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Krikova K, Klein S, Kampa M, Walter B, Stark R, Klucken T. Appetitive conditioning with pornographic stimuli elicits stronger activation in reward regions than monetary and gaming-related stimuli. Hum Brain Mapp 2024; 45:e26711. [PMID: 38798103 PMCID: PMC11128778 DOI: 10.1002/hbm.26711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024] Open
Abstract
Appetitive conditioning plays an important role in the development and maintenance of pornography-use and gaming disorders. It is assumed that primary and secondary reinforcers are involved in these processes. Despite the common use of pornography and gaming in the general population appetitive conditioning processes in this context are still not well studied. This study aims to compare appetitive conditioning processes using primary (pornographic) and secondary (monetary and gaming-related) rewards as unconditioned stimuli (UCS) in the general population. Additionally, it investigates the conditioning processes with gaming-related stimuli as this type of UCS was not used in previous studies. Thirty-one subjects participated in a differential conditioning procedure in which four geometric symbols were paired with either pornographic, monetary, or gaming-related rewards or with nothing to become conditioned stimuli (CS + porn, CS + game, CS + money, and CS-) in an functional magnetic resonance imaging study. We observed elevated arousal and valence ratings as well as skin conductance responses for each CS+ condition compared to the CS-. On the neural level, we found activations during the presentation of the CS + porn in the bilateral nucleus accumbens, right medial orbitofrontal cortex, and the right ventral anterior cingulate cortex compared to the CS-, but no significant activations during CS + money and CS + game compared to the CS-. These results indicate that different processes emerge depending on whether primary and secondary rewards are presented separately or together in the same experimental paradigm. Additionally, monetary and gaming-related stimuli seem to have a lower appetitive value than pornographic rewards.
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Affiliation(s)
- Kseniya Krikova
- Clinical Psychology and PsychotherapyUniversity of SiegenSiegenGermany
- Department of Psychotherapy and Systems NeuroscienceJustus Liebig University GiessenGiessenGermany
- Bender Institute for Neuroimaging (BION)Justus Liebig University GiessenGiessenGermany
| | - Sanja Klein
- Department of Psychotherapy and Systems NeuroscienceJustus Liebig University GiessenGiessenGermany
- Bender Institute for Neuroimaging (BION)Justus Liebig University GiessenGiessenGermany
| | - Miriam Kampa
- Department of Psychotherapy and Systems NeuroscienceJustus Liebig University GiessenGiessenGermany
- Bender Institute for Neuroimaging (BION)Justus Liebig University GiessenGiessenGermany
| | - Bertram Walter
- Department of Psychotherapy and Systems NeuroscienceJustus Liebig University GiessenGiessenGermany
- Bender Institute for Neuroimaging (BION)Justus Liebig University GiessenGiessenGermany
| | - Rudolf Stark
- Department of Psychotherapy and Systems NeuroscienceJustus Liebig University GiessenGiessenGermany
- Bender Institute for Neuroimaging (BION)Justus Liebig University GiessenGiessenGermany
- Center for Mind, Brain and BehaviorUniversities of Marburg and GießenMarburgGermany
| | - Tim Klucken
- Clinical Psychology and PsychotherapyUniversity of SiegenSiegenGermany
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Mehanna R, Jankovic J. Systemic Symptoms in Huntington's Disease: A Comprehensive Review. Mov Disord Clin Pract 2024; 11:453-464. [PMID: 38529740 PMCID: PMC11078495 DOI: 10.1002/mdc3.14029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 02/26/2024] [Accepted: 03/12/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND Although Huntington's disease (HD) is usually thought of as a triad of motor, cognitive, and psychiatric symptoms, there is growing appreciation of HD as a systemic illness affecting the entire body. OBJECTIVES This review aims to draw attention to these systemic non-motor symptoms in HD. METHODS We identified relevant studies published in English by searching MEDLINE (from 1966 to September 2023), using the following subject headings: Huntington disease, autonomic, systemic, cardiovascular, respiratory, gastrointestinal, urinary, sexual and cutaneous, and additional specific symptoms. RESULTS Data from 123 articles were critically reviewed with focus on systemic features associated with HD, such as cardiovascular, respiratory, gastrointestinal, urinary, sexual and sweating. CONCLUSION This systematic review draws attention to a variety of systemic and autonomic co-morbidities in patients with HD. Not all of them correlate with the severity of the primary HD symptoms or CAG repeats. More research is needed to better understand the pathophysiology and treatment of systemic and autonomic dysfunction in HD.
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Affiliation(s)
- Raja Mehanna
- Department of Neurology, University of Texas Health Science Center at Houston, McGovern Medical School, Houston, TX, USA
| | - Joseph Jankovic
- Parkinson's Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
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3
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Bogacki-Rychlik W, Gawęda K, Bialy M. Neurophysiology of male sexual arousal-Behavioral perspective. Front Behav Neurosci 2024; 17:1330460. [PMID: 38333545 PMCID: PMC10851294 DOI: 10.3389/fnbeh.2023.1330460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/15/2023] [Indexed: 02/10/2024] Open
Abstract
In the presented review, we analyzed the physiology of male sexual arousal and its relation to the motivational aspects of this behavior. We highlighted the distinction between these processes based on observable physiological and behavioral parameters. Thus, we proposed the experimentally applicable differentiation between sexual arousal (SA) and sexual motivation (SM). We propose to define sexual arousal as an overall autonomic nervous system response leading to penile erection, triggered selectively by specific sexual cues. These autonomic processes include both spinal and supraspinal neuronal networks, activated by sensory pathways including information from sexual partner and sexual context, as well as external and internal genital organs. To avoid misinterpretation of experimental data, we also propose to precise the term "sexual motivation" as all actions performed by the individual that increase the probability of sexual interactions or increase the probability of exposition to sexual context cues. Neuronal structures such as the amygdala, bed nucleus of stria terminalis, hypothalamus, nucleus raphe, periaqueductal gray, and nucleus paragigantocellularis play crucial roles in controlling the level of arousal and regulating peripheral responses via specific autonomic effectors. On the highest level of CNS, the activity of cortical structures involved in the regulation of the autonomic nervous system, such as the insula and anterior cingulate cortex, can visualize an elevated level of SA in both animal and human brains. From a preclinical perspective, we underlie the usefulness of the non-contact erection test (NCE) procedure in understanding factors influencing sexual arousal, including studies of sexual preference in animal models. Taken together results obtained by different methods, we wanted to focus attention on neurophysiological aspects that are distinctly related to sexual arousal and can be used as an objective parameter, leading to higher translational transparency between basic, preclinical, and clinical studies.
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Affiliation(s)
| | | | - Michal Bialy
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
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Mokros A, Habermeyer E, Poeppl TB, Santtila P, Ziogas A. Tower of Babel or Lighthouse? The State of Research on Neuroelectric Correlates of Human Sexuality: A Response to the Commentaries. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:611-615. [PMID: 36481834 PMCID: PMC9886606 DOI: 10.1007/s10508-022-02496-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 06/17/2023]
Affiliation(s)
- Andreas Mokros
- Faculty of Psychology, FernUniversität in Hagen, 58084, Hagen, Germany.
| | - Elmar Habermeyer
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Pekka Santtila
- Institute for Social Development, New York University Shanghai, Shanghai, China
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Yang Y, Qu L, Mu L, Yao J, Su C, Zheng Q, Zheng H, Zhang P, Li Y. Electroacupuncture for psychogenic erectile dysfunction: A resting-state functional magnetic resonance imaging study exploring the alteration of fractional amplitude of low frequency fluctuation. Front Hum Neurosci 2023; 17:1116202. [PMID: 37063106 PMCID: PMC10098132 DOI: 10.3389/fnhum.2023.1116202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023] Open
Abstract
Background Psychogenic erectile dysfunction (PED) can seriously affect emotional and marital wellbeing. Electroacupuncture (EA) seems an effective method for treating PED. However, the central mechanisms underlying PED and the beneficial effects of EA treatment are unclear. The purpose of this study was to explore the central mechanisms of PED and to examine the impact of EA on erectile function. Methods We recruited 14 PED patients and 14 matched normal controls (NCs). PED patients underwent twice rs-fMRI scans, respectively, pre- and post-treatment. The NCs only completed one rs-fMRI scan. We used the fractional amplitude of low frequency fluctuation (fALFF) to compare spontaneous neural activity between the PED patients and NCs, and to examine the differences between the pre- and post-EA treatment scans in the PED patients. Results Scores on the IIEF5, QEQ, and SEAR improved after EA treatment. Compared with the NCs, PED patients showed increased fALFF in the right posterior cingulate cortex (PCC), right dorsolateral prefrontal cortex (DLPFC), right supplementary motor area (SMA), and left middle occipital gyrus. Most of these regions are closely implicated in sexual inhibition. The results of the correlation analysis results indicated that the fALFF of the right PCC was negatively correlated with IIEF5 scores. After treatment, fALFF values were substantially lower in the left triangular part of the inferior frontal gyrus, right DLPFC, right SMA, bilateral PCC and the orbital part of the middle frontal gyrus, and higher in the left middle temporal gyrus and left caudate nucleus. These regions mainly belong to the default mode network (DMN), executive control network and primary sensory motor network. The results of the correlation analysis indicated a positive association between the changes in IIEF5 score and changes in the fALFF value in the right PCC after EA treatment. Conclusion In conclusion, our study highlights that PED patients have abnormal patterns of activity in the right PCC, right DLPFC, and right SMA mainly involved in the DMN, executive central network, and sensory motor network which could lead to a higher levels of sexual inhibition. EA might regulate the process of sexual inhibition to improve erection function in PED patients probably by modulating spontaneous brain activity in the DMN, executive central network, and sensory motor network.
