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Pinto J, Comprido C, Moreira V, Maccarone MT, Cogoni C, Faustino R, Pignatelli D, Cera N. The Complex Role Played by the Default Mode Network during Sexual Stimulation: A Cluster-Based fMRI Meta-Analysis. Behav Sci (Basel) 2024; 14:570. [PMID: 39062393 PMCID: PMC11273531 DOI: 10.3390/bs14070570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/14/2024] [Accepted: 07/02/2024] [Indexed: 07/28/2024] Open
Abstract
The default mode network (DMN) is a complex network that plays a significant and active role during naturalistic stimulation. Previous studies that have used naturalistic stimuli, such as real-life stories or silent or sonorous films, have found that the information processing involved a complex hierarchical set of brain regions, including the DMN nodes. The DMN is not involved in low-level features and is only associated with high-level content-related incoming information. The human sexual experience involves a complex set of processes related to both external context and inner processes. Since the DMN plays an active role in the integration of naturalistic stimuli and aesthetic perception with beliefs, thoughts, and episodic autobiographical memories, we aimed at quantifying the involvement of the nodes of the DMN during visual sexual stimulation. After a systematic search in the principal electronic databases, we selected 83 fMRI studies, and an ALE meta-analysis was calculated. We performed conjunction analyses to assess differences in the DMN related to stimulus modalities, sex differences, and sexual orientation. The results show that sexual stimulation alters the topography of the DMN and highlights the DMN's active role in the integration of sexual stimuli with sexual schemas and beliefs.
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Affiliation(s)
- Joana Pinto
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
| | - Camila Comprido
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
| | - Vanessa Moreira
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
| | | | - Carlotta Cogoni
- Instituto de Biofísica e Engenharia Biomédica, Faculty of Sciences, University of Lisbon, 1749-016 Lisbon, Portugal;
| | - Ricardo Faustino
- Research Unit in Medical Imaging and Radiotherapy, Cross I&D Lisbon Research Center, Escola Superior de Saúde da Cruz Vermelha Portuguesa, 1300-125 Lisbon, Portugal;
| | - Duarte Pignatelli
- Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
- Department of Endocrinology, Centro Hospitalar Universitário de São João, 4200-319 Porto, Portugal
| | - Nicoletta Cera
- Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal (C.C.)
- Research Unit in Medical Imaging and Radiotherapy, Cross I&D Lisbon Research Center, Escola Superior de Saúde da Cruz Vermelha Portuguesa, 1300-125 Lisbon, Portugal;
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Chen J, Huang X, Tang Q, Xiang Z, Xu Y, Liu T, Yang Z, Yang J, Chen Y. Altered Regional Homogeneity in Patients With Diabetic Erectile Dysfunction: A Resting-State fMRI Study. Front Endocrinol (Lausanne) 2022; 13:817523. [PMID: 35937825 PMCID: PMC9355575 DOI: 10.3389/fendo.2022.817523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 06/09/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is a common complication of Type-2 Diabetes Mellitus (T2DM) for male patients and it is considered to be associated with different causes including hyperglicemia-induced vascular endothelial cell damages. However, the possible central neural mechanisms shared by these two diseases remain unclear. This study aimed to explore the changes of brain activity and their relationships with the clinical characteristics in patients with diabetic ED. METHODS The data of resting-state functional magnetic resonance imaging were acquired in 31 T2DM patients with ED (DM-ED) and 31 matched healthy controls (HCs). The whole-brain regional homogeneity (ReHo) values were calculated and compared between groups. In addition, Pearson correlation analysis was performed to evaluate the relationships between brain regions with altered ReHo values and clinical characteristics in the patient group. RESULTS The DM-ED group exhibited increased ReHo values in the right middle frontal gyrus (orbital part) and decreased ReHo values in the left superior frontal gyrus (dorsolateral), paracentral lobule, precuneus and bilateral supplementary motor area when compared with the HCs group. Moreover, significantly negative correlations were found between ReHo values of the left superior frontal gyrus (dorsolateral) and IIEF-5 scores, as well as the level of HbA1c in the DM-ED group. CONCLUSION The altered spontaneous brain activity in cognitive-related regions revealed by ReHo values might provide new insights into the neurological pathophysiology underlying DM-ED and serve as potential neuroimaging biomarkers for detecting and evaluating ED in diabetes patients.
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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
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qinglai Tang
- Department of Urology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Xu
- 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
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People’s Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, People’s Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture Artux, Xinjiang, China
- *Correspondence: Yun Chen, ; Jie Yang,
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yun Chen, ; Jie Yang,
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Stridh A, Pontén M, Arver S, Kirsch I, Abé C, Jensen KB. Placebo Responses Among Men With Erectile Dysfunction Enrolled in Phosphodiesterase 5 Inhibitor Trials: A Systematic Review and Meta-analysis. JAMA Netw Open 2020; 3:e201423. [PMID: 32196105 PMCID: PMC7084170 DOI: 10.1001/jamanetworkopen.2020.1423] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
IMPORTANCE Placebo responses in the treatment of erectile dysfunction (ED) are poorly described in the literature to date. OBJECTIVE To quantify the association of placebo with ED outcomes among men enrolled in placebo-controlled, phosphodiesterase 5 inhibitor (PDE5I) trials. DATA SOURCES For this systematic review and meta-analysis, a database search was conducted to identify double-blind, placebo-controlled studies using PDE5Is for the treatment of ED published from January 1, 1998, to December 31, 2018, within MEDLINE, Embase, Cochrane Library, and Web of Science. Only articles published in the English language were included. STUDY SELECTION Double-blind, placebo-controlled randomized clinical trials of PDE5Is for ED were included. Studies were excluded if they did not provide distribution measures for statistical analysis. Study selection review assessments were conducted by 2 independent investigators. A total of 2215 studies were identified from the database search, and after review, 63 studies that included 12 564 men were analyzed. DATA EXTRACTION AND SYNTHESIS Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed in abstracting data and assessing validity. Data were extracted from published reports by 2 independent reviewers. Quality assessment was performed using the Jadad scale. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES The main outcome was improvement in the erectile function domain of the International Index of Erectile Function questionnaire in the placebo arm of the included studies. Effect size was reported as bias-corrected standardized mean difference (Hedges g). The hypothesis was formulated before data extraction. RESULTS A total of 63 studies that included 12 564 men (mean [SD] age, 55 [7] years; age range, 36-68 years) were included. Erectile function was significantly improved among participants in the placebo arm, with a small to moderate effect size (Hedges g [SE], 0.35 [0.03]; P < .001). Placebo effect size was larger among participants with ED associated with posttraumatic stress disorder (Hedges g [SE], 0.78 [0.32]; P = .02) compared with the overall analysis. No significant difference was found between placebo and PDE5Is for ED after prostate surgery or radiotherapy (Hedges g [SE], 0.30 [0.17]; P = .08). CONCLUSIONS AND RELEVANCE In this study, placebo was associated with improvement of ED, especially among men with ED-related posttraumatic stress disorder. No difference was found between placebo and PDE5I among men treated for ED after prostate surgery.
