarize the pathophysiology of ejaculation and look into prevalence, aetiology, diagnosis, and treatment of painful ejaculation. We carried out a comprehensive search of PubMed in order to look for literature on male painful ejaculation using keywords post-orgasmic pain, painful ejaculation, dysejaculation, odynorgasmia, post-orgasmic pain, or dysorgasmia. Painful ejaculation has an alarming prevalence throughout the world, between 1 to 25%. It has a detrimental effect on patients' quality of life as it reduces individual self-esteem and is associated with sexual dysfunction. Its aetiology includes simple infection or inflammation of the urinary tract, benign prostate hyperplasia, ejaculatory duct obstruction, post-radical prostatectomy and side effects of certain medications. Once reported, it should be investigations and treatments should be tailored according to the etiology. Both medical and surgical treatment is available depending on the cause of painful ejaculation. Due to the sensitive nature of its presentation, it is a symptom that can be identified best when specifically asked. Our understanding regarding painful ejaculation is very limited and only a few articles have revealed insight into this topic. Further research is required in order to set proper guidelines for diagnosis and treatment of painful ejaculation.
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Affiliation(s)
- Muhammad Waqar
- Urology, King's College Hospital NHS Foundation Trust, London, GBR
| | - Kawa Omar
- Urology, King's College Hospital NHS Foundation Trust, London, GBR
| | - Amr Moubasher
- Urology, King's College Hospital NHS Foundation Trust, London, GBR
| | - Oliver Brunckhorst
- Urology, MRC Centre for Transplantation, Guy's Hospital Campus, King's College London, King's Health Partners, London, GBR
| | - Kamran Ahmed
- Urology, King's College Hospital NHS Foundation Trust, London, GBR
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The role of anterior and posterior insula in male genital response and in visual attention: an exploratory multimodal fMRI study. Sci Rep 2020; 10:18463. [PMID: 33116146 PMCID: PMC7595210 DOI: 10.1038/s41598-020-74681-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 09/21/2020] [Indexed: 12/27/2022] Open
Abstract
Several studies highlighted the role of insula on several functions and in sexual behavior. This exploratory study examines the relationships among genital responses, brain responses, and eye movements, to disentangle the role played by the anterior and posterior insula during different stages of male sexual response and during visual attention to sexual stimuli. In 19 healthy men, fMRI, eye movement, and penile tumescence data were collected during a visual sexual stimulation task. After a whole-brain analysis comparing neutral and sexual clips and confirming a role for the bilateral insulae, we selected two bilateral seed regions in anterior and posterior insula for functional connectivity analysis. Single-ROI-GLMs were run for the FC target regions. Single-ROI-GLMs were performed based on areas to which participants fixate: “Faces”, “Genitals,” and “Background” with the contrast “Genitals > Faces”. Single-ROI-GLMs with baseline, onset, and sustained PT response for the sexual clips were performed. We found stronger effects for the posterior than the anterior insula. In the target regions of the posterior insula, we found three different pathways: the first involved in visual attention, onset of erection, and sustained erection; the second involved only in the onset of erection, and the third limited to sustained erection.
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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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Past, Present, and Future in the Study of Neural Control of the Lower Urinary Tract. Int Neurourol J 2020; 24:191-199. [PMID: 33017890 PMCID: PMC7538290 DOI: 10.5213/inj.2040318.159] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022] Open
Abstract
The neurological coordination of the lower urinary tract can be analyzed from the perspective of motor neurons or sensory neurons. First, sensory nerves with receptors in the bladder and urethra transmits stimuli to the cerebral cortex through the periaqueductal gray (PAG) of the midbrain. Upon the recognition of stimuli, the cerebrum carries out decision-making in response. Motor neurons are divided into upper motor neurons (UMNs) and lower motor neurons (LMNs) and UMNs coordinate storage and urination in the brainstem for synergic voiding. In contrast, LMNs, which originate in the spinal cord, cause muscles to contract. These neurons are present in the sacrum, and in particular, a specific neuron group called Onuf’s nucleus is responsible for the contraction of the external urethral sphincter and maintains continence in states of rising vesical pressure through voluntary contraction of the sphincter. Parasympathetic neurons originating from S2–S4 are responsible for the contraction of bladder muscles, while sympathetic neurons are responsible for contraction of the urethral smooth muscle, including the bladder neck, during the guarding reflex. UMNs are controlled in the pons where various motor stimuli to the LMNs are directed along with control to various other pelvic organs, and in the PAG, where complex signals from the brain are received and integrated. Future understanding of the complex mechanisms of micturition requires integrative knowledge from various fields encompassing these distinct disciplines.
