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Feng S, Dong L, Yan B, Zheng S, Feng Z, Li K, Jia H, Ning Y. Altered White Matter Structural Network Connectivity Associated with Cognitive Declines in Psychogenic Erectile Dysfunction. Neuroscience 2023; 529:54-61. [PMID: 37595940 DOI: 10.1016/j.neuroscience.2023.08.015] [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: 05/02/2023] [Revised: 07/17/2023] [Accepted: 08/09/2023] [Indexed: 08/20/2023]
Abstract
It has been reported that individuals with psychogenic erectile dysfunction (pED) potentially suffer from cognitive declines. Despite that increasing neuroimaging studies have demonstrated abnormalities of cerebral structural changes in pED, the association between altered white matter (WM) structural network and cognitive impairments remains unclear. Hence, this study aimed to explore the relationship between WM structural network connectivity and cognitive performance in patients with pED. Forty pED patients and 33 healthy controls (HCs) were recruited to perform cognitive assessments, and diffusion tensor imaging scans. We firstly constructed the WM structural network and applied the machine learning method to identify the important features. Then, we examined group differences in cognitive assessments, WM structural network connectivity within the identified features, and associations between altered WM structural network connectivity and cognitive scores in pED patients. From 26,896 features of DTI data, 24 important features were identified by K-Nearest Neighbor classification with a satisfactory accuracy (78%). Compared with HCs, we found that pED patients showed higher fractional anisotropy (FA) values between left transverse temporal sulcus and left supramarginal gyrus, and lower FA values between left suborbital sulcus and left para-hippocampal part of the medial occipito-temporal gyrus in pED patients. Furthermore, the increased FA between left transverse temporal sulcus and left supramarginal gyrus was observed to be negatively associated with impaired delayed memory. Overall, our findings provide new insights into WM network alterations associated with impaired cognitive functions in pED, which may unravel the potential neural mechanisms underlying the cognitive impairments of pED patients.
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Affiliation(s)
- Sitong Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 100088 Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069 Beijing, China
| | - Linrui Dong
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 100088 Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069 Beijing, China
| | - Bin Yan
- Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, 100091 Beijng, China
| | - Sisi Zheng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 100088 Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069 Beijing, China
| | - Zhengtian Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 100088 Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069 Beijing, China
| | - Kuangshi Li
- Dongzhimen Hospital, Beijing University of Chinese Medicine, 100700 Beijing, China.
| | - Hongxiao Jia
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 100088 Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069 Beijing, China.
| | - Yanzhe Ning
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, 100088 Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100069 Beijing, China.
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Feng S, Dong L, Yan B, Zheng S, Feng Z, Li X, Li J, Sun N, Ning Y, Jia H. Altered Functional Connectivity of Large-Scale Brain Networks in Psychogenic Erectile Dysfunction Associated with Cognitive Impairments. Neuropsychiatr Dis Treat 2023; 19:1925-1933. [PMID: 37693091 PMCID: PMC10492568 DOI: 10.2147/ndt.s426213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
Purpose Several studies have demonstrated that psychogenic erectile dysfunction (pED) patients potentially suffer from cognitive dysfunction. Despite that previous neuroimaging studies have reported abnormal functional connections of brain areas associated with cognitive function in pED, the underlying mechanisms of cognitive dysfunction in pED remain elusive. This study aims to investigate the underlying mechanisms of cognitive dysfunction by analyzing large-scale brain networks. Patients and Methods A total of 30 patients with pED and 30 matched healthy controls (HCs) were recruited in this study and scanned by resting-state functional magnetic resonance imaging. The Dosenbach Atlas was used to define large-scale networks across the brain. The resting-state functional connectivity (FC) within and between large-scale brain networks was calculated to compare pED patients with HCs. The relationship among cognitive performances and altered FC of large-scale brain networks was further explored in pED patients. Results Our results showed that the decreased FC within visual network, and between visual network and default mode network, visual network and frontoparietal network, and ventral attention and default mode network were found in pED patients. Furthermore, there was a positive correlation between immediate memory score and FC within visual network. The visuospatial score was negatively correlated with decreased FC between ventral attention network and default mode network. Conclusion Taken together, our findings revealed the relationship between cognitive impairments and altered FC between large-scale brain networks in pED patients, providing the new evidence about the neural mechanisms of cognitive dysfunction in pED patients.