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Affiliation(s)
- Alexander Stridh
- Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Moa Pontén
- Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Stefan Arver
- Department of Medicine, Karolinska Institute, Solna, Sweden
| | - Irving Kirsch
- Program in Placebo Studies, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
| | - Christoph Abé
- Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
| | - Karin B. Jensen
- Department of Clinical Neuroscience, Karolinska Institute, Solna, Sweden
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Auffret M, Drapier S, Vérin M. New tricks for an old dog: A repurposing approach of apomorphine. Eur J Pharmacol 2018; 843:66-79. [PMID: 30395851 DOI: 10.1016/j.ejphar.2018.10.052] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/29/2018] [Accepted: 10/31/2018] [Indexed: 02/07/2023]
Abstract
Apomorphine is a 150-year old nonspecific dopaminergic agonist, currently indicated for treating motor fluctuations in Parkinson's disease. At the era of drug repurposing, its pleiotropic biological functions suggest other possible uses. To further explore new therapeutic and diagnostic applications, the available literature up to July 2018 was reviewed using the PubMed and Google Scholar databases. As many of the retrieved articles consisted of case reports and preclinical studies, we adopted a descriptive approach, tackling each area of research in turn, to give a broad overview of the potential of apomorphine. Apomorphine may play a role in neurological diseases like restless legs syndrome, Huntington's chorea, amyotrophic lateral sclerosis, Alzheimer's disease and disorders of consciousness, but also in sexual disorders, neuroleptic malignant(-like) syndrome and cancer. Further work is needed in both basic and clinical research; current developments in novel delivery strategies and apomorphine derivatives are expected to open the way.
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Affiliation(s)
- Manon Auffret
- Behavior and Basal Ganglia Research Unit (EA 4712), University of Rennes 1, Rennes, France; Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France.
| | - Sophie Drapier
- Behavior and Basal Ganglia Research Unit (EA 4712), University of Rennes 1, Rennes, France; Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France; Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, Rennes, France
| | - Marc Vérin
- Behavior and Basal Ganglia Research Unit (EA 4712), University of Rennes 1, Rennes, France; Institut des Neurosciences Cliniques de Rennes (INCR), Rennes, France; Movement Disorders Unit, Neurology Department, Pontchaillou University Hospital, Rennes, France
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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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Zhu Q, Wang J, Fan H, Ma G, Zhang B, Shen C, Wang W. Blink reflex under external emotional-stimuli in bipolar I and II disorders. Psychiatry Res 2018; 259:520-525. [PMID: 29156424 DOI: 10.1016/j.psychres.2017.11.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Revised: 11/02/2017] [Accepted: 11/04/2017] [Indexed: 11/17/2022]
Abstract
Bipolar disorder types I (BD I) and II (BD II) might present different cortico-brainstem circuit dysfunctions under external emotions, which might be reflected by the blink reflex. We therefore invited 32 BD I and 23 BD II patients, and 46 healthy volunteers to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik - van Praag Depression inventory, and to undergo the blink reflex test under external emotions (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness. Compared to healthy controls, BD I showed prolonged R2/R2' latencies under most emotions, and their PVP scores were negatively correlated with the areas under curve (AUCs) of R2 and R2' under Erotica; and BD II showed reduced R2/R2' AUCs under all emotions. Moreover, R2' AUCs under Disgust, Fear, and Happiness were significantly reduced in BD II than those in BD I. Our results have shown that, irrespective of patients' on-going affective states, the R2/R2' components were delayed in BD I but suppressed in BD II under most external emotions. Our study provides some hints to distinguish the two types of bipolar disorder, referring to the cortico-brainstem circuit dysfunctions under external emotions.
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Affiliation(s)
- Qisha Zhu
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Jiawei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Hongying Fan
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Guorong Ma
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Bingren Zhang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Chanchan Shen
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/School of Public Health, Zhejiang University College of Medicine, Hangzhou, China.
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Bertol E, Fineschi V, Karch SB, Mari F, Riezzo I. Nymphaea Cults in Ancient Egypt and the New World: A Lesson in Empirical Pharmacology. J R Soc Med 2017; 97:84-5. [PMID: 14749409 PMCID: PMC1079300 DOI: 10.1177/014107680409700214] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Elisabetta Bertol
- Department of Forensic Toxicology, University of Florence, Florence, Italy
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Zhu Q, Wang J, Shen C, Fan H, Zhang B, Ma G, Lu Y, Wang W. Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders. BMC Psychiatry 2017; 17:224. [PMID: 28629452 PMCID: PMC5477268 DOI: 10.1186/s12888-017-1390-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Bipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and brainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under different stimuli of external emotions. METHODS This study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression inventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness. RESULTS The scale scores were elevated in both patient groups, but were not correlated with ES2 parameters. Compared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness and sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged ES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness. Moreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I. CONCLUSIONS The cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was independent of the patient's ongoing emotions. Our study thus provides some hints to distinguish the two types of bipolar disorders.