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Nam JH, Yun J, Jin IH, Chung D. hubViz: A Novel Tool for Hub-centric Visualization. CHEMOMETRICS AND INTELLIGENT LABORATORY SYSTEMS : AN INTERNATIONAL JOURNAL SPONSORED BY THE CHEMOMETRICS SOCIETY 2020; 203:104071. [PMID: 32753773 PMCID: PMC7402588 DOI: 10.1016/j.chemolab.2020.104071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Visualization algorithms have been widely used for intuitive interrogation of genomic data and popularly used tools include MDS, t-SNE, and UMAP. However, these algorithms are not tuned for the visualization of binary data and none of them consider the hubness of observations for the visualization. In order to address these limitations, here we propose hubViz, a novel tool for hub-centric visualization of binary data. We evaluated the performance of hubViz with its application to the gene expression data measured in multiple brain regions of rats exposed to cocaine, the single-cell RNA-seq data of peripheral blood mononuclear cells treated with interferon beta, and the literature mining data to investigate relationships among diseases. We further evaluated the performance of hubViz using simulation studies. We showed that hubViz provides effective visual inspection by locating the hub in the center and the contrasting elements in the opposite sides around the center. We believe that hubViz and its software can be powerful tools that can improve visualizations of various genomic data. The hubViz is implemented as an R package hubviz, which is publicly available at https://dongjunchung.github.io/hubviz/.
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Affiliation(s)
- Jin Hyun Nam
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, South Carolina 29425, United States of America
- School of Pharmacy, Sungkyunkwan University, Suwon, Republic of Korea
| | - Jonghyun Yun
- Institute of Statistical Data Intelligence, Mansfield, Texas 76063, United States of America
| | - Ick Hoon Jin
- Department of Applied Statistics, Yonsei University, Seoul, Republic of Korea
| | - Dongjun Chung
- Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio 43210, United States of America
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Trejo-Sánchez I, Pérez-Monter C, Huerta-Pacheco S, Gutiérrez-Ospina G. Male Ejaculatory Endophenotypes: Revealing Internal Inconsistencies of the Concept in Heterosexual Copulating Rats. Front Behav Neurosci 2020; 14:90. [PMID: 32670030 PMCID: PMC7332778 DOI: 10.3389/fnbeh.2020.00090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 05/14/2020] [Indexed: 12/17/2022] Open
Abstract
Distinct manifestations of sexual behavior are conceived as separate phenotypes. Each sexual phenotype is assumed to be associated with a characteristic brain. These notions have justified the phenotyping of heterosexual copulator males based upon their ejaculation's latencies (EL) or frequencies (i.e., cumulative ejaculation number; EN). For instance, men and male rats showing premature, normal or retarded ejaculation are assumed to be distinctive endophenotypes. This concept, nonetheless, contradicts past and recent evidence that supports that sexual behavior is highly variable within each sex, and that the brain sexual functional morphology represents an intricate sexual phenotypic mosaic. Hence, for ejaculatory male endophenotypes to be considered as a valid biological concept, it must show internal consistency at various levels of organization (including genetic architectures), after being challenged by intrinsic and/or extrinsic factors. We then judged the internal consistency of the presumed ejaculatory endophenotypes by assessing whether copulatory behavior and the expression of copulation relevant genes and brain limbic structures are specific to each of the presumed EL- or EN-ejaculatory endophenotypes. To do this, copulating male rats were first phenotyped in groups consistently displaying short, average or long ejaculation latencies or very high, high, average, low or very low EN, based in their copulatory performance. Then, the internal consistency of the presumed EL- or EN-endophenotypes was tested by introducing as covariates of phenotyping other copulatory parameters (e.g., number of intromissions) in addition to EL or EN, or by analyzing the expression levels of genes encoding for estrogen receptor alpha, progesterone receptor, androgen receptor, aromatase, DNA methyl-transferase 3a and DNA methyl-transferase 1 in the amygdala, medial preoptic area, ventromedial hypothalamus and olfactory bulb. We found that even though there were group-level differences in all the variables that were studied, these differences did not add-up to create the presumed EL- or EN-ejaculatory endophenotypes. In fact, the extensive overlapping of copulatory parameters and expression levels of copulation relevant genes in limbic structures across EL- or EN-phenotyped copulating male rats, is not consistent with the hypothesis that distinct ejaculatory endophenotypes exist and that they are associated with specific brain characteristics.