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Affiliation(s)
- Sitong Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Linrui Dong
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Bin Yan
- Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Sisi Zheng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Zhengtian Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Xue Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Jiajia Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Ning Sun
- Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Yanzhe Ning
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
| | - Hongxiao Jia
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, People’s Republic of China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, People’s Republic of China
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3
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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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Franco I. Anatomy, physiology, and evaluation: Bowel, bladder, and sexual disorders. HANDBOOK OF CLINICAL NEUROLOGY 2023; 196:403-423. [PMID: 37620081 DOI: 10.1016/b978-0-323-98817-9.00009-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
Our present understanding of bowel and bladder control has changed dramatically with the introduction of functional imagining technologies such as PET, SPECT, fMRI scanning, and near-infrared spectroscopy of the brain. Urologists tend to see control of urination and defecation as processes that occurred at or below the level of the pons for the most part. In this chapter, we examine the control of storing and emptying of urine and stool from what will be a more neurocentric perspective, integrating the frontal lobes into the process and moving beyond the pons on which most of the literature has focused in the past. Utilizing this approach gives us a better understanding of why there is an overlapping of neuropsychiatric problems in many patients with voiding dysfunction.
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Affiliation(s)
- Israel Franco
- Yale School of Medicine, Yale-New Haven Children's Bladder and Continence Program, Yale New Haven Children's Hospital, New Haven, CT, United States.
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Chen J, Wang Q, Huang X, Xu Y, Xiang Z, Liu S, Yang J, Chen Y. Potential biomarkers for distinguishing primary from acquired premature ejaculation: A diffusion tensor imaging based network study. Front Neurosci 2022; 16:929567. [PMID: 36340794 PMCID: PMC9626512 DOI: 10.3389/fnins.2022.929567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/03/2022] [Indexed: 11/24/2022] Open
Abstract
Introduction Premature ejaculation (PE) is classified as primary and acquired and may be facilitated by different pathophysiology. Brain plays an important role in PE, however, differences in the central neuropathological mechanisms among subtypes of PE are unknown. Materials and methods We acquired diffusion tensor imaging (DTI) data from 44 healthy controls (HC) and 47 PE patients (24 primary PE and 23 acquired PE). Then, the whole-brain white matter (WM) structural networks were constructed and between-group differences of nodal segregative parameters were identified by the method of graph theoretical analysis. Moreover, receiver operating characteristic (ROC) curves were performed to determine the suitability of the altered parameters as potential neuroimaging biomarkers for distinguishing primary PE from acquired PE. Results PE patients showed significantly increased clustering coefficient C(i) in the left inferior frontal gyrus (triangular part) (IFGtriang.L) and increased local efficiency Eloc(i) in the left precental gyrus (PreCG.L) and IFGtriang.L when compared with HC. Compared to HC, primary PE patients had increased C(i) and Eloc(i) in IFGtriang.L and the left amygdala (AMYG.L) while acquired PE patients had increased C(i) and Eloc(i) in IFGtriang.L, and decreased C(i) and Eloc(i) in AMYG.L. Compared to acquired PE, primary PE patients had increased C(i) and Eloc(i) in AMYG.L. Moreover, ROC analysis revealed that PreCG.L, IFGtriang.L and AMYG.L might be helpful for distinguishing different subtypes of PE from HC (PE from HC: sensitivity, 61.70–78.72%; specificity, 56.82–77.27%; primary PE from HC: sensitivity, 66.67–87.50%; specificity, 52.27–77.27%; acquired PE from HC: sensitivity, 34.78–86.96%; specificity, 54.55–100%) while AMYG.L might be helpful for distinguishing primary PE from acquired PE (sensitivity, 83.33–91.70%; specificity, 69.57–73.90%). Conclusion These findings improved our understanding of the pathophysiological processes that occurred in patients with ejaculatory dysfunction and suggested that the abnormal segregation of left amygdala might serve as a useful marker to help clinicians distinguish patients with primary PE from those with acquired PE.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People’s Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, People’s Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture, Xinjiang, China