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Affiliation(s)
- Qisha Zhu
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Jiawei Wang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Chanchan Shen
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Hongying Fan
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Bingren Zhang
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Guorong Ma
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Yanxia Lu
- 0000 0000 8744 8924grid.268505.cDepartment of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang 310058 China
| | - Wei Wang
- Department of Clinical Psychology and Psychiatry/ School of Public Health, Zhejiang University College of Medicine, Yuhangtang Road 866, Hangzhou, Zhejiang, 310058, China.
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Abstract
Delayed ejaculation (DE) is an uncommon and a challenging disorder to treat. It is often quite concerning to patients and it can affect psychosocial well-being. Here we reviewed how DE is treated pharmacologically .We also highlighted specific settings where drugs could be introduced to medical practice. Electronic databases were searched from 1966 to February 2016, including PubMed MEDLINE, EMBASE, EBCSO Academic Search Complete, Cochrane Systematic Reviews Database, and Google Scholar using key words; delayed ejaculation, retarded ejaculation, inhibited ejaculation, drugs, treatment, or pharmacology. To achieve the maximum sensitivity of the search strategy and to identify all studies, we combined “delayed ejaculation” as Medical Subject Headings (MeSH) terms or keywords with each of “testosterone” or “cabergoline” or “bupropion” or “amantadine” or “cyproheptadine” or “midodrine” or “imipramine” or “ephedrine” or “pseudoephedrine” or “yohimbine” or “buspirone” or “oxytocin” or “bethanechol” as MeSH terms or keywords. There are a number of drugs to treat patients with DE including: testosterone, cabergoline, bupropion, amantadine, cyproheptadine, midodrine, imipramine, ephedrine, pseudoephedrine, yohimbine, buspirone, oxytocin, and bethanechol. Although there are many pharmacological treatment options, the evidence is still limited to small trials, case series or case reports. Review of literature showed that evidence level 1 (Double blind randomized clinical trial) studies were performed with testosterone, oxytocin, buspirone or bethanechol treatment. It is concluded that successful drug treatment of DE is still in its infancy. The clinicians need to be aware of the pathogenesis of DE and the pharmacological basis underlying the use of different drugs to extend better care for these patients. Various drugs are available to address such problem, however their evidence of efficacy is still limited and their choice needs to be individualized to each specific case.
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Affiliation(s)
| | | | - Taymour Mostafa
- Department of Andrology & Sexology, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
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Prause N, Pfaus J. Viewing Sexual Stimuli Associated with Greater Sexual Responsiveness, Not Erectile Dysfunction. Sex Med 2015; 3:90-8. [PMID: 26185674 PMCID: PMC4498826 DOI: 10.1002/sm2.58] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Introduction Time spent viewing visual sexual stimuli (VSS) has the potential to habituate the sexual response and generalize to the partner context. Aim The aim of this study was to examine whether the time spent viewing VSS is related to sexual responsiveness felt in the laboratory or with a sexual partner. Methods Nontreatment-seeking men (N = 280) reported their weekly average VSS viewing in hours. VSS hours were examined in relation to the sexual arousal experienced while viewing a standardized sexual film in the laboratory and erectile problems experienced with a sexual partner. Main Outcome Measures Self-reported sexual arousal in response to sexual films and erectile problems on the International Index of Erectile Function were the main outcome measures. Results More hours viewing VSS was related to stronger experienced sexual responses to VSS in the laboratory, was unrelated to erectile functioning with a partner, and was related to stronger desire for sex with a partner. Conclusions VSS use within the range of hours tested is unlikely to negatively impact sexual functioning, given that responses actually were stronger in those who viewed more VSS.
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Affiliation(s)
- Nicole Prause
- Department of Psychiatry, University of California Los Angeles, CA, USA
| | - James Pfaus
- Department of Psychology, Concordia University Montreal, QC, Canada
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Cerebral Activity Changes in Different Traditional Chinese Medicine Patterns of Psychogenic Erectile Dysfunction Patients. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:503536. [PMID: 26180534 PMCID: PMC4477190 DOI: 10.1155/2015/503536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2014] [Revised: 01/03/2015] [Accepted: 01/16/2015] [Indexed: 02/05/2023]
Abstract
Background. Pattern differentiation is the foundation of traditional Chinese medicine (TCM) treatment for erectile dysfunction (ED). This study aims to investigate the differences in cerebral activity in ED patients with different TCM patterns. Methods. 27 psychogenic ED patients and 27 healthy subjects (HS) were enrolled in this study. Each participant underwent an fMRI scan in resting state. The fractional amplitude of low-frequency fluctuation (fALFF) was used to detect the brain activity changes in ED patients with different patterns. Results. Compared to HS, ED patients showed an increased cerebral activity in bilateral cerebellum, insula, globus pallidus, parahippocampal gyrus, orbitofrontal cortex (OFC), and middle cingulate cortex (MCC). Compared to the patients with liver-qi stagnation and spleen deficiency pattern (LSSDP), the patients with kidney-yang deficiency pattern (KDP) showed an increased activity in bilateral brainstem, cerebellum, hippocampus, and the right insula, thalamus, MCC, and a decreased activity in bilateral putamen, medial frontal gyrus, temporal pole, and the right caudate nucleus, OFC, anterior cingulate cortex, and posterior cingulate cortex (P < 0.005). Conclusions. The ED patients with different TCM patterns showed different brain activities. The differences in cerebral activity between LSSDP and KDP were mainly in the emotion-related regions, including prefrontal cortex and cingulated cortex.