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Affiliation(s)
- Itztli Trejo-Sánchez
- Laboratorio de Biología de Sistemas, Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Programa de Doctorado en Ciencias Biomédicas, Unidad de Posgrado, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Carlos Pérez-Monter
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubirán”, Mexico City, Mexico
| | - Sofía Huerta-Pacheco
- Consejo Nacional de Ciencia y Tecnología, Ciencia Forense, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Gabriel Gutiérrez-Ospina
- Laboratorio de Biología de Sistemas, Instituto de Investigaciones Biomédicas, Departamento de Biología Celular y Fisiología, Universidad Nacional Autónoma de México, Mexico City, Mexico
- Coordinación de Psicobiología y Neurociencias, Facultad de Psicología, Universidad Nacional Autónoma de México, Mexico City, Mexico
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Benzodiazepines related sexual dysfunctions: A critical review on pharmacology and mechanism of action. Rev Int Androl 2020; 19:62-68. [PMID: 32063496 DOI: 10.1016/j.androl.2019.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 06/26/2019] [Accepted: 08/11/2019] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Normal sexual functioning of both men and women, being a very complex process, is affected by numerous issues besides aging. Many factors affect the sexual function and lifestyle of the young population. In this article, we tried to review the literature to update the knowledge on benzodiazepine-related (BZD) sexual dysfunction (SD) and involved mechanisms of actions based on animal and human studies. METHODS Different standard websites such as PubMed were used to review the literature and keywords including benzodiazepines, sexual dysfunction, gammaaminobutyric acid A (GABAA) receptor and erectile dysfunction were used. RESULTS SD is one of the most common disorders in males and females which has recently been demonstrated to be associated with psychotropic medications such as antihypertensive agents, tranquilizers, antihistamines, appetite suppressants, antidepressants and anxiolytics. BZDs are among the most common psychotropic agents worldwide. SD including decreased libido, erectile dysfunction (ED) and other undesired sexual urges were observed in the patients receiving BZDs. DISCUSSION The mechanisms of action of BZDs to induce SD mainly relate to enhanced GABAA receptor function which reduces penile erection.
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Chen J, Yang J, Huang X, Ni L, Fan Q, Liu T, Yao Z, Chen Y. Reduced segregation and integration of structural brain network associated with sympathetic and dorsal penile nerve activity in anejaculation patients: a graph‐based connectome study. Andrology 2019; 8:392-399. [PMID: 31610095 DOI: 10.1111/andr.12715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/11/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - J. Yang
- Department of Urology Jiangsu Provincial People's Hospital First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - L. Ni
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Q. Fan
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - T. Liu
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Z. Yao
- Department of Psychiatry Nanjing Brain Hospital Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Y. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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Chen C, Guderyon MJ, Li Y, Ge G, Bhattacharjee A, Ballard C, He Z, Masliah E, Clark RA, O'Connor JC, Li S. Non-toxic HSC Transplantation-Based Macrophage/Microglia-Mediated GDNF Delivery for Parkinson's Disease. MOLECULAR THERAPY-METHODS & CLINICAL DEVELOPMENT 2019; 17:83-98. [PMID: 31890743 PMCID: PMC6931095 DOI: 10.1016/j.omtm.2019.11.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 11/15/2019] [Indexed: 02/08/2023]
Abstract
Glial cell-line-derived neurotrophic factor (GDNF) is a potent neuroprotective agent in cellular and animal models of Parkinson’s disease (PD). However, CNS delivery of GDNF in clinical trials has proven challenging due to blood-brain barrier (BBB) impermeability, poor diffusion within brain tissue, and large brain size. We report that using non-toxic mobilization-enabled preconditioning, hematopoietic stem cell (HSC) transplantation-based macrophage-mediated gene delivery may provide a solution to overcome these obstacles. Syngeneic bone marrow HSCs were transduced ex vivo with a lentiviral vector expressing macrophage promoter-driven GDNF and transplanted into 14-week-old MitoPark mice exhibiting PD-like