- Jie Yang,
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yun Chen,
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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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Xu Y, Zhang X, Xiang Z, Wang Q, Huang X, Liu T, Yang Z, Chen Y, Xue J, Chen J, Yang J. Abnormal Functional Connectivity Between the Left Medial Superior Frontal Gyrus and Amygdala Underlying Abnormal Emotion and Premature Ejaculation: A Resting State fMRI Study. Front Neurosci 2021; 15:704920. [PMID: 34421524 PMCID: PMC8375680 DOI: 10.3389/fnins.2021.704920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 06/28/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Premature ejaculation (PE) is a common sexual dysfunction and is found to be associated with abnormal emotion. The amygdala plays an important role in the processing of emotion. The process of ejaculation is found to be mediated by the frontal-limbic neural circuits. However, the correlations between PE and emotion are still unclear. Methods Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired in 27 PE patients with stable emotion (SPE), 27 PE patients with abnormal emotion (NPE), and 30 healthy controls (HC). We used rs-fMRI to explore the underlying neural mechanisms in SPE, NPE, and HC by measuring the functional connectivity (FC). Differences of FC values among the three groups were compared when choosing bilateral amygdala as the regions of interest (ROIs). We also explored the correlations between the brain regions showing altered FC values and scores of the premature ejaculation diagnostic tool (PEDT)/Eysenck Personality Inventory about neuroticism (EPQ-N) in the PE group. Results When the left amygdala was chosen as the ROI, the SPE group exhibited an increased FC between the left medial superior frontal gyrus (SFGmed) and amygdala compared with the NPE or HC group. When the right amygdala was chosen as the ROI, the NPE group exhibited a decreased FC between the left SFGmed and right amygdala compared with the HC group. In addition, FC values of the left SFGmed had positive correlations with PEDT and negative correlations with EPQ-N scores in the PE group. Moreover, FC values of the left superior temporal gyrus had positive correlations with EPQ-N scores in the PE group. Conclusion The increased FC values between the left SFGmed and amygdala could reflect a compensatory cortical control mechanism with the effect of stabilized emotion in the limbic regions of PE patients. Abnormal FC between these brain regions could play a critical role in the physiopathology of PE and could help us in dividing PE into more subtypes.
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Affiliation(s)
- Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing Zhang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,Department of Andrology, Yangzhou Traditional Chinese Medicine Hospital, Affiliated to Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Tao Liu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhaoxu Yang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianguo Xue
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Department of Urology, People's Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture, Ürümqi, China
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8
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The role of anterior and posterior insula in male genital response and in visual attention: an exploratory multimodal fMRI study. Sci Rep 2020; 10:18463. [PMID: 33116146 PMCID: PMC7595210 DOI: 10.1038/s41598-020-74681-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 09/21/2020] [Indexed: 12/27/2022] Open
Abstract
Several studies highlighted the role of insula on several functions and in sexual behavior. This exploratory study examines the relationships among genital responses, brain responses, and eye movements, to disentangle the role played by the anterior and posterior insula during different stages of male sexual response and during visual attention to sexual stimuli. In 19 healthy men, fMRI, eye movement, and penile tumescence data were collected during a visual sexual stimulation task. After a whole-brain analysis comparing neutral and sexual clips and confirming a role for the bilateral insulae, we selected two bilateral seed regions in anterior and posterior insula for functional connectivity analysis. Single-ROI-GLMs were run for the FC target regions. Single-ROI-GLMs were performed based on areas to which participants fixate: “Faces”, “Genitals,” and “Background” with the contrast “Genitals > Faces”. Single-ROI-GLMs with baseline, onset, and sustained PT response for the sexual clips were performed. We found stronger effects for the posterior than the anterior insula. In the target regions of the posterior insula, we found three different pathways: the first involved in visual attention, onset of erection, and sustained erection; the second involved only in the onset of erection, and the third limited to sustained erection.