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Cera N, Di Pierro ED, Ferretti A, Tartaro A, Romani GL, Perrucci MG. Brain networks during free viewing of complex erotic movie: new insights on psychogenic erectile dysfunction. PLoS One 2014; 9:e105336. [PMID: 25126947 PMCID: PMC4134311 DOI: 10.1371/journal.pone.0105336] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Accepted: 07/23/2014] [Indexed: 11/24/2022] Open
Abstract
Psychogenic erectile dysfunction (ED) is defined as a male sexual dysfunction characterized by a persistent or recurrent inability to attain adequate penile erection due predominantly or exclusively to psychological or interpersonal factors. Previous fMRI studies were based on the common occurrence in the male sexual behaviour represented by the sexual arousal and penile erection related to viewing of erotic movies. However, there is no experimental evidence of altered brain networks in psychogenic ED patients (EDp). Some studies showed that fMRI activity collected during non sexual movie viewing can be analyzed in a reliable manner with independent component analysis (ICA) and that the resulting brain networks are consistent with previous resting state neuroimaging studies. In the present study, we investigated the modification of the brain networks in EDp compared to healthy controls (HC), using whole-brain fMRI during free viewing of an erotic video clip. Sixteen EDp and nineteen HC were recruited after RigiScan evaluation, psychiatric, and general medical evaluations. The performed ICA showed that visual network (VN), default-mode network (DMN), fronto-parietal network (FPN) and salience network (SN) were spatially consistent across EDp and HC. However, between-group differences in functional connectivity were observed in the DMN and in the SN. In the DMN, EDp showed decreased connectivity values in the inferior parietal lobes, posterior cingulate cortex and medial prefrontal cortex, whereas in the SN decreased and increased connectivity was observed in the right insula and in the anterior cingulate cortex respectively. The decreased levels of intrinsic functional connectivity principally involved the subsystem of DMN relevant for the self relevant mental simulation that concerns remembering of past experiences, thinking to the future and conceiving the viewpoint of the other’s actions. Moreover, the between group differences in the SN nodes suggested a decreased recognition of autonomical and sexual arousal changes in EDp.
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Affiliation(s)
- Nicoletta Cera
- Department of Neuroscience, Imaging and Clinical Science, “G.d’Annunzio” University of Chieti, and ITAB–Institute for Advanced Biomedical Technologies, Chieti, Italy
- * E-mail:
| | - Ezio Domenico Di Pierro
- Division of Urology, “L’immacolata” Hospital of Celano, Celano, Italy
- Catholic University of the Sacred Heart, Rome, Italy
| | - Antonio Ferretti
- Department of Neuroscience, Imaging and Clinical Science, “G.d’Annunzio” University of Chieti, and ITAB–Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Armando Tartaro
- Department of Neuroscience, Imaging and Clinical Science, “G.d’Annunzio” University of Chieti, and ITAB–Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Gian Luca Romani
- Department of Neuroscience, Imaging and Clinical Science, “G.d’Annunzio” University of Chieti, and ITAB–Institute for Advanced Biomedical Technologies, Chieti, Italy
| | - Mauro Gianni Perrucci
- Department of Neuroscience, Imaging and Clinical Science, “G.d’Annunzio” University of Chieti, and ITAB–Institute for Advanced Biomedical Technologies, Chieti, Italy
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14
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Zhang P, Liu J, Li G, Pan J, Li Z, Liu Q, Qin W, Dong M, Sun J, Huang X, Wu T, Chang D. White matter microstructural changes in psychogenic erectile dysfunction patients. Andrology 2014; 2:379-85. [PMID: 24711250 DOI: 10.1111/j.2047-2927.2014.00191.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Revised: 01/01/2014] [Accepted: 01/13/2014] [Indexed: 11/26/2022]
Affiliation(s)
- P. Zhang
- The Urology and Andrology Department; The 1st Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
| | - J. Liu
- Life Sciences Research Center; School of Life Sciences and Technology; Xidian University; Xi'an Shaanxi China
| | - G. Li
- The Urology and Andrology Department; The 1st Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
| | - J. Pan
- The Urology and Andrology Department; Traditional Chinese Medicine Hospital of Meishan City; Meishan Sichuan China
| | - Z. Li
- The 3rd Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
| | - Q. Liu
- The 3rd Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
| | - W. Qin
- Life Sciences Research Center; School of Life Sciences and Technology; Xidian University; Xi'an Shaanxi China
| | - M. Dong
- Life Sciences Research Center; School of Life Sciences and Technology; Xidian University; Xi'an Shaanxi China
| | - J. Sun
- Life Sciences Research Center; School of Life Sciences and Technology; Xidian University; Xi'an Shaanxi China
| | - X. Huang
- The Urology and Andrology Department; The 1st Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
| | - T. Wu
- The Urology and Andrology Department; The 1st Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
| | - D. Chang
- The Urology and Andrology Department; The 1st Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
- The Andrology Department; The 2nd Teaching Hospital; Chengdu University of Traditional Chinese Medicine; Chengdu Sichuan China
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Poeppl TB, Langguth B, Laird AR, Eickhoff SB. The functional neuroanatomy of male psychosexual and physiosexual arousal: a quantitative meta-analysis. Hum Brain Mapp 2013; 35:1404-21. [PMID: 23674246 DOI: 10.1002/hbm.22262] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 11/28/2012] [Accepted: 01/03/2013] [Indexed: 01/14/2023] Open
Abstract
Reproductive behavior is mandatory for conservation of species and mediated by a state of sexual arousal (SA), involving both complex mental processes and bodily reactions. An early neurobehavioral model of SA proposes cognitive, emotional, motivational, and autonomic components. In a comprehensive quantitative meta-analysis on previous neuroimaging findings, we provide here evidence for distinct brain networks underlying psychosexual and physiosexual arousal. Psychosexual (i.e., mental sexual) arousal recruits brain areas crucial for cognitive evaluation, top-down modulation of attention and exteroceptive sensory processing, relevance detection and affective evaluation, as well as regions implicated in the representation of urges and in triggering autonomic processes. In contrast, physiosexual (i.e., physiological sexual) arousal is mediated by regions responsible for regulation and monitoring of initiated autonomic processes and emotions and for somatosensory processing. These circuits are interconnected by subcortical structures (putamen and claustrum) that provide exchange of sensorimotor information and crossmodal processing between and within the networks. Brain deactivations may imply attenuation of introspective processes and social cognition, but be necessary to release intrinsic inhibition of SA.