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Affiliation(s)
- Yuqing Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Liu Qu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Linxuan Mu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Junpeng Yao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chengguo Su
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Huabin Zheng
- Department of Acupuncture and Moxibustion, The Hospital of Chengdu University of Chinese Medicine, Chengdu, Sichuan, China
| | - Peihai Zhang
- Department of Urology/Andrology, The Hospital of Chengdu University of Chinese Medicine, Chengdu, Sichuan, China
- Peihai Zhang,
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- *Correspondence: Ying Li,
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Distended Seminal Vesicles Are Involved in Specific Cerebral Sexual Arousal: A Pilot Study Using Functional Brain Imaging in Young Healthy Men. EUR UROL SUPPL 2022; 42:10-16. [PMID: 35911083 PMCID: PMC9334823 DOI: 10.1016/j.euros.2022.05.008] [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] [Accepted: 05/27/2022] [Indexed: 11/21/2022] Open
Abstract
Background Objective Design, setting, and participants Outcome measurements and statistical analysis Results and limitations Conclusions Patient summary
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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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8
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A psychophysical and neuroimaging analysis of genital hedonic sensation in men. Sci Rep 2022; 12:10181. [PMID: 35715453 PMCID: PMC9205885 DOI: 10.1038/s41598-022-14020-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/31/2022] [Indexed: 11/08/2022] Open
Abstract
Current understanding of human genital-brain interactions relates primarily to neuroendocrine and autonomic control, whereas interactions during sexual stimulation remain largely unexplored. Here we present a systematic approach towards identifying how the human brain encodes sensory genital information. Using a validated affective touch paradigm and functional magnetic resonance imaging, we found that hedonic responses to discriminatory versus affective tactile stimulation were distinctly different for both penile shaft and forearm. This suggests that, as with other body sites, genital skin contains small diameter mechanoreceptive nerve fibres that signal pleasant touch. In the brain, secondary somatosensory cortex (S2) distinguished between affective and discriminative touch for the penile shaft, but not for the forearm. Frenulum stimulation induced the greatest reports of subjective pleasure and led to the greatest deactivation of the default-mode network. This study represents a first pass at investigating, in humans, the relationship between innervation of genital surfaces, hedonic feelings, and brain mechanisms, in a systematic way.
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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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10
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Ma Z, Ren F, Huang X, Yang X, Li H, Li G, Chang D, Yin T, Zhang P. Decreased gray matter volume of the anterior insular cortex in patients with psychogenic erectile dysfunction: A voxel-based morphometry study. J Psychiatr Res 2021; 145:125-131. [PMID: 34920162 DOI: 10.1016/j.jpsychires.2021.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/08/2021] [Accepted: 12/10/2021] [Indexed: 01/03/2023]
Abstract
This study aimed to explore the gray matter morphological alteration and its correlation with the severity of symptoms in patients with psychogenic erectile dysfunction (pED). Fifty patients with pED and 50 healthy controls (HCs) were included. The whole-brain voxel-based morphometry analysis was conducted to compare the differences in gray matter volume (GMV) between patients with pED and HCs. And then, the region-of-interest-based correlation analyses were performed between the GMV of these regions with the most pronounced between-group differences and clinical symptoms in patients. The results demonstrated that patients with pED manifested decreased GMV in the bilateral anterior insula (aINS), bilateral precentral gyrus, left postcentral gyrus, bilateral anterior cingulate cortex, bilateral middle cingulate cortex, bilateral fusiform gyrus, and cerebellum when compared to HCs. Taking the bilateral aINS as the region-of-interest, the results of voxel-based correlation analyses showed that the GMV of the bilateral aINS were positively correlated with the International Index of Erectile Function 5 (IIEF-5) and Quality of Erection Questionnaire score, and the GMV of right aINS was positively associated with duration and sexual craving score in patients with pED. Furthermore, the significant correlations between the total GMV of the right aINS and IIEF-5 and sexual craving score, as well as between the total GMV of the left aINS and sexual craving score were also detected. In conclusion, these results suggested that the decreased GMV of aINS might be a critical neuropathological characteristic of pED, which provided new evidence for understanding the neurobiological basis of pED from the perspective of brain structure alterations.
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Affiliation(s)
- Ziyang Ma
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Feiqiang Ren
- Department of Urology, Chongqing Hospital of Traditional Chinese Medicine Hospital, Chongqing, 400021, China
| | - Xiaopeng Huang
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Xuemei Yang
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Hao Li
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Guangsen Li
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Degui Chang
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China; Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
| | - Peihai Zhang
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China.
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11
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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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12
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Abstract
The science of penile erection, including recent advances in its molecular physiology and neuroanatomic pathways, is described. The pathophysiology of erectile dysfunction is presented, acknowledging associated disease states, and accordingly follows a practical classification scheme: vasculogenic, neurogenic, endocrine, and psychogenic.
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Affiliation(s)
- Susan M MacDonald
- Division of Urology, Penn State Health Milton S. Hershey Medical Center, Mail Code H055, 500 University Drive, Hershey, PA 17033, USA.
| | - Arthur L Burnett
- James Buchanan Brady Urological Institute, Johns Hopkins School of Medicine, 600 North Wolfe Street, Marburg 407, Baltimore, MD 21287, USA
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13
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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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14
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Brideau-Duquette M, Boucher O, Tremblay J, Robert M, Bouthillier A, Lepore F, Nguyen DK. Insular Cortex Response to Static Visual Sexual Stimuli. J PSYCHOPHYSIOL 2021. [DOI: 10.1027/0269-8803/a000285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. According to previous research, the insula is important for processing salient and emotional stimuli, but its precise role remains elusive. By combining high spatial and temporal resolution, intracranial electroencephalography (iEEG) might contribute to filling this gap. Four drug-resistant epileptic patients with intracranial electrodes in the insula were instructed to watch and rate pictures with sexual content and neutral pictures. Event-related potentials (ERPs) were computed separately for both types of stimuli. Ninety-three percent of the anterior insula (AI) and 85% of the posterior insula (PI) contacts showed differences between ERPs. AI-positive deflections tended to have an earlier onset than PI-positive deflections. The results suggest that the AI generates a P300-like response and contributes to the early phase of the late positive potential, both components found enhanced while viewing emotional stimuli in the ERP literature. The present findings are interpreted as congruent with the role of the AI in maintaining attention to salient stimuli.
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Affiliation(s)
- Mathieu Brideau-Duquette
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
- Département de Psychologie, Université de Montréal, Canada
- Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Montréal, Canada
| | - Olivier Boucher
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
- Département de Psychologie, Université de Montréal, Canada
- CHUM, Service de Psychologie, Montréal, Canada
| | - Julie Tremblay
- Centre de recherche du CHU Sainte-Justine, Montréal, Canada
| | - Manon Robert
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
| | | | - Franco Lepore
- Département de Psychologie, Université de Montréal, Canada
- Centre de Recherche en Neuropsychologie et Cognition (CERNEC), Montréal, Canada
| | - Dang Khoa Nguyen
- Centre de Recherche du Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
- CHUM, Service de Neurologie, Montréal, Canada
- Département de Neurosciences, Université de Montréal, Canada
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15
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High Frequency of Concomitant Bladder, Bowel, and Sexual Symptoms in Huntington's Disease: A Self-Reported Questionnaire Study. J Pers Med 2021; 11:jpm11080714. [PMID: 34442358 PMCID: PMC8401810 DOI: 10.3390/jpm11080714] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/20/2021] [Accepted: 07/23/2021] [Indexed: 11/17/2022] Open
Abstract
Huntington's disease (HD) can be associated with pathologic involvement beyond the striatum including the autonomic nervous system. Bladder, bowel, and sexual dysfunction have been reported independently in HD, but little is known about their concomitant occurrence. To document this concomitant phenomena, forty-eight subjects (54% male, ages 28-74 years, CAG repeat 38-61) with manifest/symptomatic HD completed detailed questionnaires regarding bladder, bowel, and sexual function. In total, 45 subjects (93.8%) reported symptoms in at least one organ system (bladder, bowel, or sexual), 13 (27.1%) reported symptoms in two systems, and 19 (39.6%) reported concomitant symptoms in all three systems. Urinary problems were most frequent in 42 subjects (87.5%) followed by lower bowel (60.4%) and sexual dysfunction (56.2%). Participants reporting concomitant symptoms were more likely to have longer duration of disease and lower Total Functional Capacity (TFC) scores. This study documents the high frequency of bladder, bowel, and sexual dysfunction in HD and the common occurrence of concomitance of these pelvic organ problems.
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16
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Markert C, Baranowski AM, Koch S, Stark R, Strahler J. The Impact of Negative Mood on Event-Related Potentials When Viewing Pornographic Pictures. Front Psychol 2021; 12:673023. [PMID: 34290650 PMCID: PMC8288192 DOI: 10.3389/fpsyg.2021.673023] [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: 02/26/2021] [Accepted: 06/02/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Negative affective states may increase the risk for problematic pornography use. Underlying neurophysiological mechanisms are, however, not completely understood. Previous research suggests that the participants' emotional state may affect neural processing of sexual stimuli. The aim of this study was to investigate neural correlates of negative affect-induced alterations in sexual cue reactivity in healthy men. The moderating effects of habitual porn consumption, trait sexual motivation, and symptoms of cybersex addiction were also considered. Method: Sixty-four healthy men engaged in a sexual cue reactivity task (passive viewing of explicit sexual pictures and neutral pictures depicting scenes of social interaction) during negative (n = 32) vs. neutral affect (n = 32), induced via tailored feedback on a performance task. Self-reported sexual arousal and event-related brain potentials indicated cue reactivity and motivated attention. Symptoms of cybersex addiction and trait sexual motivation were assessed with the help of the short Internet Addiction Test, adapted to online sexual activities, and the Trait Sexual Motivation Questionnaire. Results: Negative feedback increased negative affect after the performance task. While sexual pictures compared to neutral pictures elicited significantly larger P300 and late positive potential (LPP) amplitudes, there was no general effect of negative feedback on sexual stimuli-related P300 and LPP amplitudes. In the negative feedback group, men with higher solitary sexual motivation levels showed higher P300/LPP difference amplitudes for sexual stimuli compared to men with lower levels of solitary sexual motivation. The opposite effect was found in the group with neutral feedback. There was no link to other aspects of trait sexual motivation and symptoms of cybersex addiction. Conclusions: Results suggest that higher levels of solitary sexual motivation may enhance motivated attention toward sexual stimuli among men receiving negative performance feedback. Other characteristics of sexual behaviors and traits provided no exploratory value. Future studies extending onto men suffering from compulsive sexual behavior disorder will have to closer look at the neurophysiological bases of why and when some men develop an addictive pornography consumption.