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9
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Yin T, Liu Q, Ma Z, Li Z, Sun R, Ren F, Li G, Huang X, Chang D, Zhang P. Associations Between Altered Cerebral Activity Patterns and Psychosocial Disorders in Patients With Psychogenic Erectile Dysfunction: A Mediation Analysis of fMRI. Front Psychiatry 2020; 11:583619. [PMID: 33192729 PMCID: PMC7652753 DOI: 10.3389/fpsyt.2020.583619] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/09/2020] [Indexed: 12/24/2022] Open
Abstract
Previous studies had illustrated the significant neural pathological changes in patients with psychogenic erectile dysfunction (pED), while few works focused on the neural underpinning of the psychosocial status in patients with pED. This study aimed to investigate the associations among the altered cerebral activity patterns, impaired erectile function, and the disrupted psychosocial status in patients with pED. Thirty-two patients with pED and 28 healthy controls (HCs) were included. The amplitude of low-frequency fluctuations (ALFF), region-of-interest-based functional connectivity (FC), as well as Pearson correlation analyses and mediation analyses between neuroimaging outcomes and clinical outcomes were performed. Compared to HCs, patients with pED manifested lower erectile function, disrupted psychosocial status, as well as decreased ALFF in the left dorsolateral prefrontal cortex (dlPFC) and reduced FC between the left dlPFC and left angular gyrus, and left posterior cingulate cortex (PCC) and precuneus, which belonged to the default mode network (DMN). Moreover, both the ALFF of the left dlPFC and FC between the left dlPFC and left PCC and precuneus were significantly correlated with the sexual function and psychosocial status in patients with pED. The disrupted psychosocial status mediated the influence of atypical FC between dlPFC and DMN on decreased erectile function. This study widened our understanding of the important role of psychosocial disorders in pathological neural changes in patients with pED.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture-Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qi Liu
- Acupuncture and Tuina School, Shaanxi University of Chinese Medicine, Xian, China
| | - Ziyang Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Clinical Medical School, 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 Science 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 Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Feiqiang Ren
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangsen Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaopeng Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Degui Chang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihai Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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10
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Calabrò RS, Cacciola A, Bruschetta D, Milardi D, Quattrini F, Sciarrone F, la Rosa G, Bramanti P, Anastasi G. Neuroanatomy and function of human sexual behavior: A neglected or unknown issue? Brain Behav 2019; 9:e01389. [PMID: 31568703 PMCID: PMC6908863 DOI: 10.1002/brb3.1389] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/03/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Sexual desire, arousal, and orgasm are mediated by complex, yet still not fully understood, interactions of the somatic and autonomic nervous systems operating at the central and peripheral levels. Disruption of endocrine, neural, or vascular response, caused by aging, medical illness, neurological diseases, surgery, or drugs, can lead to sexual dysfunctions, thus significantly affecting patients' quality of life. PURPOSE This narrative review aims at characterizing the involvement of the central nervous system in human sexual behavior. METHODS A literature search was conducted using PubMed in its entirety up to June 2018, analyzing the studies dealing with the neurobiological and neurophysiological basis of human sexuality. RESULTS Sexual behavior is regulated by both subcortical structures, such as the hypothalamus, brainstem, and spinal cord, and several cortical brain areas acting as an orchestra to finely adjust this primitive, complex, and versatile behavior. At the central level, dopaminergic and serotonergic systems appear to play a significant role in various factors of sexual response, although adrenergic, cholinergic, and other neuropeptide transmitter systems may contribute as well. CONCLUSIONS Providing healthcare professionals with information concerning sexual behavior may overcome useless and sometimes dangerous barriers and improve patient management, since sexual well-being is considered one of the most important aspects of one's quality of life.