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Affiliation(s)
- Timm B Poeppl
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
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16
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Georgiadis JR, Kringelbach ML, Pfaus JG. Sex for fun: a synthesis of human and animal neurobiology. Nat Rev Urol 2012; 9:486-98. [PMID: 22926422 DOI: 10.1038/nrurol.2012.151] [Citation(s) in RCA: 124] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Sex is a fundamental pleasure, and crucial to the survival of our species. Though not many people would disagree with the proposition that sexual behaviour depends on the brain, the neuroscientific study of human sex is still relatively taboo and much remains to be discovered. On the contrary, excellent experimental animal models (mostly rat) are available that have uncovered major behavioural, neurochemical, and neuroanatomical characteristics of sexual behaviour. Restructuring sexual behaviour into broader terms reflecting behavioural states (wanting, liking, and inhibition) facilitates species comparison, revealing many similarities between animal and human sexual pleasure cycles, some of which can serve as potential avenues of new human sex research. In particular, behavioural and brain evidence clearly shows that motivational and consummatory phases are fundamentally distinct, and that genitally-induced sexual reward is a major factor in sexual learning mechanisms.
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Affiliation(s)
- Janniko R Georgiadis
- Department of Neuroscience (Section Anatomy), University Medical Centre Groningen, Antonius Deusinglaan 1, 9713AV, Groningen, The Netherlands.
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17
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Cera N, Delli Pizzi S, Di Pierro ED, Gambi F, Tartaro A, Vicentini C, Paradiso Galatioto G, Romani GL, Ferretti A. Macrostructural alterations of subcortical grey matter in psychogenic erectile dysfunction. PLoS One 2012; 7:e39118. [PMID: 22723943 PMCID: PMC3377616 DOI: 10.1371/journal.pone.0039118] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 05/16/2012] [Indexed: 11/19/2022] Open
Abstract
Psychogenic erectile dysfunction (ED) has been defined as the persistent inability to attain and maintain an erection sufficient to permit sexual performance. It shows a high incidence and prevalence among men, with a significant impact on the quality of life. Few neuroimaging studies have investigated the cerebral basis of erectile dysfunctions observing the role played by prefrontal, cingulate, and parietal cortices during erotic stimulation. In spite of the well-known involvement of subcortical regions such as hypothalamus and caudate nucleus in male sexual response, and the key role of nucleus accumbens in pleasure and reward, poor attention was paid to their role in male sexual dysfunction. In this study, we determined the presence of grey matter (GM) atrophy patterns in subcortical structures such as amygdala, hippocampus, nucleus accumbens, caudate nucleus, putamen, pallidum, thalamus, and hypothalamus in patients with psychogenic ED and healthy men. After Rigiscan evaluation, urological, general medical, metabolic and hormonal, psychological and psychiatric assessment, 17 outpatients with psychogenic ED and 25 healthy controls were recruited for structural MRI session. Significant GM atrophy of nucleus accumbens was observed bilaterally in patients with respect to controls. Shape analysis showed that this atrophy was located in the left medial-anterior and posterior portion of accumbens. Left nucleus accumbens volumes in patients correlated with low erectile functioning as measured by IIEF-5 (International Index of Erectile Function). In addition, a GM atrophy of left hypothalamus was also observed. Our results suggest that atrophy of nucleus accumbens plays an important role in psychogenic erectile dysfunction. We believe that this change can influence the motivation-related component of sexual behavior. Our findings help to elucidate a neural basis of psychogenic erectile dysfunction.
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Affiliation(s)
- Nicoletta Cera
- Department of Neuroscience and Imaging, Institute for Advanced Biomedical Technologies (ITAB), University G. d'Annunzio of Chieti, Chieti, Italy.
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18
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Georgiadis JR, Kringelbach ML. The human sexual response cycle: brain imaging evidence linking sex to other pleasures. Prog Neurobiol 2012; 98:49-81. [PMID: 22609047 DOI: 10.1016/j.pneurobio.2012.05.004] [Citation(s) in RCA: 190] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 04/21/2012] [Accepted: 05/08/2012] [Indexed: 12/30/2022]
Abstract
Sexual behavior is critical to species survival, yet comparatively little is known about the neural mechanisms in the human brain. Here we systematically review the existing human brain imaging literature on sexual behavior and show that the functional neuroanatomy of sexual behavior is comparable to that involved in processing other rewarding stimuli. Sexual behavior clearly follows the established principles and phases for wanting, liking and satiety involved in the pleasure cycle of other rewards. The studies have uncovered the brain networks involved in sexual wanting or motivation/anticipation, as well as sexual liking or arousal/consummation, while there is very little data on sexual satiety or post-orgasmic refractory period. Human sexual behavior also interacts with other pleasures, most notably social interaction and high arousal states. We discuss the changes in the underlying brain networks supporting sexual behavior in the context of the pleasure cycle, the changes to this cycle over the individual's life-time and the interactions between them. Overall, it is clear from the data that the functional neuroanatomy of sex is very similar to that of other pleasures and that it is unlikely that there is anything special about the brain mechanisms and networks underlying sex.
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Affiliation(s)
- J R Georgiadis
- Department of Neuroscience/Section Anatomy, University Medical Center Groningen (UMCG), University of Groningen, Groningen, The Netherlands.
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19
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Ribarič S. The pharmacological properties and therapeutic use of apomorphine. Molecules 2012; 17:5289-309. [PMID: 22565480 PMCID: PMC6268166 DOI: 10.3390/molecules17055289] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Revised: 04/22/2012] [Accepted: 04/25/2012] [Indexed: 12/12/2022] Open
Abstract
Apomorphine (APO) is an aporphine derivative used in human and veterinary medicine. APO activates D1, D2S, D2L, D3, D4, and D5 receptors (and is thus classified as a non-selective dopamine agonist), serotonin receptors (5HT1A, 5HT2A, 5HT2B, and 5HT2C), and α-adrenergic receptors (α1B, α1D, α2A, α2B, and α2C). In veterinary medicine, APO is used to induce vomiting in dogs, an important early treatment for some common orally ingested poisons (e.g., anti-freeze or insecticides). In human medicine, it has been used in a variety of treatments ranging from the treatment of addiction (i.e., to heroin, alcohol or cigarettes), for treatment of erectile dysfunction in males and hypoactive sexual desire disorder in females to the treatment of patients with Parkinson's disease (PD). Currently, APO is used in patients with advanced PD, for the treatment of persistent and disabling motor fluctuations which do not respond to levodopa or other dopamine agonists, either on its own or in combination with deep brain stimulation. Recently, a new and potentially important therapeutic role for APO in the treatment of Alzheimer’s disease has been suggested; APO seems to stimulate Aβ catabolism in an animal model and cell culture, thus reducing the rate of Aβ oligomerisation and consequent neural cell death.