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Affiliation(s)
- Charlotte Markert
- Department of Psychotherapy and Systems Neuroscience, Psychology and Sport Science, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Universities of Marburg and Giessen, Giessen, Germany
| | - Andreas M. Baranowski
- Department of Psychotherapy and Systems Neuroscience, Psychology and Sport Science, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Universities of Marburg and Giessen, Giessen, Germany
| | - Simon Koch
- Department of Psychotherapy and Systems Neuroscience, Psychology and Sport Science, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Psychology and Sport Science, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Universities of Marburg and Giessen, Giessen, Germany
| | - Jana Strahler
- Department of Psychotherapy and Systems Neuroscience, Psychology and Sport Science, University of Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, University of Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Universities of Marburg and Giessen, Giessen, Germany
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17
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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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18
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Markert C, Klein S, Strahler J, Kruse O, Stark R. Sexual incentive delay in the scanner: Sexual cue and reward processing, and links to problematic porn consumption and sexual motivation. J Behav Addict 2021; 10:65-76. [PMID: 33822748 PMCID: PMC8969854 DOI: 10.1556/2006.2021.00018] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/27/2021] [Accepted: 02/22/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND AIMS The use of pornography, while unproblematic for the majority, can grow into addiction-like behavior which in its extreme form is labeled as compulsive sexual behavioral disorder in the ICD-11 (WHO, 2018). The aim of this study was to investigate the addiction-specific reactivity to cues in order to better understand underlying mechanisms in the development of this disorder. METHODS We have used an optimized Sexual Incentive Delay Task to study brain activity in reward associated brain areas during an anticipation phase (with cues predicting pornographic videos, control videos or no videos) and a corresponding delivery phase in healthy men. Correlations to indicators of problematic pornography use, the time spent on pornography use, and trait sexual motivation were analyzed. RESULTS The results of 74 men showed that reward-related brain areas (amygdala, dorsal cingulate cortex, orbitofrontal cortex, nucleus accumbens, thalamus, putamen, caudate nucleus, and insula) were significantly more activated by both the pornographic videos and the pornographic cues than by control videos and control cues, respectively. However, we found no relationship between these activations and indicators of problematic pornography use, time spent on pornography use, or with trait sexual motivation. DISCUSSION AND CONCLUSIONS The activity in reward-related brain areas to both visual sexual stimuli as well as cues indicates that optimization of the Sexual Incentive Delay Task was successful. Presumably, associations between reward-related brain activity and indicators for problematic or pathological pornography use might only occur in samples with increased levels and not in a rather healthy sample used in the present study.
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Affiliation(s)
- Charlotte Markert
- Department of Psychotherapy and Systems Neuroscience, University of Giessen, Germany,Bender Institute of Neuroimaging (BION), University of Giessen, Germany,Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, Germany,Corresponding author E-mail:
| | - Sanja Klein
- Department of Psychotherapy and Systems Neuroscience, University of Giessen, Germany,Bender Institute of Neuroimaging (BION), University of Giessen, Germany,Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, Germany
| | - Jana Strahler
- Department of Psychotherapy and Systems Neuroscience, University of Giessen, Germany,Bender Institute of Neuroimaging (BION), University of Giessen, Germany
| | - Onno Kruse
- Department of Psychotherapy and Systems Neuroscience, University of Giessen, Germany,Bender Institute of Neuroimaging (BION), University of Giessen, Germany,Department of Clinical Psychology, University of Siegen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, University of Giessen, Germany,Bender Institute of Neuroimaging (BION), University of Giessen, Germany,Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, Germany
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19
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Krylova M, Ristow I, Marr V, Borchardt V, Li M, Witzel J, Drumkova K, Harris JA, Zacharias N, Schiltz K, Amelung T, Beier KM, Kruger THC, Ponseti J, Schiffer B, Walter H, Kärgel C, Walter M. MEG reveals preference specific increases of sexual-image-evoked responses in paedophilic sexual offenders and healthy controls. World J Biol Psychiatry 2021; 22:257-270. [PMID: 32623929 DOI: 10.1080/15622975.2020.1789216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Paedophilic disorder is characterised by sexual attraction towards children. Classification of a counterpart as sexually attractive likely occurs rapidly, and involves both conscious and unconscious attentional and cognitive processes. Magnetoencephalography (MEG) is an imaging method especially well-suited to examine visual and attentional processes triggered by sexual images within the range of milliseconds. METHODS We investigated brain responses to sexual images depicting adults (frequent) and children (infrequent stimulus) in seventeen paedophilic patients with a history of child sexual offending (P + CSO) and twenty healthy controls (HC) during a passive visual oddball paradigm. Event-related fields (ERF) were measured to extract the magnetic visual mismatch negativity (vMMNm), and how it relates to the processing of different classes of sexual stimuli. RESULTS P + CSO exhibited significantly longer vMMNm latencies (100-180 ms post-stimulus) than HC. Moreover, P + CSO showed widespread increased amplitudes in response to child images starting from P3a and P3b components and lasting up to 400 ms post-stimulus presentation localised in frontal and temporal brain regions. CONCLUSIONS This study uncovers the first MEG differences in automatic change detection between P + CSO and HC during the presentation of subliminal sexual images of adults and children, contributing towards a better understanding of the neurobiological processes of P + CSO.
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Affiliation(s)
- Marina Krylova
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany.,Department of Psychiatry, Eberhard Karls University, Tübingen, Germany
| | - Inka Ristow
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany.,Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vanessa Marr
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany
| | - Meng Li
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany
| | - Joachim Witzel
- Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany
| | - Krasimira Drumkova
- Forensic Psychiatric State Hospital of Saxony-Anhalt, Stendal-Uchtspringe, Germany
| | - Joseph A Harris
- Department of Psychology, Bradley University, Peoria, IL, USA
| | - Norman Zacharias
- Clinical Neuroscience Research Group, Experimental and Clinical Research Center (ECRC), Department of Anesthesiology and Operative Intensive Care Medicine (CCM, CVK), Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kolja Schiltz
- Section of Forensic Psychiatry, Department of Psychiatry and Psychotherapy, Ludwig Maximilian University, Munich, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany
| | - Till Amelung
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Klaus M Beier
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Section of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany
| | - Jorge Ponseti
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Christian-Albrechts-University of Kiel, Medical School, Kiel, Germany
| | - Boris Schiffer
- Division of Forensic Psychiatry, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Christian Kärgel
- Division of Forensic Psychiatry, LWL-University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany.,Department of Psychiatry, Eberhard Karls University, Tübingen, Germany.,Clinical Affective Neuroimaging Laboratory (CANLAB), Magdeburg, Germany.,Leibniz Institute for Neurobiology, Department for Behavioral Neurology, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, Otto-von-Guericke University of Magdeburg, Magdeburg, Germany.,Max Planck Institute for Biological Cybernetics, Tübingen, Germany
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20
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21
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Thibaut F, Cosyns P, Fedoroff JP, Briken P, Goethals K, Bradford JMW. The World Federation of Societies of Biological Psychiatry (WFSBP) 2020 guidelines for the pharmacological treatment of paraphilic disorders. World J Biol Psychiatry 2020; 21:412-490. [PMID: 32452729 DOI: 10.1080/15622975.2020.1744723] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Objectives: The primary aim of these guidelines is to evaluate the role of pharmacological agents in the treatment and management of patients with paraphilic disorders, with a focus on the treatment of adult males. Because such treatments are not delivered in isolation, the role of specific psychotherapeutic interventions is also briefly covered. These guidelines are intended for use in clinical practice by clinicians who diagnose and treat patients, including sexual offenders, with paraphilic disorders. The aim of these guidelines is to bring together different views on the appropriate treatment of paraphilic disorders from experts representing different countries in order to aid physicians in clinical decisions and to improve the quality of care.Methods: An extensive literature search was conducted using the English-language-literature indexed on MEDLINE/PubMed (1990-2018 for SSRIs) (1969-2018 for hormonal treatments), supplemented by other sources, including published reviews.Results: Each treatment recommendation was evaluated and discussed with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. The type of medication used depends on the severity of the paraphilic disorder and the respective risk of behaviour endangering others. GnRH analogue treatment constitutes the most relevant treatment for patients with severe paraphilic disorders.Conclusions: An algorithm is proposed with different levels of treatment for different categories of paraphilic disorders accompanied by different risk levels.
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Affiliation(s)
- Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin, University of Paris, INSERM U1266, Institute of Psychiatry and Neurosciences, Paris, France
| | - Paul Cosyns
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Antwerp, Belgium
| | - John Paul Fedoroff
- Division of Forensic Psychiatry, The Royal Institute of Mental Health Research, University of Ottawa, Ottawa, ON, Canada
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine and Forensic Psychiatry, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kris Goethals
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp and University Forensic Centre, Antwerp University Hospital, Antwerp, Belgium
| | - John M W Bradford
- The Royal Institute of Mental Health Research, University of Ottawa, McMaster University, Ottawa & Hamilton, ON, Canada
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22
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Klein S, Kruse O, Markert C, Tapia León I, Strahler J, Stark R. Subjective reward value of visual sexual stimuli is coded in human striatum and orbitofrontal cortex. Behav Brain Res 2020; 393:112792. [PMID: 32598998 DOI: 10.1016/j.bbr.2020.112792] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 10/24/2022]
Abstract
Human neuroimaging research suggests the existence of one core network for the subjective valuation of rewards, including the striatum and orbitofrontal cortex. However, there is little research on the neural representation of subjective reward values of visual sexual stimuli (VSS) and on the role of these subjective valuations in the development of related addictive behaviors. Here, we investigate how neural reactivity to VSS is connected to individual preference using functional magnetic resonance imaging (fMRI). During the fMRI scan, 72 men viewed different VSS film clips. Ratings regarding valence and sexual arousal were collected and used as parametric modulators in the fMRI analysis. Subjects also filled out questionnaires on self-reported symptoms of problematic pornography use (PPU). Firstly, we found that neural reactivity towards VSS clips in the nucleus accumbens, caudate nucleus and orbitofrontal cortex was positively correlated with individual ratings of the respective VSS in all subjects. Second, the strength of the association between neural activity and sexual arousal ratings was positively correlated with self-reported symptoms of PPU. The first result suggests a precise appraisal of VSS according to individual preferences in established reward valuation regions. Secondly, stronger neural differentiation based on preference in participants with more PPU symptoms indicates an increased importance of VSS/preference fit in these individuals. This heightened correspondence between individual liking and neural activity may facilitate PPU development by increased signaling of incentive salience, thus boosting motivation to seek out and respond to these preferred stimuli.