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Affiliation(s)
| | | | - Daniele Bruschetta
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | | | | | | | - Giuseppe Anastasi
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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11
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Ren F, Ma Z, Shen Y, Li G, You Y, Yu X, Li Z, Chang D, Zhang P. Effects of Chaihu-Shugan-San capsule for psychogenic erectile dysfunction: Study protocol of a randomized placebo-controlled trial. Medicine (Baltimore) 2019; 98:e17925. [PMID: 31725644 PMCID: PMC6867737 DOI: 10.1097/md.0000000000017925] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 10/15/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Erectile dysfunction (ED) affects many adult men worldwide. Many studies on the brain of psychogenic ED have shown significant cerebral functional changes and reduced volume of gray matter and white matter microstructural alterations in widespread brain regions. Chaihu-Shugan-San (CHSGS) capsule has been used to treat ED from the 20th century in China. However, clinical research of CHSGS capsule in the treatment of ED was lack. We design this study to evaluate the efficacy and safety of CHSGS capsule in the treatment of patients suffering from psychogenic ED. Furthermore, we also aim to provide a new evidence as well as an innovation of the clinical treatment in psychogenic ED. METHODS This study is designed as a multi-center, 3-arms, randomized trial. From the perspective of psychogenic ED, we will divide patients into 3 groups, which are placebo group, tadalafil group and CHSGS group. One hundred thirty-five patients will be randomly allocated to receive placebo, CHSGS capsule or tadalafil oral pharmacotherapy. After the period of 4-week treatment, the outcome of primary assessment changes in the brain MRI, IIEF-5, EHS, and QEQ total scores from baseline. Secondary assessments include the SEAR, HAMA-14, HAMD-17 scores, response rate of the patients and their partners. DISCUSSION We designed this study based on previous research about psychogenic erectile dysfunction (ED). This study will provide objective evidences to evaluate the effects of CHSGS capsule as an adjuvant treatment for psychogenic ED. TRIAL REGISTRATION NUMBER chictr.org.cn, ChiCTR-IOR-1800018301.
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Affiliation(s)
- Feiqiang Ren
- Hospital of Chengdu University of Traditional Chinese Medicine and Chengdu University of Traditional Chinese Medicine
| | - Ziyang Ma
- Hospital of Chengdu University of Traditional Chinese Medicine and Chengdu University of Traditional Chinese Medicine
| | - Yifeng Shen
- Hospital of Chengdu University of Traditional Chinese Medicine and Chengdu University of Traditional Chinese Medicine
| | - Guangsen Li
- The Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine
| | - Yaodong You
- The Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine
| | - Xujun Yu
- The Andrology Department, The School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine
| | - Zhengjie Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, PR China
| | - Degui Chang
- The Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine
| | - Peihai Zhang
- The Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine
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12
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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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13
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Xu Z, Yang X, Gao M, Liu L, Sun J, Liu P, Qin W. Abnormal Resting-State Functional Connectivity in the Whole Brain in Lifelong Premature Ejaculation Patients Based on Machine Learning Approach. Front Neurosci 2019; 13:448. [PMID: 31139043 PMCID: PMC6519512 DOI: 10.3389/fnins.2019.00448] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 04/18/2019] [Indexed: 11/30/2022] Open
Abstract
Recent neuroimaging studies have indicated that abnormalities in brain structure and function may play an important role in the etiology of lifelong premature ejaculation (LPE). LPE patients have exhibited aberrant cortical structure, altered brain network function and abnormal brain activation in response to erotic pictures. However, it remains unclear whether resting-state whole brain functional connectivity (FC) is altered in LPE patients. Machine learning analysis has the advantage of screening the best classification features from high-throughput data (such as FC), which has the potential to identify the pathophysiological targets of disease by establishing classification indicators for patients and healthy controls (HCs). Therefore, the supported vector machine based classification model using FC as features was used in the present study to confirm the most specific FCs that distinguish LPE patients from healthy controls. After feature selection, the remained features were used to build the classification model, with an accuracy 0.85 ± 0.14, sensitivity of 0.92 ± 0.18, specificity of 0.72 ± 0.30, and recall index of 0.85 ± 0.17 across 1000 testing groups (100 times 10-folds cross validation). After that, two-sample t-tests with family-wise error correction were used to compare these features that occur more than 500 times during training steps between LPE patients and HCs. Four FCs, (1) between left medial part of orbital frontal cortex (mOFC) and right mOFC, (2) between the left rectus and right postcentral gyrus, (3) between the right insula and left pallidum, and (4) between the right middle part of temporal pole and right inferior part of temporal gyrus showed significant group difference. These results demonstrate that resting-state brain FC might be a discriminating feature to distinguish LPE patients from HCs. These classification features, especially the FC between bilateral mOFC, provide underlying abnormal central functional targets in LPE etiology, which offers a novel alternative target for future intervention in LPE treatment.