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Affiliation(s)
- Samo Ribarič
- Institute of Pathophysiology, Medical Faculty, University of Ljubljana, Zaloška 4, SI-1000 Ljubljana, Slovenia.
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20
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Richards N, Wayman C, Allers KA. Electrophysiological actions of the dopamine agonist apomorphine in the paraventricular nucleus during penile erection. Neurosci Lett 2009; 465:242-7. [DOI: 10.1016/j.neulet.2009.08.078] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 08/13/2009] [Accepted: 08/29/2009] [Indexed: 11/29/2022]
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Paul T, Schiffer B, Zwarg T, Krüger TH, Karama S, Schedlowski M, Forsting M, Gizewski ER. Brain response to visual sexual stimuli in heterosexual and homosexual males. Hum Brain Mapp 2008; 29:726-35. [PMID: 17636559 PMCID: PMC6870890 DOI: 10.1002/hbm.20435] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2005] [Revised: 04/03/2007] [Accepted: 05/04/2007] [Indexed: 11/07/2022] Open
Abstract
Although heterosexual and homosexual individuals clearly show differences in subjective response to heterosexual and homosexual sexual stimuli, the neurobiological processes underlying sexual orientation are largely unknown. We addressed the question whether the expected differences in subjective response to visual heterosexual and homosexual stimuli may be reflected in differences in brain activation pattern. Twenty-four healthy male volunteers, 12 heterosexuals and 12 homosexuals, were included in the study. BOLD signal was measured while subjects were viewing erotic videos of heterosexual and homosexual content. SPM02 was used for data analysis. Individual sexual arousal was assessed by subjective rating. As compared to viewing sexually neutral videos, viewing erotic videos led to a brain activation pattern characteristic for sexual arousal in both groups only when subjects were viewing videos of their respective sexual orientation. Particularly, activation in the hypothalamus, a key brain area in sexual function, was correlated with sexual arousal. Conversely, when viewing videos opposite to their sexual orientation both groups showed absent hypothalamic activation. Moreover, the activation pattern found in both groups suggests that stimuli of opposite sexual orientation triggered intense autonomic response and may be perceived, at least to some extent, as aversive.
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Affiliation(s)
- Thomas Paul
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Boris Schiffer
- Department of Medical Psychology, University of Duisburg‐Essen, Germany
| | - Thomas Zwarg
- Department of Medical Psychology, University of Duisburg‐Essen, Germany
| | - Tillmann H.C. Krüger
- Institute of Psychology and Behavioral Immunobiology, Swiss Federal Institute of Technology ETH, Zurich, Switzerland
| | - Sherif Karama
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Manfred Schedlowski
- Institute of Psychology and Behavioral Immunobiology, Swiss Federal Institute of Technology ETH, Zurich, Switzerland
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
| | - Elke R. Gizewski
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany
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Han DH, Chae MR, So I, Park JK, Lee SW. The effects of dopamine receptor agonists on BK Ca channels and signal transduction mechanism in corpus cavernosal smooth muscle cells. Int J Impot Res 2007; 20:53-9. [PMID: 18094703 DOI: 10.1038/sj.ijir.3901623] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In this study, we investigated the effect of dopamine receptor agonists on potassium channels' activity and their signal transduction pathway in corporal smooth muscle cells. We used cultured human corporal smooth muscle cells. The whole cell and cell-attached configuration of the patch-clamp technique were used for electrophysiological recordings, and enzyme immunoassay was used for measuring cyclic AMP (cAMP) and cyclic GMP levels. Extracellular application of 10 microM dopamine and apomorphine significantly increased whole-cell K(+) currents by 283.5+/-55.7% (at +60 mV; n=12, P<0.001), 292.4+/-58.8.0% (at +60 mV; n=9, P<0.005), respectively. We confirmed that the increase in whole-cell currents was mainly due to activation of the tetraethylammonium-sensitive large conductance Ca(2+)-activated K(+) channels (BK(Ca) channels). Enzyme immunoassay indicated that dopamine and apomorphine stimulates cAMP levels in corporal smooth muscle cells in a concentration-dependent fashion. The activation of BK(Ca) channels by dopamine receptor agonists in corporal smooth muscle cells might be one of the mechanisms in inducing penile erection.
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Affiliation(s)
- D H Han
- Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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23
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Olivier JDA, de Jong TR, Jos Dederen P, van Oorschot R, Heeren D, Pattij T, Waldinger MD, Coolen LM, Cools AR, Olivier B, Veening JG. Effects of acute and chronic apomorphine on sex behavior and copulation-induced neural activation in the male rat. Eur J Pharmacol 2007; 576:61-76. [PMID: 17826765 DOI: 10.1016/j.ejphar.2007.08.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2007] [Revised: 08/13/2007] [Accepted: 08/15/2007] [Indexed: 12/20/2022]
Abstract
Apomorphine is a non-selective dopaminergic receptor agonist. Because of its pro-erectile effects, apomorphine is clinically used for treatment of erectile dysfunction. We investigated the effects of subcutaneous apomorphine administration (0.4 mg/kg rat) on sexual behavior and mating-induced Fos-expression following acute (day 1) or chronic apomorphine treatment (days 8 and 15) in sexually experienced male rats. Consistent facilitatory effects of apomorphine were observed in the reduced numbers of mounts and intromissions over time and an increased ejaculation frequency on day 1. The first post-ejaculatory interval, however, was lengthened, while other behavioral parameters were unaffected. Fos-immunoreactivity induced by acute apomorphine administration (barrel cortex, paraventricular hypothalamic nucleus, central amygdala and locus coeruleus) was strongly reduced after chronic administration. After mating, induction of Fos-immunoreactivity was observed in well-known areas like medial preoptic nucleus and the posterodorsal medial amygdaloid area. Apomorphine, however, reduced mating-induced Fos-immunoreactivity in the nucleus accumbens shell and prevented its occurrence in its core area. This remarkable apomorphine effect was not observed in any other brain area. We conclude that the behavioral (pro-erectile) effects of apomorphine are consistent over time, and that the diminished accumbens-Fos-immunoreactivity and the elongated post-ejaculatory interval may reflect a decreased response to remote cues from the estrus female.