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Affiliation(s)
- Sanja Klein
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, 35032 Marburg, Germany.
| | - Onno Kruse
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Clinical Psychology, University Siegen, 57076 Siegen, Germany
| | - Charlotte Markert
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, 35032 Marburg, Germany
| | - Isabell Tapia León
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Clinical Psychology, University Siegen, 57076 Siegen, Germany
| | - Jana Strahler
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University, 35394 Giessen, Germany; Bender Institute for Neuroimaging (BION), Justus Liebig University, 35394 Giessen, Germany; Center of Mind, Brain and Behavior, Universities of Marburg and Giessen, 35032 Marburg, Germany
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23
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Gao M, Feng N, Guo B, Wu J, Sun J, Zhang L, Zeng X, Guo J, Yuan J, Liu P. Striatum-related Intrinsic Connectivity Deficits in Lifelong Premature Ejaculation Patients. Urology 2020; 143:159-164. [PMID: 32544552 DOI: 10.1016/j.urology.2020.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/13/2020] [Accepted: 06/01/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate abnormal intrinsic connectivity of striatum in lifelong premature ejaculation (PE) patients compared with healthy controls (HCs). METHODS Forty-seven lifelong PE patients and 30 healthy controls were enrolled in the present study and underwent resting-state functional magnetic resonance imaging. The functional connectivity (FC) analysis and 2-sample t tests were applied to investigate the alterations of striatum-related connectivity in patients compared with HCs (significant threshold at P < .05, false discovery rate corrected), and during which Fisher's r-to-z transformation was adopted and the resulting z values were used as the statistical FC values. Correlation analysis was performed to test possible relationships between the imaging findings and clinical characteristics in the patient group (P < .05, Bonferroni correction). RESULTS The results showed that compared with HCs, lifelong PE patients had significantly decreased FC between the right caudate and insula, superior temporal pole (STP) and orbitofrontal cortex (OFC) as well as decreased FC between the bilateral putamen and insula, STP and middle cingulate cortex (MCC). Meanwhile, patients had significantly increased FC between the left caudate and OFC, and increased FC between the right putamen and fusiform. The mean FC value from the caudate-OFC, caudate-insula, and caudate-STP connectivity negatively correlated with the Premature Ejaculation Diagnostic Tool score, separately. CONCLUSION The current study showed the functional abnormality of lifelong PE in multiple brain regions implicated in sensation, motivation, and ejaculation-related inhibitory control, which may improve our understanding of the abnormal striatum-related neural mechanisms in lifelong PE patients.
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Affiliation(s)
- Ming Gao
- Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China; Department of Andrology, XiYuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Nana Feng
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 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
| | - Boda Guo
- Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China; Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Jiayu Wu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 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
| | - Jianhua Sun
- Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiao Zeng
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 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
| | - Jun Guo
- Department of Andrology, XiYuan Hospital, China Academy of Chinese Medical Sciences, Beijing, 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, 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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Balcioglu YH, Dogan M, Incı I, Solmaz M. Sexual Behavioral Disinhibition Associated with Nucleus Lentiformis Lesion: A Forensic Neuroscience Perspective Through a Case. J Forensic Sci 2020; 65:1779-1783. [PMID: 32525581 DOI: 10.1111/1556-4029.14477] [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: 04/21/2020] [Revised: 05/08/2020] [Accepted: 05/21/2020] [Indexed: 11/30/2022]
Abstract
Organic brain disturbances particularly related to frontal cortex structures and subcortical areas including the basal ganglia may play a role in behavioral disinhibition disorders. Kluver-Bucy syndrome (KBS), which is one of the better knowns of these syndromes, includes hyperorality, visual agnosia, and hypersexuality, has been reported to occur after temporal lobe and amygdala lesions; however, several patients who had focal lesions in areas other than the temporal cortex and amygdala have been reported to present partial KBS symptoms. Nucleus lentiformis refers to a large portion of the basal ganglia including the putamen and globus pallidus, and specific structures within this broad area are known to be important for reward and value-based decision making. To date, KBS symptoms including hypersexual behavior associated with nucleus lentiformis lesions have never been reported. Here, we present a 38-year-old male patient who developed increased sexual interest and hyperorality after infarctions in the right lenticular nucleus and right occipitotemporal region and committed a first-degree sexual assault. He was sent to our institution for the assessment of criminal responsibility to the index sexual crime. According to a comprehensive and thorough forensic psychiatric evaluation, he was diagnosed as having an organic personality disorder with partial KBS symptoms. To the best of our knowledge, this is the first reported case of deviant sexual behavior and hyperorality developing after nucleus lentiformis infarction. We aimed to discuss possible neurobiologic explanations of late-onset deviant sexual behavior, which resulted in sexual criminal behavior following a cerebrovascular infarction.
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Affiliation(s)
- Yasin Hasan Balcioglu
- Bakirkoy Prof. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology, and Neurosurgery, Forensic Psychiatry Unit, Istanbul, Turkey
| | - Mehmet Dogan
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey
| | - Ipek Incı
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey
| | - Mustafa Solmaz
- Ministry of Justice, The Council of Forensic Medicine, Istanbul, Turkey.,Department of Psychiatry, Bagcilar Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
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25
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Long X, Tian F, Zhou Y, Cheng B, Jia Z. Different Neural Correlates of Sexually Preferred and Sexually Nonpreferred Stimuli. J Sex Med 2020; 17:1254-1267. [PMID: 32312660 DOI: 10.1016/j.jsxm.2020.03.007] [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: 12/19/2019] [Revised: 03/09/2020] [Accepted: 03/11/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The differences and relationships between stimulus-related brain activation for sexually preferred stimuli and sexually nonpreferred stimuli are still unclear. AIM This study aimed to identify brain regions that were mostly associated with sexual stimuli. METHODS We used the activation likelihood estimation, meta-analytic connectivity modelling, and behavioral domain metadata in the BrainMap database to perform this analysis. OUTCOMES We found convergent activation foci and created a model for the extended brain network involved in responses to sexual stimuli and also assessed the functional properties of these regions. RESULTS A total of 34 experiments from 15 studies including 368 subjects and 343 foci were analyzed. The results showed that sexual stimuli are related to the extensive activation of the occipital-temporal-limbic system and less extensive activation of the basal ganglia. Sexually preferred stimuli activated mainly the anterior cingulate cortex and right fusiform gyrus, while sexually nonpreferred stimuli activated the limbic system, occipital gyrus, and thalamus. CLINICAL IMPLICATIONS To have a further understanding of the central mechanisms of human sexuality. STRENGTHS & LIMITATIONS Patient characteristics and analysis techniques in the included studies were heterogeneous. CONCLUSIONS These findings suggest that the anterior cingulate cortex is an important cognitive control area for both sexually preferred and nonpreferred stimuli. Meta-analytic connectivity modelling analysis revealed a network of the core brain areas involved in response to sexual stimuli, and behavioral domain analysis indicated that these areas have both common and discrete functional properties. Long X, Tian F, Zhou Y, et al. Different Neural Correlates of Sexually Preferred and Sexually Nonpreferred Stimuli. J Sex Med 2020;17:1254-1267.
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Affiliation(s)
- Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Yushan Zhou
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China; Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, China.
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26
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Gao M, Feng N, Wu J, Sun J, Zhang L, Guo X, Yuan J, Guo J, Liu P. Altered Functional Connectivity of Hypothalamus in Lifelong Premature Ejaculation Patients. J Magn Reson Imaging 2020; 52:778-784. [PMID: 32068927 DOI: 10.1002/jmri.27099] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 02/06/2020] [Accepted: 02/06/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND As one of the most prevalent sexual dysfunctions in men, lifelong premature ejaculation (PE) often leads to patient distress. The hypothalamus is implicated in the ejaculatory control of healthy males. However, we do not know whether the hypothalamus-related intrinsic connectivity is altered in lifelong PE patients. PURPOSE To investigate abnormal intrinsic connectivity of the hypothalamus in lifelong PE patients compared with healthy controls (HCs). STUDY TYPE Prospective pilot study using cross-sectional data of patients and HCs. SUBJECTS Forty-seven lifelong PE patients and 30 HCs were included in this study. FIELD STRENGTH/SEQUENCE 3.0T MRI scanner for T1 -weighted imaging using spoiled gradient recalled echo sequence and functional imaging using a single-shot gradient recalled echo sequence. ASSESSMENT Preprocessing of MRI data and hypothalamus-seeded functional connectivity (FC) computation were performed using DPABI4.1. STATISTICAL TESTS The two-sample t-test within SPM12 was adopted to examine possible alterations of intrinsic connectivity of hypothalamus in lifelong PE patients compared with HCs including anxiety and depression scores as covariates (false discovery rate-corrected, P < 0.05). The correlation analysis was then used to assess possible associations between the imaging findings and clinical features in the patient group (Bonferroni-corrected, P < 0.05). RESULTS Compared with HCs, lifelong PE patients had decreased hypothalamus-seeded FC in the left orbitofrontal cortex, bilateral insula, superior temporal cortex, superior temporal pole, middle temporal cortex, left fusiform, right parahippocampal gyrus, and right cerebellum. The intravaginal ejaculatory latency time positively correlated with the mean z-score from the hypothalamus-insula (r = 0.45) and hypothalamus-cerebellum (r = 0.48) intrinsic connectivity, separately. DATA CONCLUSION We have shown that hypothalamus-seeded FC alterations and the correlations between the aforementioned abnormal FC alterations and intravaginal ejaculatory latency time. The current findings may promote the understanding of the hypothalamus-related neural mechanisms involved in the abnormal ejaculatory information processing in lifelong PE patients. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY STAGE: 3 J. Magn. Reson. Imaging 2020;52:778-784.