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Affiliation(s)
- Ziliang Xu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Xuejuan Yang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Ming Gao
- Assisted Reproduction Center, Northwest Women's and Children's Hospital, Xi'an, China.,Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.,Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Lin Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Jinbo Sun
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Peng Liu
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Wei Qin
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
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14
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Zou Z, Lin H, Zhang Y, Wang R. The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review. Sex Med Rev 2019; 7:442-454. [PMID: 30612976 DOI: 10.1016/j.sxmr.2018.10.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 10/21/2018] [Accepted: 10/21/2018] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Nocturnal penile tumescence and rigidity (NPTR) monitoring with RigiScan was considered one of the most reliable methods to differentiate psychogenic erectile dysfunction (pED) from organic ED. However, its reliability has been questioned because of some limitations in the practice. AIM To present contemporary views on the role of NPTR monitoring in the diagnosis of pED. METHOD We performed a comprehensive review of English-language literature on NPTR and pED by a PubMed search. MAIN OUTCOME MEASURES Studies were included if the mechanisms of pED and nocturnal erection and the practice of NPTR monitoring in ED were the main research contents. RESULTS The pED results from not only psychosocial factors but also physiological changes containing central nervous abnormality. NPTR monitoring with RigiScan is still considered a useful method for the diagnosis of pED. A normal NPTR recording in a man with ED complaints probably suggests pED, whereas an abnormal recording may represent organic ED. Radial rigidity of no more than 60% is correlated well with axial rigidity, but, when it is more than 60%, the correlation between them is questioned. The consistency between NPTR and sex-stimulated erection is questionable, and the correlation of NPTR with different patient-reported outcome scoring systems is different. A normal NPTR recording in patients with ED does not necessarily mean pED, especially in patients with spinal cord injury. NPTR recordings can be influenced by depression, smoking, aging, negative dream content, and sleep disorders. CONCLUSION NPTR monitoring with the RigiScan is still considered a useful diagnostic tool for pED at the present stage. However, there are some disputes regarding the correlation between penile radial rigidity and axial rigidity and between NPTR and sex-related erection, as well as normative evaluation criteria for ED and the possibility of a false NPTR result, that need to be further studied. Zou Z, Lin H, Zhang Y, et al. The Role of Nocturnal Penile Tumescence and Rigidity (NPTR) Monitoring in the Diagnosis of Psychogenic Erectile Dysfunction: A Review. Sex Med Rev 2019;7:442-454.
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Affiliation(s)
- Zijun Zou
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Haocheng Lin
- Department of Urology, Peking University Third Hospital, Beijing, China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Run Wang
- Division of Urology, Department of Surgery, University of Texas McGovern Medical School at Houston, Houston, Texas, USA; University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
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15
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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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16
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Abnormal White Matter Microstructure in Lifelong Premature Ejaculation Patients Identified by Tract–Based Spatial Statistical Analysis. J Sex Med 2018; 15:1272-1279. [DOI: 10.1016/j.jsxm.2018.07.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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17
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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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18
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Chen J, Chen Y, Gao Q, Chen G, Dai Y, Yao Z, Lu Q. Brain structural network topological alterations of the left prefrontal and limbic cortex in psychogenic erectile dysfunction. Int J Neurosci 2017; 128:393-403. [PMID: 28969487 DOI: 10.1080/00207454.2017.1387116] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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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19
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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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20
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Wang Y, Dong M, Guan M, Wu J, He Z, Zou Z, Chen X, Shi D, Liang J, Zhang X. Aberrant Insula-Centered Functional Connectivity in Psychogenic Erectile Dysfunction Patients: A Resting-State fMRI Study. Front Hum Neurosci 2017; 11:221. [PMID: 28559803 PMCID: PMC5433384 DOI: 10.3389/fnhum.2017.00221] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 04/18/2017] [Indexed: 11/23/2022] Open
Abstract
Most previous studies exploring the neural mechanism of psychogenic erectile dysfunction (pED) focused on brain activity under tasks. We suggest that the resting brain activity is equally important in pED studies, in that the patterns of spontaneous neural activities is independent of modalities of sensory input, therefore providing substantial information regarding the central mechanism of pED. Our previous study reported the altered baseline activity in right anterior insula (aINS) in pED patients. Also, the insula is a pivotal region in sexual behavior, which is suggested to be able to directly mediate erection. Therefore, the current study employed resting-state fMRI to examine alterations in functional connectivity (FC) of the aINS comparing pED patients with matched control subjects. After rigorous participant inclusion procedure, 27 pED patients and 27 healthy male controls were enrolled. Our results elucidated the disrupted homogeneity within the right aINS and aberrant connection patterns between the right aINS and the right dorsolateral prefrontal cortex (dlPFC), as well as the right aINS and the right temporoparietal junction (TPJ) respectively in pED group, as compared with the healthy controls. In conclusion, our results demonstrated the aberrant insula-centered FC in pED, which may be related to the abnormal representation of internal bodily state or needs in pED patients and thus further affect the inhibitory control in the sexual context. We hope that these findings may shed new light on the understanding of the central mechanism of pED.