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24
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Prause N, Graham CA. Asexuality: classification and characterization. ARCHIVES OF SEXUAL BEHAVIOR 2007; 36:341-56. [PMID: 17345167 DOI: 10.1007/s10508-006-9142-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The term "asexual" has been defined in many different ways and asexuality has received very little research attention. In a small qualitative study (N = 4), individuals who self-identified as asexual were interviewed to help formulate hypotheses for a larger study. The second larger study was an online survey drawn from a convenience sample designed to better characterize asexuality and to test predictors of asexual identity. A convenience sample of 1,146 individuals (N = 41 self-identified asexual) completed online questionnaires assessing sexual history, sexual inhibition and excitation, sexual desire, and an open-response questionnaire concerning asexual identity. Asexuals reported significantly less desire for sex with a partner, lower sexual arousability, and lower sexual excitation but did not differ consistently from non-asexuals in their sexual inhibition scores or their desire to masturbate. Content analyses supported the idea that low sexual desire is the primary feature predicting asexual identity.
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Affiliation(s)
- Nicole Prause
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, Indiana, USA
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25
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Abstract
The advent of non-invasive functional brain imaging has clarified which regions of the brain are recruited during sexual arousal. Injuries to those regions, and to the spinal cord and peripheral nerves that link genitalia to limbic and cognitive centres, can profoundly influence sexual wellbeing. In epilepsy, expressions of hypersexuality and hyposexuality interact with the location of epileptogenic foci in the temporolimbic circuitry, and are tempered by the sexual effects of drug treatments. We outline the sexual consequences of epilepsy, stroke, multiple sclerosis, Parkinson's disease, and other common neurological disorders. Management of sexual dysfunction from both disease and treatment is discussed. Nerve-sparing techniques could mitigate the substantial sexual dysfunction in both men and women through surgical disruption of the autonomic nerves during radical pelvic surgery.
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Affiliation(s)
- Peter M Rees
- Burnaby Hospital, Neurology Department, Burnaby, BC, Canada.
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26
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Moulier V, Mouras H, Pélégrini-Issac M, Glutron D, Rouxel R, Grandjean B, Bittoun J, Stoléru S. Neuroanatomical correlates of penile erection evoked by photographic stimuli in human males. Neuroimage 2006; 33:689-99. [PMID: 16962339 DOI: 10.1016/j.neuroimage.2006.06.037] [Citation(s) in RCA: 106] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2006] [Revised: 05/20/2006] [Accepted: 06/22/2006] [Indexed: 01/09/2023] Open
Abstract
The objective of this study was to identify the cerebral correlates of the early phase, and of low to moderate levels, of penile tumescence using for the first time a volumetric measure of the penile response. We hypothesized that (i) regions whose response had been found correlated with circumferential penile responses in previous studies would be identified with volumetric plethysmography and (ii) that other brain regions, including the amygdalae, would be found using the more sensitive volumetric measurement. In ten healthy males, functional magnetic resonance imaging (fMRI) was used to study brain responses to sexually stimulating photographs and to various categories of control photographs. Both ratings of perceived erection and penile plethysmography demonstrated an erectile response to the presentation of sexually stimulating photographs. Regions where the BOLD signal was correlated with penile volumetric responses included the right medial prefrontal cortex, the right and left orbitofrontal cortices, the insulae, the paracentral lobules, the right ventral lateral thalamic nucleus, the right anterior cingulate cortex and regions involved in motor imagery and motor preparation (supplementary motor areas, left ventral premotor area). This study suggests that the development of low levels of penile tumescence in response to static sexual stimuli is controlled by a network of frontal, parietal, insular and cingulate cortical areas and that penile tumescence reciprocally induces activation in somatosensory regions of the brain.
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Affiliation(s)
- V Moulier
- Inserm, U742, Univ Pierre et Marie Curie, Paris, F-75005, and Assistance Publique des Hôpitaux de Paris, Centre Inter-Etablissements de Résonance Magnétique, Le Kremlin-Bicêtre, France
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27
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Cerveau et excitation sexuelle : utilisation conjointe de la neuro-imagerie et de pléthysmographie pénienne. SEXOLOGIES 2006. [DOI: 10.1016/j.sexol.2006.03.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Kalisch R, Delfino M, Murer MG, Auer DP. The phenylephrine blood pressure clamp in pharmacologic magnetic resonance imaging: reduction of systemic confounds and improved detectability of drug-induced BOLD signal changes. Psychopharmacology (Berl) 2005; 180:774-80. [PMID: 15864557 DOI: 10.1007/s00213-005-2252-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2004] [Accepted: 02/18/2005] [Indexed: 11/24/2022]
Abstract
RATIONALE Peripheral physiologic changes accompany many central pharmacologic manipulations and can interact with brain activity and cerebral perfusion in complex ways. This considerably complicates the interpretation of drug-induced brain activity changes. OBJECTIVES To evaluate a method whereby drug-induced blood pressure (BP) changes are prevented. METHODS A continuously adjusted infusion of the peripheral vasoconstrictor phenylephrine (PEP) was used to counter-regulate BP changes elicited by application of the dopamine receptor agonist apomorphine (APO) in the rat. Central effects of APO were measured using pharmacologic magnetic resonance imaging (phMRI) with blood oxygenation level dependent (BOLD) contrast at a field strength of 7 T. RESULTS Compared to a NOPEP control group, the PEP blood pressure clamp successfully prevented BP changes and improved the detectability of central APO effects. Moreover, APO-induced central changes no longer correlated with BP time courses. CONCLUSIONS The method is suitable for isolating central drug effects from peripherally originating (BP) confounds in high-field functional magnetic resonance imaging (fMRI) studies. It may also be useful in fMRI studies of autonomic regulation, cognition, and emotion if the experimental manipulation entails BP changes.