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Affiliation(s)
- Ming Gao
- Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China.,Department of Andrology, XiYuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Nana Feng
- Life Science 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
| | - Jiayu Wu
- Life Science 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
| | - Jianhua Sun
- Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xinlong Guo
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jun Guo
- Department of Andrology, XiYuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Peng Liu
- Life Science 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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27
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Cazala F, Fonteille V, Moulier V, Pélégrini-Issac M, De Beaurepaire C, Abondo M, Bodon-Bruzel M, Cano J, Cochez F, Fouli T, Thevenon C, Dauba B, Pugeat M, Stoléru S. Brain responses to pictures of children in men with pedophilic disorder: a functional magnetic resonance imaging study. Eur Arch Psychiatry Clin Neurosci 2019; 269:713-729. [PMID: 30094544 DOI: 10.1007/s00406-018-0933-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
Abstract
Structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of pedophilic disorder, and have reported many contradictory or non-replicated findings. Here, our purpose was to identify through functional magnetic resonance imaging the brain responses of 25 male outpatients with pedophilic disorder to visual stimuli depicting children (VSc) and to compare them with 24 male healthy controls matched on sexual orientation (to female or male adults), age, and handedness. No region was differentially activated across the two groups in response to VSc. However, as shown by a random-effects statistical analysis (cluster-level pFWE-corrected < 0.05), in patients with pedophilia, but not in controls, the presentation of VSc induced a bilateral activation in the lateral occipital and temporal cortices, in particular in the right inferior temporal gyrus, as well as an activation in the declive of the cerebellar vermis. In addition, in patients the level of bilateral activation in the above-mentioned regions was positively correlated with ratings of perceived sexual arousal elicited by VSc. These results implicate these regions as possible candidate areas mediating sexual arousal in patients with pedophilic disorder.
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Affiliation(s)
- Fadwa Cazala
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, 69500, France
| | - Véronique Fonteille
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Centre Hospitalo-Universitaire et Université de Saint-Etienne, Saint-Etienne, France
| | - Virginie Moulier
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France.,Unité de Recherche Clinique, EPS Ville Evrard, Neuilly-sur-Marne, France
| | - Mélanie Pélégrini-Issac
- Sorbonne Université, CNRS, INSERM, Laboratoire d'Imagerie Biomédicale (LIB) Paris, Paris, France
| | | | - Marlène Abondo
- Antenne Rennaise du Centre de Ressources Régional sur les Auteurs de Violences Sexuelles de Bretagne, CHU Pontchaillou, Rennes, France
| | | | - Jean Cano
- CHRU de Tours, Hôpital Trousseau, Tours, France.,ERIOS-CRIAVS Aquitaine, Centre Hospitalier Charles-Perrens, Bordeaux, France
| | | | - Taoufik Fouli
- Département Santé-Justice du Centre Hospitalier Esquirol, Limoges, France
| | | | - Bernard Dauba
- Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, 69500, France.,AP-HP, Centre d'Investigation Clinique-1421, Pitié-Salpêtrière University Hospital, Paris, France
| | - Michel Pugeat
- Université Claude Bernard Lyon 1, INSERM U1060 and Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, France
| | - Serge Stoléru
- CESP, Fac. de médecine-Univ. Paris-Sud, Fac. de médecine-UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif, France. .,Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, Bron, 69500, France. .,Institut du Cerveau et de la Moelle épinière, Sorbonne Université, CNRS, INSERM, Centre de neuroimagerie de recherche (CENIR), Paris, France.
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28
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Chen J, Huang X, Liu S, Lu C, Dai Y, Yao Z, Chen Y. Disrupted topological properties of brain networks in erectile dysfunction patients owing predominantly to psychological factors: a structural and functional neuroimaging study. Andrology 2019; 8:381-391. [PMID: 31468742 DOI: 10.1111/andr.12684] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 06/27/2019] [Accepted: 06/28/2019] [Indexed: 12/14/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese MedicineAffiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese MedicineAffiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - S. Liu
- Department of Radiology Jiangsu Province Hospital of Chinese MedicineAffiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - C. Lu
- Department of Radiology Jiangsu Province Hospital of Chinese MedicineAffiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Y. Dai
- Department of Andrology Nanjing Drum Tower HospitalAffiliated 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 MedicineAffiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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29
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Yin T, Li Z, Xiong J, Lan L, Sun R, Ren F, Zhang P. Neuroimaging biomarkers of psychogenic erectile dysfunction: protocol for a systematic review. BMJ Open 2019; 9:e030061. [PMID: 31455711 PMCID: PMC6720482 DOI: 10.1136/bmjopen-2019-030061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is the most common male sexual disorder that severely impacts the sexual performance and quality of life of men. As the main subtype of ED, psychogenic ED (pED) has been demonstrated to be a genitourinary disease and also associated with alterations in both brain structure and function. However, the scattered neuroimaging evidence from individual studies has not yet been integrated, and the central pathological alterations associated with pED remain unclear. The objective of this systematic review is to integrate and assess the evidence of the impact of pED on brain structure and function. METHODS AND ANALYSIS Five databases (PubMed, EMBASE, Web of Science, China Biology Medicine Database and China National Knowledge Infrastructure (CNKI)) will be systematically searched from inception to 1 October 2019 (the anticipated completion date of this review), with language restricted to English and Chinese. Studies focusing on the structural or functional alterations in patients with pED will be retrieved. The study selection process will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and quality assessment will be conducted with a customised checklist. After data extraction, a qualitative review will be performed to synthesise the structural and functional brain alterations as well as the correlations between the altered cerebral structures and functions and the clinical characteristics of patients with pED. If the collected data make it feasible, an activation likelihood estimation meta-analysis will also be launched. ETHICS AND DISSEMINATION Ethical approval is not required as primary data will not be collected. This review will be published in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42019117206.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhengjie Li
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture-Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Xiong
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lei Lan
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture-Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture-Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Feiqiang Ren
- Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihai Zhang
- Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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30
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Strahler J, Baranowski AM, Walter B, Huebner N, Stark R. Attentional bias toward and distractibility by sexual cues: A meta-analytic integration. Neurosci Biobehav Rev 2019; 105:276-287. [PMID: 31415866 DOI: 10.1016/j.neubiorev.2019.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 06/06/2019] [Accepted: 07/20/2019] [Indexed: 12/29/2022]
Abstract
From an evolutionary perspective, sexual stimuli are highly salient and are assumed to be processed with high priority. Hence, attentional processing of sexual cues is expected to not only bias attention but to also distract from other cognitive (foreground) tasks. It is, however, unclear to what extent these stimuli capture attention and whether there are differences between men and women. This meta-analysis combined the results of 32 studies employing experiments of attentional bias toward and distraction by sexual stimuli. From these, 13 studies provided data to examine gender differences. Overall, attentional bias and distractibility was lower than anticipated (gz = 0.43, p < .001) and there was support for the assumption of higher attention bias/interference in men (gs = 0.29, p = .031). Importantly, there was evidence for the presence of publication bias. With this in mind, findings are discussed in the context of stimulus features, the impact of provoked sexual arousal and motivational state, and gender-specific and -nonspecific neural processing of sexual stimuli which influence attention toward them.
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Affiliation(s)
- J Strahler
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany.
| | - A M Baranowski
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany
| | - B Walter
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany
| | - N Huebner
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany
| | - R Stark
- Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Germany
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31
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Stark R, Klein S, Kruse O, Weygandt M, Leufgens LK, Schweckendiek J, Strahler J. No Sex Difference Found: Cues of Sexual Stimuli Activate the Reward System in both Sexes. Neuroscience 2019; 416:63-73. [PMID: 31394197 DOI: 10.1016/j.neuroscience.2019.07.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 01/27/2023]
Abstract
Sexually explicit material (SEM) is increasingly used in western societies. One reason for this high usage might be the rewarding property of SEM demonstrated in many brain imaging studies showing an activation of the reward system during the presentation of SEM. It is not yet well understood why women use SEM to a remarkably lesser extent than men. Maybe men react stronger to stimuli - so called SEM cues -, which signal the presentation of SEM and are therefore more vulnerable to use SEM than women. Therefore, the present study aimed at investigating the sex specific neural correlates towards SEM and SEM cues. We were further interested in whether person characteristics as trait sexual motivation, extent of SEM use in the last month, and age at onset of goal-oriented SEM use affect the neural responses to SEM and SEM cues. The trials of the fMRI experiment consisted of an expectation phase with SEM or neutral cues and a presentation phase with SEM or neutral stimuli, respectively. Analyses showed that the reward circuitry was activated by SEM, but also by SEM cues. There were some sex differences in hemodynamic responses to SEM during the presentation phase, but not during the expectation phase to SEM cues in any of the regions of interest. The influence of the investigated person characteristics was only small if existent. The results suggest that sex specific cue processing cannot explain sex differences in the use of SEM.
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Affiliation(s)
- Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany; Bender Institute of Neuroimaging, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany; Center of Mind, Brain and Behavior, Universities of Marburg and Gießen, Hans-Meerwein-Straße 6, 35032 Marburg, Germany.
| | - Sanja Klein
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany; Bender Institute of Neuroimaging, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany.
| | - Onno Kruse
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany; Department of Clinical Psychology, University of Siegen, Adolf-Reichwein-Str. 2a, 57076 Siegen, Germany.
| | - Martin Weygandt
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Excellence Cluster NeuroCure, 10117 Berlin, Germany.
| | - Lisa K Leufgens
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany.
| | - Jan Schweckendiek
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany
| | - Jana Strahler
- Department of Psychotherapy and Systems Neuroscience, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany; Bender Institute of Neuroimaging, Justus-Liebig-Universität Giessen, Otto-Behaghel-Str. 10H, 35394 Giessen, Germany.
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32
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Abstract
Neuroimaging studies suggest differences in the underlying biology of sexual arousal associated with sex and sexual orientation, yet their findings are conflicting. Following a thorough statistical review of all significant neuroimaging studies, we offer strong quantitative evidence that the neuronal response to visual sexual stimuli, contrary to the widely accepted view, is independent of biological sex. Both men and women show increased activation in many cortical and subcortical brain regions thought to be involved in the response to visual sexual stimuli, while the limited sex differences that have been found and reported previously refer to subjective rating of the content. Sexual arousal is a dynamical, highly coordinated neurophysiological process that is often induced by visual stimuli. Numerous studies have proposed that the cognitive processing stage of responding to sexual stimuli is the first stage, in which sex differences occur, and the divergence between men and women has been attributed to differences in the concerted activity of neural networks. The present comprehensive metaanalysis challenges this hypothesis and provides robust quantitative evidence that the neuronal circuitries activated by visual sexual stimuli are independent of biological sex. Sixty-one functional magnetic resonance imaging studies (1,850 individuals) that presented erotic visual stimuli to men and women of different sexual orientation were identified. Coordinate-based activation likelihood estimation was used to conduct metaanalyses. Sensitivity and clustering analyses of averaged neuronal response patterns were performed to investigate robustness of the findings. In contrast to neutral stimuli, sexual pictures and videos induce significant activations in brain regions, including insula, middle occipital, anterior cingulate and fusiform gyrus, amygdala, striatum, pulvinar, and substantia nigra. Cluster analysis suggests stimulus type as the most, and biological sex as the least, predictor for classification. Contrast analysis further shows no significant sex-specific differences within groups. Systematic review of sex differences in gray matter volume of brain regions associated with sexual arousal (3,723 adults) did not show any causal relationship between structural features and functional response to visual sexual stimuli. The neural basis of sexual arousal in humans is associated with sexual orientation yet, contrary to the widely accepted view, is not different between women and men.