impairments. Transplant preconditioning with granulocyte colony-stimulating factor (G-CSF) and AMD3100 was used to vacate bone marrow stem cell niches. Chimerism reached ∼80% after seven transplantation cycles. Transgene-expressing macrophages infiltrated degenerating CNS regions of MitoPark mice (not wild-type littermate controls), resulting in increased GDNF levels in the midbrain. Macrophage GDNF delivery not only markedly improved motor and non-motor dysfunction, but also dramatically mitigated the loss of dopaminergic neurons in both substantia nigra and the ventral tegmental area and preserved axonal terminals in the striatum. Striatal dopamine levels were almost completely restored. Our data support further development of mobilization-enabled HSC transplantation (HSCT)-based macrophage-mediated GDNF gene delivery as a disease-modifying therapy for PD.
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Affiliation(s)
- Cang Chen
- Department of Medicine, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Michael J Guderyon
- Department of Medicine, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Yang Li
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Guo Ge
- Department of Medicine, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Anindita Bhattacharjee
- Department of Medicine, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Cori Ballard
- Department of Medicine, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
| | - Zhixu He
- Department of Pediatrics, Zunyi Medical University Affiliated Hospital and Key Laboratory of Adult Stem Cell Transformation Research, Chinese Academy of Medical Science, Guiyang, Guizhou 550025, China
| | | | - Robert A Clark
- Department of Medicine, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.,Audie L. Murphy VA Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA
| | - Jason C O'Connor
- Department of Pharmacology, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.,Audie L. Murphy VA Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA
| | - Senlin Li
- Department of Medicine, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.,Department of Pharmacology, The University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.,Audie L. Murphy VA Hospital, 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA
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Hull EM, Dominguez JM. Neuroendocrine Regulation of Male Sexual Behavior. Compr Physiol 2019; 9:1383-1410. [DOI: 10.1002/cphy.c180018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Chen J, Huang X, Lu C, Liu T, Dai Y, Yao Z, Chen Y. Graph analysis of
DTI
‐based connectome: decreased local efficiency of subcortical regions in
PE
patients with high sympathetic activity. Andrology 2019; 8:400-406. [PMID: 31532583 DOI: 10.1111/andr.12701] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - C. Lu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - T. Liu
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Y. Dai
- Department of Andrology Nanjing Drum Tower Hospital Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Z. Yao
- Department of Psychiatry Nanjing Brain Hospital Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Y. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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Semple E, Shalabi F, Hill JW. Oxytocin Neurons Enable Melanocortin Regulation of Male Sexual Function in Mice. Mol Neurobiol 2019; 56:6310-6323. [PMID: 30756300 PMCID: PMC6684847 DOI: 10.1007/s12035-019-1514-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 01/28/2019] [Indexed: 12/13/2022]
Abstract
The melanocortin pathway has been implicated in both metabolism and sexual function. When the melanocortin 4 receptor (MC4R) is knocked out globally, male mice display obesity, low sexual desire, and copulatory difficulties; however, it is unclear whether these phenotypes are interdependent. To elucidate the neuronal circuitry involved in sexual dysfunction in MC4R knockouts, we re-expressed the MC4R in these mice exclusively on Sim1 neurons (tbMC4RSim1 mice) or on a subset of Sim1 neurons, namely oxytocin neurons (tbMC4Roxt mice). The groups were matched at young ages to control for the effects of obesity. Interestingly, young MC4R null mice had no deficits in sexual motivation or erectile function. However, MC4R null mice were found to have an increased latency to reach ejaculation compared to control mice, which was restored in both tbMC4RSim1 and tbMC4Roxt mice. These results indicate that melanocortin signaling via the MC4R on oxytocin neurons is important for normal ejaculation independent of the male's metabolic health.