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Affiliation(s)
- Yue Wang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian UniversityXi'an, China
| | - Minghao Dong
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian UniversityXi'an, China.,Henan Andrological Academician Workstation of Basic and Clinical Research, Henan Provincial People's HospitalZhengzhou, China
| | - Min Guan
- Henan Andrological Academician Workstation of Basic and Clinical Research, Henan Provincial People's HospitalZhengzhou, China.,Department of Interventional Radiology, Henan Provincial People's HospitalZhengzhou, China
| | - Jia Wu
- School of Foreign Languages, Northwestern Polytechnical UniversityXi'an, China
| | - Zhen He
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian UniversityXi'an, China
| | - Zhi Zou
- Department of Radiology, Henan Provincial People's HospitalZhengzhou, China
| | - Xin Chen
- Henan Andrological Academician Workstation of Basic and Clinical Research, Henan Provincial People's HospitalZhengzhou, China.,Department of Uro-Andrology, Henan Provincial People's HospitalZhengzhou, China
| | - Dapeng Shi
- Department of Radiology, Henan Provincial People's HospitalZhengzhou, China
| | - Jimin Liang
- Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian UniversityXi'an, China
| | - Xiangsheng Zhang
- Henan Andrological Academician Workstation of Basic and Clinical Research, Henan Provincial People's HospitalZhengzhou, China.,Department of Uro-Andrology, Henan Provincial People's HospitalZhengzhou, China
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Xu J, Zhang J, Zhang J, Wang Y, Zhang Y, Wang J, Li G, Hu Q, Zhang Y. Abnormalities in Structural Covariance of Cortical Gyrification in Parkinson's Disease. Front Neuroanat 2017; 11:12. [PMID: 28326021 PMCID: PMC5339339 DOI: 10.3389/fnana.2017.00012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 02/17/2017] [Indexed: 01/21/2023] Open
Abstract
Although abnormal cortical morphology and connectivity between brain regions (structural covariance) have been reported in Parkinson's disease (PD), the topological organizations of large-scale structural brain networks are still poorly understood. In this study, we investigated large-scale structural brain networks in a sample of 37 PD patients and 34 healthy controls (HC) by assessing the structural covariance of cortical gyrification with local gyrification index (lGI). We demonstrated prominent small-world properties of the structural brain networks for both groups. Compared with the HC group, PD patients showed significantly increased integrated characteristic path length and integrated clustering coefficient, as well as decreased integrated global efficiency in structural brain networks. Distinct distributions of hub regions were identified between the two groups, showing more hub regions in the frontal cortex in PD patients. Moreover, the modular analyses revealed significantly decreased integrated regional efficiency in lateral Fronto-Insula-Temporal module, and increased integrated regional efficiency in Parieto-Temporal module in the PD group as compared to the HC group. In summary, our study demonstrated altered topological properties of structural networks at a global, regional and modular level in PD patients. These findings suggests that the structural networks of PD patients have a suboptimal topological organization, resulting in less effective integration of information between brain regions.