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Serotonergic, Dopaminergic, and Noradrenergic Modulation of Erotic Stimulus Processing in the Male Human Brain. J Clin Med 2019; 8:jcm8030363. [PMID: 30875818 PMCID: PMC6463265 DOI: 10.3390/jcm8030363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 03/05/2019] [Accepted: 03/12/2019] [Indexed: 01/23/2023] Open
Abstract
Human sexual behavior is mediated by a complex interplay of cerebral and spinal centers, as well as hormonal, peripheral, and autonomic functions. Neuroimaging studies identified central neural signatures of human sexual responses comprising neural emotional, motivational, autonomic, and cognitive components. However, empirical evidence regarding the neuromodulation of these neural signatures of human sexual responses was scarce for decades. Pharmacological functional magnetic resonance imaging (fMRI) provides a valuable tool to examine the interaction between neuromodulator systems and functional network anatomy relevant for human sexual behavior. In addition, this approach enables the examination of potential neural mechanisms regarding treatment-related sexual dysfunction under psychopharmacological agents. In this article, we introduce common neurobiological concepts regarding cerebral sexual responses based on neuroimaging findings and we discuss challenges and findings regarding investigating the neuromodulation of neural sexual stimulus processing. In particular, we summarize findings from our research program investigating how neural correlates of sexual stimulus processing are modulated by serotonergic, dopaminergic, and noradrenergic antidepressant medication in healthy males.
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34
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Fonteille V, Redouté J, Lamothe P, Straub D, Lavenne F, Le Bars D, Raverot V, Moulier V, Marchand JJ, Vittoz A, Leriche C, Pugeat M, Stoléru S. Brain processing of pictures of children in men with pedophilic disorder: A positron emission tomography study. NEUROIMAGE-CLINICAL 2019; 21:101647. [PMID: 30612938 PMCID: PMC6412007 DOI: 10.1016/j.nicl.2018.101647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 12/11/2018] [Accepted: 12/21/2018] [Indexed: 12/14/2022]
Abstract
Although structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of pedophilic disorder, the differences in the processing of child sexual stimuli between men attracted to children and those attracted to adults remain unclear. Here, our purpose was to identify through positron emission tomography the brain responses of 15 male outpatients with pedophilic disorder to validated visual sexual stimuli depicting children (VSSc) and to compare them with 15 male healthy controls matched for sexual orientation (to female or male adults), age, and handedness. The patients' sample comprised both offenders and non-offenders. In response to VSSc, the between-groups analysis showed that activation in the right inferior temporal cortex [Brodmann area (BA) 20] was lower in patients than in controls. Moreover, in patients but not in controls, the presentation of VSSc induced an activation in a more caudal region of the right inferior temporal gyrus (BA 37) and in the left middle occipital gyrus (BA 19). In addition, in patients the level of activation in the caudal right inferior temporal gyrus was positively correlated with ratings of sexual arousal elicited by VSSc, whereas this correlation was negative in BA 20. These results implicate the right inferior temporal gyrus as a possible candidate area mediating sexual arousal in patients with pedophilic disorder and suggest that two of its areas play opposite, i.e., activating and inhibitory, roles. Images of children activate the pedophilic patients' right Brodmann area (BA) 37. Images of children (IC) activate the pedophilic patients' left BA 19. Right BA37 activation correlates with pedophilic patients' rating of sexual arousal. IC induce lower right BA 20 activation in pedophilic patients than in controls.
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Affiliation(s)
- Véronique Fonteille
- Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, 59 Boulevard Pinel, Bron F-69500, France
| | - Jérôme Redouté
- CERMEP-Imagerie du Vivant, 59 Boulevard Pinel, 69677, France
| | - Pierre Lamothe
- Service Médico-Psychologique Régional, Centre Hospitalier Le Vinatier, BP 30039, 95 bd Pinel, Bron Cedex 69678, France
| | - Dominique Straub
- CRIAVS Rhône-Alpes - Délégation de St Étienne, Hôpital Bellevue, Pavillon 5 bis, Bvd Pasteur, Saint-Étienne 42055, France
| | - Frank Lavenne
- CERMEP-Imagerie du Vivant, 59 Boulevard Pinel, 69677, France
| | - Didier Le Bars
- CERMEP-Imagerie du Vivant, 59 Boulevard Pinel, 69677, France
| | - Véronique Raverot
- Centre de Biologie Est, Groupement Hospitalier Est, Hospices Civils de Lyon, 59 Boulevard Pinel, Bron, 69677, France
| | - Virginie Moulier
- Unité de Recherche Clinique, EPS Ville Evrard, 202 avenue Jean Jaurès, Neuilly-sur-Marne 93330, France
| | - Jean-Jacques Marchand
- Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, 59 Boulevard Pinel, Bron F-69500, France
| | - Aurélie Vittoz
- Service Médico-Psychologique Régional, Centre Hospitalier Le Vinatier, BP 30039, 95 bd Pinel, Bron Cedex 69678, France
| | - Charlotte Leriche
- Service Médico-Psychologique Régional, Centre Hospitalier Le Vinatier, BP 30039, 95 bd Pinel, Bron Cedex 69678, France
| | - Michel Pugeat
- Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, 59 Boulevard Pinel, Bron F-69500, France
| | - Serge Stoléru
- Hospices Civils de Lyon, Groupement Hospitalier Est, Fédération d'Endocrinologie, 59 Boulevard Pinel, Bron F-69500, France; CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, Hôpital Paul Brousse, Porte 45, 16 avenue Paul Vaillant-Couturier, Villejuif Cedex 94807, France; Corresponding author at: Inserm U1178, Hôpital Paul Brousse, Porte 45, 16 avenue Paul Vaillant-Couturier, Villejuif Cedex 94807, France..
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Kneer J, Borchardt V, Kärgel C, Sinke C, Massau C, Tenbergen G, Ponseti J, Walter H, Beier KM, Schiffer B, Schiltz K, Walter M, Kruger THC. Diminished fronto-limbic functional connectivity in child sexual offenders. J Psychiatr Res 2019. [PMID: 29530321 DOI: 10.1016/j.jpsychires.2018.01.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Child sexual abuse and neglect have been related to an increased risk for the development of a wide range of behavioral, psychological, and sexual problems and increased rates of suicidal behavior. Contrary to the large amount of research focusing on the negative mental health consequences of child sexual abuse, very little is known about the characteristics of child sexual offenders and the neuronal underpinnings contributing to child sexual offending. METHODS AND SAMPLE This study investigates differences in resting state functional connectivity (rs-FC) between non-pedophilic child sexual offenders (N = 20; CSO-P) and matched healthy controls (N = 20; HC) using a seed-based approach. The focus of this investigation of rs-FC in CSO-P was put on prefrontal and limbic regions highly relevant for emotional and behavioral processing. RESULTS Results revealed a significant reduction of rs-FC between the right centromedial amygdala and the left dorsolateral prefrontal cortex in child sexual offenders compared to controls. CONCLUSION & RECOMMENDATIONS Given that, in the healthy brain, there is a strong top-down inhibitory control of prefrontal over limbic structures, these results suggest that diminished rs-FC between the amygdala and the dorsolateral prefrontal cortex and may foster sexual deviance and sexual offending. A profound understanding of these concepts should contribute to a better understanding of the occurrence of child sexual offending, as well as further development of more differentiated and effective interventions.
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Affiliation(s)
- Jonas Kneer
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg Strasse 1, D-30625 Hannover, Germany
| | - Viola Borchardt
- Clinical Affective Neuroimaging Laboratory, Magdeburg, Germany; Leibniz Institute for Neurobiology, Department of Behavioral Neurology, Magdeburg, Germany
| | - Christian Kärgel
- LWL-University Hospital Bochum, Division of Forensic Psychiatry, Alexandrinenstr. 1-3, 44791 Bochum, Germany
| | - Christopher Sinke
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg Strasse 1, D-30625 Hannover, Germany
| | - Claudia Massau
- LWL-University Hospital Bochum, Division of Forensic Psychiatry, Alexandrinenstr. 1-3, 44791 Bochum, Germany
| | - Gilian Tenbergen
- Department of Psychology, SUNY College at Oswego, Oswego, NY, USA
| | - Jorge Ponseti
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Kiel University, Medical School, Kiel, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Klaus M Beier
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Boris Schiffer
- LWL-University Hospital Bochum, Division of Forensic Psychiatry, Alexandrinenstr. 1-3, 44791 Bochum, Germany
| | - Kolja Schiltz
- Department of Forensic Psychiatry, Psychiatric Hospital of the Ludwig-Maximilians-University, München, Germany; (j)Otto-von-Guericke-University Magdeburg, Department of Psychiatry, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Martin Walter
- Department of Psychiatry University of Tübingen Osianderstr. 24, 72076 Tübingen, Germany
| | - Tillmann H C Kruger
- Division of Clinical Psychology and Sexual Medicine, Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Carl-Neuberg Strasse 1, D-30625 Hannover, Germany
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Stark R, Klucken T, Potenza MN, Brand M, Strahler J. A Current Understanding of the Behavioral Neuroscience of Compulsive Sexual Behavior Disorder and Problematic Pornography Use. Curr Behav Neurosci Rep 2018. [DOI: 10.1007/s40473-018-0162-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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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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Trovão JN, Serefoglu EC. Neurobiology of male sexual dysfunctions in psychiatric disorders: the cases of depression, anxiety, mania and schizophrenia. Int J Impot Res 2018; 30:279-286. [PMID: 30228317 DOI: 10.1038/s41443-018-0077-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 08/16/2018] [Accepted: 09/03/2018] [Indexed: 01/09/2023]
Abstract
While the pathophysiology of several psychiatric disorders has become modestly elucidated in the last decade, comorbid sexual dysfunctions in such patients are frequently left apart from clinical and research interest. We aimed to address the malfunctioning neurocircuitry underlying sexual dysfunctions in depression, anxiety, schizophrenia and mania. We performed a comprehensive literature review, addressing any combination of the topics of "neurobiology"/"neural", "sexual"/"desire"/"arousal"/"orgasm"/"ejaculation" and "depression"/"anxiety"/"schizophrenia"/"mania"/"bipolar". Altered neurotransmitter levels or connectivity in patients are reported in sexual dysfunctions (either desire, arousal, orgasm and ejaculation) and main psychiatric disorders (depression, anxiety, mania and schizophrenia). Neuronal pathways responsible for the occurrence of sexual dysfunctions in psychiatric disorders can be figured out by overlap of their acknowledged pathophysiology. However, specific research in that group is scant, so future tailored studies are warranted to elucidate actual mechanisms.