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Affiliation(s)
- Raffael Kalisch
- NMR Study Group, Max-Planck-Institute of Psychiatry, Munich, Germany.
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29
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Ferretti A, Caulo M, Del Gratta C, Di Matteo R, Merla A, Montorsi F, Pizzella V, Pompa P, Rigatti P, Rossini PM, Salonia A, Tartaro A, Romani GL. Dynamics of male sexual arousal: distinct components of brain activation revealed by fMRI. Neuroimage 2005; 26:1086-96. [PMID: 15961048 DOI: 10.1016/j.neuroimage.2005.03.025] [Citation(s) in RCA: 227] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2004] [Revised: 03/09/2005] [Accepted: 03/17/2005] [Indexed: 11/21/2022] Open
Abstract
The peripheral mechanisms of male sexual arousal are well known. Recently, neuroimaging techniques, such as PET or fMRI, allowed the investigation of the subjacent cerebral mechanisms. In ten healthy subjects, we have simultaneously recorded fMRI images of brain activation elicited by viewing erotic scenes, and the time course of penile tumescence by means of a custom-built MRI-compatible pneumatic cuff. We have compared activation elicited by video clips with a long duration, that led to sexual arousal and penile erection, and activation elicited by briefly presented still images, that did induce sexual arousal without erection. This comparison and the use of the time course of penile tumescence in video clips allowed to perform a time resolved data analysis and to correlate different patterns of brain activation with different phases of sexual response. The activation maps highlighted a complex neural circuit involved in sexual arousal. Of this circuit, only a few areas (anterior cingulate, insula, amygdala, hypothalamus, and secondary somatosensory cortices) were specifically correlated with penile erection. Finally, these areas showed distinct dynamic relationships with the time course of sexual response. These differences might correspond to different roles in the development and appraisal of the sexual response. These findings shed light on the psychophysiology of male sexuality and open new perspectives for the diagnosis, therapy, and possible rehabilitation of sexual dysfunction.
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Affiliation(s)
- Antonio Ferretti
- Istituto di Tecnologie Avanzate Biomediche-Fondazione Università G. D'Annunzio, Chieti, Italy; Dipartmento di Scienze Cliniche e Bioimmagini, Università G. D'Annunzio, Chieti, Italy
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Redouté J, Stoléru S, Pugeat M, Costes N, Lavenne F, Le Bars D, Dechaud H, Cinotti L, Pujol JF. Brain processing of visual sexual stimuli in treated and untreated hypogonadal patients. Psychoneuroendocrinology 2005; 30:461-82. [PMID: 15721058 DOI: 10.1016/j.psyneuen.2004.12.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2004] [Revised: 12/07/2004] [Accepted: 12/08/2004] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Although various brain regions have been shown to respond to the presentation of visual sexual stimuli (VSS), whether these regions are specifically mediating sexual arousal or whether they mediate general emotional or motivational arousal is unknown. To clarify this issue, our purpose was to map the regions where the response to VSS was related to plasma testosterone. Specific objectives were (i) to identify regions that respond differentially to VSS in untreated hypogonadal patients compared with healthy controls and (ii) to identify in hypogonadal patients the regions that respond differentially to VSS as a function of therapeutically induced increased testosterone levels. METHOD In nine male hypogonadal patients, in the same patients under treatment, and in eight healthy males, we used Positron Emission Tomography to investigate responses of regional cerebral blood flow to VSS. Statistical Parametric Mapping was used to locate regions that demonstrated a differential response. RESULTS Regions responding differentially both in untreated patients compared with controls and in untreated patients compared with themselves under treatment were the right orbitofrontal cortex, insula and claustrum, where the activation was higher in controls than in untreated patients and where activation increased under treatment, and the left inferior frontal gyrus, that demonstrated a deactivation only in controls and in patients under treatment. That these responses appear to depend on testosterone indicates that these regions mediate sexual arousal and not only a process of general emotional or motivational arousal.
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Affiliation(s)
- Jérôme Redouté
- Inserm U 483, Université Pierre et Marie Curie, Boite 23, 9 quai Saint-Bernard, 75252 Paris Cedex 05, France
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Krüger THC, Hartmann U, Schedlowski M. Prolactinergic and dopaminergic mechanisms underlying sexual arousal and orgasm in humans. World J Urol 2005; 23:130-8. [PMID: 15889301 DOI: 10.1007/s00345-004-0496-7] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2004] [Accepted: 12/08/2004] [Indexed: 12/16/2022] Open
Abstract
Dopaminergic mechanisms play a major role in modulating sexual behavior in humans and animals. Animal data demonstrate important interactions between the dopaminergic and prolactinergic system. As recently demonstrated, dopamine agonists have facilitatory properties for penile erection but may also enhance sexual drive and orgasmic quality. In contrast, chronic elevations of prolactin inhibit appetitive as well as consummatory parameters of sexual behavior. Recent human studies show a marked increase in prolactin after orgasm in males and females. Concerning the biological relevance of acute prolactin alterations after orgasm, prolactin might serve as a neuroendocrine reproductive reflex for peripheral reproductive organs. Alternatively, prolactin may feedback to dopaminergic neurons in the central nervous system and thereby modulate sexual drive and satiation. Here, we provide a brief overview of the physiology of dopamine and prolactin in regulating sexual behavior. In addition, recent experimental and clinical evidence for a postulated feedback mechanism for prolactin and its implications for orgasmic disorders are discussed.
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Affiliation(s)
- Tillmann H C Krüger
- Department of Clinical Psychiatry and Psychotherapy, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625 Hanover, Germany.
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Treatment of female sexual dysfunction in postmenopausal women—What is the evidence? ACTA ACUST UNITED AC 2004. [DOI: 10.1016/j.rigp.2004.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Bertol E, Fineschi V, Karch SB, Mari F, Riezzo I. Nymphaea cults in ancient Egypt and the New World: a lesson in empirical pharmacology. J R Soc Med 2004. [PMID: 14749409 DOI: 10.1258/jrsm.97.2.84] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Elisabetta Bertol
- Department of Forensic Toxicology, University of Florence, Florence, Italy
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