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Affiliation(s)
- Jinping Xu
- Key Laboratory for Neuroinformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengdu, China; Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen, China
| | - Jiuquan Zhang
- Department of Radiology, Southwest Hospital, Third Military Medical University Chongqing, China
| | - Jinlei Zhang
- Key Laboratory for Neuroinformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China Chengdu, China
| | - Yue Wang
- Key Laboratory for Neuroinformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China Chengdu, China
| | - Yanling Zhang
- Department of Neurology, Southwest Hospital, Third Military Medical University Chongqing, China
| | - Jian Wang
- Department of Radiology, Southwest Hospital, Third Military Medical University Chongqing, China
| | - Guanglin Li
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen, China; Key Laboratory of Human-Machine Intelligence Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen, China
| | - Qingmao Hu
- Institute of Biomedical and Health Engineering, Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen, China; Key Laboratory of Human-Machine Intelligence Synergy Systems, Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen, China
| | - Yuanchao Zhang
- Key Laboratory for Neuroinformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of ChinaChengdu, China; Center for Information in Medicine, University of Electronic Science and Technology of ChinaChengdu, China
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Zhao L, Guan M, Zhu X, Karama S, Khundrakpam B, Wang M, Dong M, Qin W, Tian J, Evans AC, Shi D. Aberrant Topological Patterns of Structural Cortical Networks in Psychogenic Erectile Dysfunction. Front Hum Neurosci 2015; 9:675. [PMID: 26733849 PMCID: PMC4683194 DOI: 10.3389/fnhum.2015.00675] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Accepted: 11/30/2015] [Indexed: 12/17/2022] Open
Abstract
Male sexual arousal (SA) has been known as a multidimensional experience involving closely interrelated and coordinated neurobehavioral components that rely on widespread brain regions. Recent functional neuroimaging studies have shown relation between abnormal/altered dynamics in these circuits and male sexual dysfunction. However, alterations in the topological organization of structural brain networks in male sexual dysfunction are still unclear. Here, we used graph theory to investigate the topological properties of large-scale structural brain networks, which were constructed using inter-regional correlations of cortical thickness between 78 cortical regions in 40 patients with psychogenic erectile dysfunction (pED) and 39 normal controls. Compared with normal controls, pED patients exhibited a less optimal global topological organization with reduced global and increased local efficiencies. Our results suggest disrupted neural integration among distant brain regions in pED patients, consistent with previous reports of impaired white matter structure and abnormal functional integrity in pED. Additionally, disrupted global network topology in pED was observed to be primarily relevant to altered subnetwork and nodal properties within the networks mediating the cognitive, motivational and inhibitory processes of male SA, possibly indicating disrupted integration of these networks in the whole brain networks and might account for pED patients' abnormal cognitive, motivational and inhibitory processes for male SA. In total, our findings provide evidence for disrupted integrity in large-scale brain networks underlying the neurobehavioral processes of male SA in pED and provide new insights into the understanding of the pathophysiological mechanisms of pED.
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Affiliation(s)
- Lu Zhao
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Min Guan
- Department of Radiology, Henan Provincial People's Hospital Zhengzhou, China
| | - Xiaobo Zhu
- Department of Urology, Henan Provincial People's Hospital Zhengzhou, China
| | - Sherif Karama
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill UniversityMontreal, QC, Canada; Douglas Mental Health University Institute, McGill UniversityMontreal, QC, Canada
| | - Budhachandra Khundrakpam
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Meiyun Wang
- Department of Radiology, Henan Provincial People's Hospital Zhengzhou, China
| | - Minghao Dong
- School of Life Science and Technology, Xi'Dian University Xi'an, China
| | - Wei Qin
- School of Life Science and Technology, Xi'Dian University Xi'an, China
| | - Jie Tian
- School of Life Science and Technology, Xi'Dian UniversityXi'an, China; Institute of Automation, Chinese Academy of SciencesBeijing, China
| | - Alan C Evans
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University Montreal, QC, Canada
| | - Dapeng Shi
- Department of Radiology, Henan Provincial People's Hospital Zhengzhou, China
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