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Affiliation(s)
- José Nuno Trovão
- Department of Psychiatry of Centro Hospitalar Vila Nova de Gaia/Espinho, Porto, Portugal
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Mokhber N, Azarpazhooh MR, Prakash A, Zamprogna Ballès JA, Prakash A. The medical-legal aspect of sexual deviant behaviors due to brain lesions: A case report and narrative review of the literature. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 58:117-121. [PMID: 29853002 DOI: 10.1016/j.ijlp.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 12/24/2017] [Accepted: 01/20/2018] [Indexed: 06/08/2023]
Abstract
We reported a case of sexual assault in a 60-year-old male with no history of mental illness. The lack of memory about the time of the assault and the patient's uncharacteristic behaviour suggested sexual deviant behaviour secondary to a brain lesion. Further investigations revealed a lentiform stroke. A possibility of abnormal sexual behaviour due to an epileptic seizure and/or a destructive brain lesion is suggested. We summarized the history of our patient in this paper and provided a review of the medico-legal aspects of hypersexuality and sexual deviant behaviors due to brain disorders.
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Affiliation(s)
- Naghmeh Mokhber
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Mahmoud Reza Azarpazhooh
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Ajay Prakash
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Julie A Zamprogna Ballès
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Arun Prakash
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
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40
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Chen J, Chen Y, Gao Q, Chen G, Dai Y, Yao Z, Lu Q. Impaired Prefrontal-Amygdala Pathway, Self-Reported Emotion, and Erection in Psychogenic Erectile Dysfunction Patients With Normal Nocturnal Erection. Front Hum Neurosci 2018; 12:157. [PMID: 29740301 PMCID: PMC5928255 DOI: 10.3389/fnhum.2018.00157] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Accepted: 04/05/2018] [Indexed: 12/31/2022] Open
Abstract
Background: Neuroimaging studies have demonstrated that the prefrontal cortex and amygdala play an important role in sexual arousal (SA). However, little is known about the interactions between the prefrontal and cortex amygdala, which mediate the cognitive regulation of emotion and SA. Objective: We seek to determine whether nocturnal erection of psychogenic erectile dysfunction (pED) patients are normal and whether there are changes of topological organization in the prefrontal-amygdala pathway of brain network in pED. In addition, whether there are correlations between network property changes and self-reported emotion and erection. Design, setting, and participants: We used the RigiScan device to evaluate erectile function of patients and employed diffusion MRI and graph theory to construct brain networks of 21 pED patients and 24 healthy controls. Outcome measurements and statistical analysis: We considered four nodal metrics and their asymmetry scores, and nocturnal penile tumescence (NPT) parameters, to evaluate the topological properties of brain networks of pED and their relationships with the impaired self-reported emotion and erection. Results and limitations: All the pED patients showed normal nocturnal penile erection, however impaired self-reported erection and negative emotion. In addition, patients showed lower connectivity degree and strength in the left prefrontal-amygdala pathway. We also found that pED exhibited lower leftward asymmetry in the inferior frontal gyrus. Furthermore, patients showed more hub regions and fewer pivotal connections. Moreover, the degree of the left amygdala of pED showed significantly negative correlation with the self-reported erection and positive correlation with the self-reported negative emotion. Conclusions: Together, these results suggest normal nocturnal erection in pED. However, abnormalities of brain network organization in pED, particularly in the left prefrontal-amygdala pathway, are associated with the impaired self-reported erection and negative emotion.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yun Chen
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Qingqiang Gao
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Guotao Chen
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yutian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhijian Yao
- Department of Psychiatry, Nanjing Brain Hospital, The Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Qing Lu
- Key Laboratory of Child Development and Learning Science, Research Centre for Learning Science, Southeast University, Nanjing, China
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Li L, Fan W, Li J, Li Q, Wang J, Fan Y, Ye T, Guo J, Li S, Zhang Y, Cheng Y, Tang Y, Zeng H, Yang L, Zhu Z. Abnormal brain structure as a potential biomarker for venous erectile dysfunction: evidence from multimodal MRI and machine learning. Eur Radiol 2018; 28:3789-3800. [PMID: 29600478 DOI: 10.1007/s00330-018-5365-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 01/17/2018] [Accepted: 02/01/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To investigate the cerebral structural changes related to venous erectile dysfunction (VED) and the relationship of these changes to clinical symptoms and disorder duration and distinguish patients with VED from healthy controls using a machine learning classification. METHODS 45 VED patients and 50 healthy controls were included. Voxel-based morphometry (VBM), tract-based spatial statistics (TBSS) and correlation analyses of VED patients and clinical variables were performed. The machine learning classification method was adopted to confirm its effectiveness in distinguishing VED patients from healthy controls. RESULTS Compared to healthy control subjects, VED patients showed significantly decreased cortical volumes in the left postcentral gyrus and precentral gyrus, while only the right middle temporal gyrus showed a significant increase in cortical volume. Increased axial diffusivity (AD), radial diffusivity (RD) and mean diffusivity (MD) values were observed in widespread brain regions. Certain regions of these alterations related to VED patients showed significant correlations with clinical symptoms and disorder durations. Machine learning analyses discriminated patients from controls with overall accuracy 96.7%, sensitivity 93.3% and specificity 99.0%. CONCLUSIONS Cortical volume and white matter (WM) microstructural changes were observed in VED patients, and showed significant correlations with clinical symptoms and dysfunction durations. Various DTI-derived indices of some brain regions could be regarded as reliable discriminating features between VED patients and healthy control subjects, as shown by machine learning analyses. KEY POINTS • Multimodal magnetic resonance imaging helps clinicians to assess patients with VED. • VED patients show cerebral structural alterations related to their clinical symptoms. • Machine learning analyses discriminated VED patients from controls with an excellent performance. • Machine learning classification provided a preliminary demonstration of DTI's clinical use.
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Affiliation(s)
- Lingli Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Wenliang Fan
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jun Li
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Quanlin Li
- State Key Laboratory of Digital Manufacturing Equipment and Technology, School of Mechanical Science and Engineering, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Jin Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yang Fan
- Advanced Application China, GE Healthcare, Wuhan 430022, China
| | - Tianhe Ye
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.,Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Jialun Guo
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Sen Li
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Youpeng Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yongbiao Cheng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yong Tang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Hanqing Zeng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China. .,Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China.
| | - Zhaohui Zhu
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Costumero V, Rosell-Negre P, Bustamante JC, Fuentes-Claramonte P, Llopis JJ, Ávila C, Barrós-Loscertales A. Left frontoparietal network activity is modulated by drug stimuli in cocaine addiction. Brain Imaging Behav 2017; 12:1259-1270. [DOI: 10.1007/s11682-017-9799-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Ruesink GB, Georgiadis JR. Brain Imaging of Human Sexual Response: Recent Developments and Future Directions. CURRENT SEXUAL HEALTH REPORTS 2017; 9:183-191. [PMID: 29225553 PMCID: PMC5711964 DOI: 10.1007/s11930-017-0123-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
PURPOSE OF REVIEW The purpose of this study is to provide a comprehensive summary of the latest developments in the experimental brain study of human sexuality, focusing on brain connectivity during the sexual response. RECENT FINDINGS Stable patterns of brain activation have been established for different phases of the sexual response, especially with regard to the wanting phase, and changes in these patterns can be linked to sexual response variations, including sexual dysfunctions. From this solid basis, connectivity studies of the human sexual response have begun to add a deeper understanding of the brain network function and structure involved. SUMMARY The study of "sexual" brain connectivity is still very young. Yet, by approaching the brain as a connected organ, the essence of brain function is captured much more accurately, increasing the likelihood of finding useful biomarkers and targets for intervention in sexual dysfunction.
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Affiliation(s)
- Gerben B. Ruesink
- Department of Neuroscience (Section Anatomy), University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Box 196, 9700 AD Groningen, The Netherlands
| | - Janniko R. Georgiadis
- Department of Neuroscience (Section Anatomy), University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, Box 196, 9700 AD Groningen, The Netherlands
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Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A). J Sex Med 2017; 13:733-59. [PMID: 27114190 DOI: 10.1016/j.jsxm.2016.02.172] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. AIM To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. CONCLUSION Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
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Affiliation(s)
- Roy J Levin
- Reader in Physiology (Retired), Department of Biomedical Science, University of Sheffield, Sheffield, UK: Section 2.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands: Section 3
| | - Janniko Georgiadis
- Department of Neuroscience, University Medical Center, Groningen, University of Groningen, The Netherlands: Section 4
| | - Tuuli Kukkonen
- College of Social and Applied Human Science, University of Guelph, Guelph, ON, Canada: Section 6
| | - Kwangsung Park
- Department of Urology, Chonnan National University Medical School, Gwangju, Korea: Section 5
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, WA, USA: Section 1
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45
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Cantor JM, Lafaille SJ, Hannah J, Kucyi A, Soh DW, Girard TA, Mikulis DJ. Independent Component Analysis of Resting-State Functional Magnetic Resonance Imaging in Pedophiles. J Sex Med 2017; 13:1546-54. [PMID: 27641922 DOI: 10.1016/j.jsxm.2016.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/01/2016] [Accepted: 08/03/2016] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Neuroimaging and other studies have changed the common view that pedophilia is a result of childhood sexual abuse and instead is a neurologic phenomenon with prenatal origins. Previous research has identified differences in the structural connectivity of the brain in pedophilia. AIM To identify analogous differences in functional connectivity. METHODS Functional magnetic resonance images were recorded from three groups of participants while they were at rest: pedophilic men with a history of sexual offenses against children (n = 37) and two control groups: non-pedophilic men who committed non-sexual offenses (n = 28) and non-pedophilic men with no criminal history (n = 39). MAIN OUTCOME MEASURE Functional magnetic resonance imaging data were subjected to independent component analysis to identify known functional networks of the brain, and groups were compared to identify differences in connectivity with those networks (or "components"). RESULTS The pedophilic group demonstrated wide-ranging increases in functional connectivity with the default mode network compared with controls and regional differences (increases and decreases) with the frontoparietal network. Of these brain regions (total = 23), 20 have been identified by meta-analytic studies to respond to sexually relevant stimuli. Conversely, of the brain areas known to be those that respond to sexual stimuli, nearly all emerged in the present data as significantly different in pedophiles. CONCLUSION This study confirms the presence of significant differences in the functional connectivity of the brain in pedophilia consistent with previously reported differences in structural connectivity. The connectivity differences detected here and elsewhere are opposite in direction from those associated with anti-sociality, arguing against anti-sociality and for pedophilia as the source of the neuroanatomic differences detected.