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Affiliation(s)
- Erin Semple
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave., Toledo, OH, 43614, USA
| | - Firas Shalabi
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave., Toledo, OH, 43614, USA
| | - Jennifer W Hill
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave., Toledo, OH, 43614, USA.
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45
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The impact of sugar consumption on stress driven, emotional and addictive behaviors. Neurosci Biobehav Rev 2019; 103:178-199. [DOI: 10.1016/j.neubiorev.2019.05.021] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 03/14/2019] [Accepted: 05/19/2019] [Indexed: 12/20/2022]
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46
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Are There Differences in Brain Morphology in Patients with Lifelong Premature Ejaculation? J Sex Med 2019; 16:992-998. [DOI: 10.1016/j.jsxm.2019.04.008] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 04/04/2019] [Accepted: 04/06/2019] [Indexed: 12/16/2022]
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47
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Xu Z, Yang X, Gao M, Liu L, Sun J, Liu P, Qin W. Abnormal Resting-State Functional Connectivity in the Whole Brain in Lifelong Premature Ejaculation Patients Based on Machine Learning Approach. Front Neurosci 2019; 13:448. [PMID: 31139043 PMCID: PMC6519512 DOI: 10.3389/fnins.2019.00448] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/18/2019] [Indexed: 11/30/2022] Open
Abstract
Recent neuroimaging studies have indicated that abnormalities in brain structure and function may play an important role in the etiology of lifelong premature ejaculation (LPE). LPE patients have exhibited aberrant cortical structure, altered brain network function and abnormal brain activation in response to erotic pictures. However, it remains unclear whether resting-state whole brain functional connectivity (FC) is altered in LPE patients. Machine learning analysis has the advantage of screening the best classification features from high-throughput data (such as FC), which has the potential to identify the pathophysiological targets of disease by establishing classification indicators for patients and healthy controls (HCs). Therefore, the supported vector machine based classification model using FC as features was used in the present study to confirm the most specific FCs that distinguish LPE patients from healthy controls. After feature selection, the remained features were used to build the classification model, with an accuracy 0.85 ± 0.14, sensitivity of 0.92 ± 0.18, specificity of 0.72 ± 0.30, and recall index of 0.85 ± 0.17 across 1000 testing groups (100 times 10-folds cross validation). After that, two-sample t-tests with family-wise error correction were used to compare these features that occur more than 500 times during training steps between LPE patients and HCs. Four FCs, (1) between left medial part of orbital frontal cortex (mOFC) and right mOFC, (2) between the left rectus and right postcentral gyrus, (3) between the right insula and left pallidum, and (4) between the right middle part of temporal pole and right inferior part of temporal gyrus showed significant group difference. These results demonstrate that resting-state brain FC might be a discriminating feature to distinguish LPE patients from HCs. These classification features, especially the FC between bilateral mOFC, provide underlying abnormal central functional targets in LPE etiology, which offers a novel alternative target for future intervention in LPE treatment.
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Affiliation(s)
- Ziliang Xu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Xuejuan Yang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Ming Gao
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China.,Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lin Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Jinbo Sun
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Peng Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Wei Qin
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
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48
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Sexual Enhancing Effect of Anacardium occidentale in Stress-Exposed Rats by Improving Dopaminergic and Testicular Functions. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6452965. [PMID: 30498760 PMCID: PMC6222230 DOI: 10.1155/2018/6452965] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 08/12/2018] [Accepted: 09/12/2018] [Indexed: 12/25/2022]
Abstract
In this study, we aimed to assess the effect and possible underlying mechanism of Anacardium occidentale leaves extract on male sexual behaviors in stress-exposed rats. Male Wistar rats were orally given A. occidentale extract at doses of 25, 100, and 200 mg/kg BW before 12-hour-immobilization exposure for 14 days. Sexual behaviors, serum testosterone and corticosterone levels, TH-positive cells density in nucleus accumbens (NAc) and ventral tegmental area (VTA), MAO-B activity in NAc and medial preoptic area (MPOA), testis histology together with phosphodiesterase type-5 ( PDE-5) activity, and endothelial nitric oxide synthase (eNOS) expression in penis were evaluated after treatment. All doses of extract improved male sexual behaviors, suppressed MAO-B in NAc, enhanced TH-positive cells density in NAc, suppressed PDE-5 in penis, and enhanced interstitial cell of Leydig. The increase of serum testosterone, TH-positive cells density in VTA, eNOS expression in penis, and the decreased serum corticosterone were observed at some doses. Therefore, the sexual enhancing effect of extract occurred mainly via the improved dopaminergic and testicular functions. PDE-5 suppression in penis also played the role especially in the increased intromission behavior. Therefore, A. occidentale leaves extract is the potential protective agent against sexual dysfunction. However, further researches are necessary.