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Affiliation(s)
- J M Cantor
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada; Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, ON, Canada; Department of Psychiatry, University of Toronto Faculty of Medicine, Toronto, ON, Canada.
| | - S J Lafaille
- Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - J Hannah
- Complex Mental Illness Program, Centre for Addiction and Mental Health, Toronto, ON, Canada; University of Rochester, Rochester, NY, USA
| | - A Kucyi
- Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
| | - D W Soh
- Department of Psychology, York University, Toronto, ON, Canada
| | - T A Girard
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - D J Mikulis
- Toronto Western Research Institute, University Health Network, Toronto, ON, Canada
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Functional insights into aberrant brain responses and integration in patients with lifelong premature ejaculation. Sci Rep 2017; 7:460. [PMID: 28352072 PMCID: PMC5428429 DOI: 10.1038/s41598-017-00421-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 02/21/2017] [Indexed: 11/23/2022] Open
Abstract
Even though lifelong premature ejaculation (PE) is highly prevalent, few studies have investigated the neural mechanisms underlying PE. The extent and pattern of brain activation can be determined through a version of functional magnetic resonance imaging (fMRI) with erotic picture stimuli (task fMRI) and a resting-state fMRI (rs fMRI). We showed that the brain activity in the left inferior frontal gyrus and left insula was decreased both during the task and in the resting state, while there was higher activation in the right middle temporal gyrus during the task. Higher functional connectivity was found in PE between those three brain areas and the bilateral middle cingulate cortex, right middle frontal gyrus and supplementary motor area. Moreover, the brain activity had positive correlation with clinical rating scales, such as intravaginal ejaculatory latency time (IELT) and the Chinese Index of Premature Ejaculation (CIPE). These findings revealed that brain responses and functional integration in certain brain areas are impaired in cases of PE, which was consistently supported by multiple measurements obtained using a task and rs fMRI approach.
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Krüger THC, Kneer J. Neurobiologische Grundlagen der Sexualität und ihrer Probleme. DER NERVENARZT 2017; 88:451-458. [DOI: 10.1007/s00115-017-0300-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Jordan K, Wieser K, Methfessel I, Fromberger P, Dechent P, Müller JL. Sex attracts - neural correlates of sexual preference under cognitive demand. Brain Imaging Behav 2017; 12:109-126. [DOI: 10.1007/s11682-016-9669-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Kärgel C, Massau C, Weiß S, Walter M, Borchardt V, Krueger THC, Tenbergen G, Kneer J, Wittfoth M, Pohl A, Gerwinn H, Ponseti J, Amelung T, Beier KM, Mohnke S, Walter H, Schiffer B. Evidence for superior neurobiological and behavioral inhibitory control abilities in non-offending as compared to offending pedophiles. Hum Brain Mapp 2016; 38:1092-1104. [PMID: 27767244 DOI: 10.1002/hbm.23443] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 09/21/2016] [Accepted: 10/11/2016] [Indexed: 01/03/2023] Open
Abstract
Neurobehavioral models of pedophilia and child sexual offending suggest a pattern of temporal and in particular prefrontal disturbances leading to inappropriate behavioral control and subsequently an increased propensity to sexually offend against children. However, clear empirical evidence for such mechanisms is still missing. Using a go/nogo paradigm in combination with functional magnetic resonance imaging (fMRI) we compared behavioral performance and neural response patterns among three groups of men matched for age and IQ: pedophiles with (N = 40) and without (N = 37) a history of hands-on sexual offences against children as well as healthy non-offending controls (N = 40). As compared to offending pedophiles, non-offending pedophiles exhibited superior inhibitory control as reflected by significantly lower rate of commission errors. Group-by-condition interaction analysis also revealed inhibition-related activation in the left posterior cingulate and the left superior frontal cortex that distinguished between offending and non-offending pedophiles, while no significant differences were found between pedophiles and healthy controls. Both areas showing distinct activation pattern among pedophiles play a critical role in linking neural networks that relate to effective cognitive functioning. Data therefore suggest that heightened inhibition-related recruitment of these areas as well as decreased amount of commission errors is related to better inhibitory control in pedophiles who successfully avoid committing hands-on sexual offences against children. Hum Brain Mapp 38:1092-1104, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Christian Kärgel
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Alexandrinenstraße 1-3, Bochum, 44791, Germany.,Department of Psychiatry and Psychotherapy, Institute of Forensic Psychiatry, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, Essen, 45147, Germany
| | - Claudia Massau
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Alexandrinenstraße 1-3, Bochum, 44791, Germany.,Department of Psychiatry and Psychotherapy, Institute of Forensic Psychiatry, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, Essen, 45147, Germany
| | - Simone Weiß
- Department of Psychiatry and Psychotherapy, Institute of Forensic Psychiatry, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, Essen, 45147, Germany
| | - Martin Walter
- Department of Psychiatry, Otto v. Guericke University, Magdeburg, Leipziger Str. 44, Magdeburg, 39120, Germany.,Department for Behavioral Neurology, Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Leipziger Str. 44, Magdeburg, 39120, Germany.,Department of Psychiatry and Psychotherapy, University Tübingen, Osianderstr. 24, Tübingen, 72076, Germany
| | - Viola Borchardt
- Department for Behavioral Neurology, Clinical Affective Neuroimaging Laboratory, Leibniz Institute for Neurobiology, Leipziger Str. 44, Magdeburg, 39120, Germany
| | - Tillmann H C Krueger
- Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Carl-Neuberg Strasse 1, Hannover, 30625, Germany
| | - Gilian Tenbergen
- Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Carl-Neuberg Strasse 1, Hannover, 30625, Germany
| | - Jonas Kneer
- Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Carl-Neuberg Strasse 1, Hannover, 30625, Germany
| | - Matthias Wittfoth
- Department of Clinical Psychiatry, Social Psychiatry, and Psychotherapy, Hannover Medical School, Hannover, Carl-Neuberg Strasse 1, Hannover, 30625, Germany
| | - Alexander Pohl
- Department for Integrative Psychiatry Kiel, Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Christian-Albrechts Kiel University, Medical School, Kiel, Niemannsweg 147, Kiel, 24105, Germany
| | - Hannah Gerwinn
- Department for Integrative Psychiatry Kiel, Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Christian-Albrechts Kiel University, Medical School, Kiel, Niemannsweg 147, Kiel, 24105, Germany
| | - Jorge Ponseti
- Department for Integrative Psychiatry Kiel, Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Christian-Albrechts Kiel University, Medical School, Kiel, Niemannsweg 147, Kiel, 24105, Germany
| | - Till Amelung
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin (Charité), Luisenstr. 57, Berlin, 10117, Germany
| | - Klaus M Beier
- Department of Health and Human Sciences, Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin (Charité), Luisenstr. 57, Berlin, 10117, Germany
| | - Sebastian Mohnke
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, University Medicine Berlin (Charité), Charitéplatz 1, Berlin, 10117, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, University Medicine Berlin (Charité), Charitéplatz 1, Berlin, 10117, Germany
| | - Boris Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, LWL-University Hospital Bochum, Alexandrinenstraße 1-3, Bochum, 44791, Germany.,Department of Psychiatry and Psychotherapy, Institute of Forensic Psychiatry, LVR-University Hospital Essen, University of Duisburg-Essen, Virchowstr. 174, Essen, 45147, Germany
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Cyders MA, Dzemidzic M, Eiler WJ, Kareken DA. An fMRI Study of Responses to Sexual Stimuli as a Function of Gender and Sensation Seeking: A Preliminary Analysis. JOURNAL OF SEX RESEARCH 2016; 53:1020-1026. [PMID: 26813476 PMCID: PMC5050163 DOI: 10.1080/00224499.2015.1112340] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Although sexual cues produce stronger neural activation in men than in women, mechanisms underlying this differential response are unclear. We examined the relationship of sensation seeking and the brain's response to sexual stimuli across gender in 27 subjects (14 men, M = 25.2 years, SD = 3.6, 85.2% Caucasian) who underwent functional magnetic resonance imaging (fMRI) while viewing sexual and nonsexual images. Whole-brain corrected significant clusters of regional activation were extracted and associated with gender, sensation seeking, and sexual behaviors. Men responded more to sexual than nonsexual images in the anterior cingulate/medial prefrontal cortex (ACC/mPFC), anterior insula/lateral orbitofrontal cortex, bilateral amygdala, and occipital regions. Sensation seeking related positively to ACC/mPFC (r = 0.65, p = 0.01) and left amygdala (r = 0.66, p = 0.01) response in men alone, with both of these correlations being significantly larger in men than in women (ps < 0.03). The relationship between brain responses and self-reported high-risk and low-risk sexual behaviors showed interesting, albeit nonsignificant, gender-specific trends. These findings suggest the relationship between sexual responsivity, sensation seeking, and sexual behavior is gender specific. This study indicates a need to identify the gender-specific mechanisms that underlie sexual responsivity and behaviors. In addition, it demonstrates that the nature of stimuli used to induce positive mood in imaging and other studies should be carefully considered.
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Affiliation(s)
- Melissa A. Cyders
- Department of Psychology, Indiana University – Purdue University Indianapolis
| | - Mario Dzemidzic
- Department of Neurology, Indiana University School of Medicine
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