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49
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Jin C, Guan M, Dong M, Wu J, He Z, Chen X, Shi D, Ren J, Shi G, Zhang X. Aberrant baseline brain activity in psychogenic erectile dysfunction patients: a resting state fMRI study. Brain Imaging Behav 2018; 12:1393-1404. [PMID: 29243122 PMCID: PMC6290711 DOI: 10.1007/s11682-017-9805-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Recent neuroimaging studies have elucidated many interesting and promising findings on sexuality regarding the neural underpinnings of both normal and abnormal sexual processes. Psychogenic erectile dysfunction (pED) consists of a major part of male sexual dysfunction in China, but the understanding of the central mechanism of pED is still in its infancy. It is commonly appreciated that pED is a functional disorder, which can be attributed predominantly or exclusively to psychological factors, such as anxiety, depression, loss of self-esteem, and psychosocial stresses. Most previous studies probed the central response in the brain of pED patients using sexual-related stimuli. However, little concern has been given to a more fundamental issue whether the baseline brain activity is altered in pED or not. With rs-fMRI data, the current study aimed to explain the central mechanism behind pED by investigating the alterations in baseline brain activity in patients with pED, as indexed by the amplitude of low-frequency (0.01-0.08 Hz) fluctuation (ALFF). After the psychological screening and urological examination procedure, 26 pED patients and 26 healthy matched controls were enrolled. Our results explicated significantly lower baseline brain activity in the right anterior insula and right orbitofrontal cortex for pED patients (multiple comparison corrected). Additionally, the voxel-wise correlation analysis showed that ALFF of the right anterior insula was correlated with the outcomes of erectile function (multiple comparison corrected). Our results implied there was impaired cognitive and motivational processing of sexual stimuli in pED patients. Our current findings may shed light on the neural pathology underlying pED. We hope that our study has provided a new angle looking into pED research by investigating resting state brain activity. Furthermore, we suggest that the current study may put forward a more subtle conception of insular influence on pED, which may help foster new specific, mechanistic insights.
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Affiliation(s)
- Chenwang Jin
- Department of Medical Imaging, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, China
| | - Min Guan
- Department of Interventional Radiology, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Minghao Dong
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China.
- Henan Andrological Academician Workstation of Basic and Clinical Research, Henan Provincial People's Hospital, Zhengzhou, 450003, China.
| | - Jia Wu
- School of Foreign Languages, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Zhen He
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Xin Chen
- Henan Andrological Academician Workstation of Basic and Clinical Research, Henan Provincial People's Hospital, Zhengzhou, 450003, China
- Department of Urology, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Dapeng Shi
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, 450003, China
| | - Junchan Ren
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Guangming Shi
- School of Electronic Engineering, Xidian University, Xi'an, Shaanxi, 710071, China
| | - Xiangsheng Zhang
- Henan Andrological Academician Workstation of Basic and Clinical Research, Henan Provincial People's Hospital, Zhengzhou, 450003, China.
- Department of Urology, Henan Provincial People's Hospital, Zhengzhou, 450003, China.
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50
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Abnormal White Matter Microstructure in Lifelong Premature Ejaculation Patients Identified by Tract–Based Spatial Statistical Analysis. J Sex Med 2018; 15:1272-1279. [DOI: 10.1016/j.jsxm.2018.07.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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