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Xiang Z, Huang Y, Xu Y, Liu X, Huang X, Liu T, Yang Z, Jiang L, Chen Y, Chen J. Altered brain activity in diabetic patients with erectile dysfunction revealed by fractional amplitude of low-frequency fluctuation: A resting-state fMRI study. Andrology 2024; 12:68-74. [PMID: 37058742 DOI: 10.1111/andr.13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/12/2023] [Accepted: 04/10/2023] [Indexed: 04/16/2023]
Abstract
INTRODUCTION Diabetes mellitus is one of the major chronic diseases, which enhances the risk of erectile dysfunction. However, the central pathological mechanisms of erectile dysfunction in diabetes mellitus patients are still unclear. METHODS Resting-state functional magnetic resonance imaging data were acquired in 30 type-2 diabetes mellitus, 31 type-2 diabetes mellitus with erectile dysfunction patients, and 31 healthy controls. The measure of fractional amplitude of low-frequency fluctuation was calculated and compared among groups. RESULTS Differences of fractional amplitude of low-frequency fluctuation values were found in the left superior frontal gyrus (medial) and middle temporal gyrus among three groups. Compared with healthy controls group, type-2 diabetes mellitus group exhibited lower fractional amplitude of low-frequency fluctuation values in the left superior frontal gyrus (dorsolateral), anterior cingulate gyrus, calcarine fissure, and increased fractional amplitude of low-frequency fluctuation values in the left post-central gyrus. Compared with healthy controls group, erectile dysfunction with type-2 diabetes mellitus group exhibited lower fractional amplitude of low-frequency fluctuation values in the left superior frontal gyrus (medial), middle temporal gyrus, temporal middle (pole), and increased fractional amplitude of low-frequency fluctuation values in the right post-central gyrus. Compared with type-2 diabetes mellitus group, erectile dysfunction with type-2 diabetes mellitus group exhibited increased fractional amplitude of low-frequency fluctuation values in the right median cingulum gyrus and left calcarine fissure. CONCLUSION Erectile dysfunction with type-2 diabetes mellitus patients showed functional changes in brain regions that were closely correlated with sexual dysfunction, which suggested that altered regional brain activity might be related to the pathophysiology of erectile dysfunction with type-2 diabetes mellitus.
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Affiliation(s)
- Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yingjun Huang
- Department of Endocrinology, Changzhou Wujin Traditional Chinese Medicine Hospital, Changzhou, China
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xue Liu
- 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
| | - Lin Jiang
- Department of Endocrinology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Yun Chen
- 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
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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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Liu X, Liu S, Liu T, Tang L, Ji M, Xu Y, Xiang Z, Zhou J, Chen Y, Chen J. Altered regional brain activity and functional connectivity in resting-state brain networks associated with psychological erectile dysfunction. Front Neurosci 2023; 17:1074327. [PMID: 37360175 PMCID: PMC10285100 DOI: 10.3389/fnins.2023.1074327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 02/14/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction Erectile dysfunction (ED), especially psychological ED (pED), is usually accompanied with psychological factors, which are related to abnormal activity in brain regions involved in sexual behavior. However, the mechanisms underlying functional changes in the brain of pED are still unclear. The present study aimed to explore the abnormalities of brain function, as well as their relationships with sexual behavior and emotion in pED patients. Materials and methods Resting state functional magnetic resonance imaging (rs-fMRI) data were collected from 31 pED patients to 31 healthy controls (HCs). The values of amplitude of fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) were calculated and compared between groups. In addition, the associations between abnormal brain regions and clinical features were evaluated by Pearson correlation analyses. Results Compared to HCs, pED patients demonstrated decreased fALFF values in the left medial superior frontal gyrus (had decreased FC values with the left dorsolateral superior frontal gyrus), the left lingual gyrus (had decreased FC values with the left parahippocamal gyrus and insula), the left putamen (had decreased FC values with the right caudate) and the right putamen (had decreased FC values with the left putamen and the right caudate). The fALFF values of the left medial superior frontal gyrus were negatively correlated with the fifth item scores of International Index of Erectile Function (IIEF-5). Negative relationships were found between fALFF values of the left putamen and the second item scores of Arizona Sexual Scale (ASEX). FC values between the right putamen and caudate were negatively related to the state scores of State-Trait Anxiety Inventory (STAI-S). Conclusion Altered brain function were found in the medial superior frontal gyrus and caudate-putamen of pED patients, which were associated with sexual function and psychological condition. These findings provided new insights into the central pathological mechanisms of pED.
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Affiliation(s)
- Xue Liu
- 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
| | - Tao Liu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Liang Tang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Mufan Ji
- Medical College of Nantong University, Nantong, 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
| | - Jianwen Zhou
- 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
| | - Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Wang H, Liu X, Zhang Z, Han Z, Jiang Y, Qiao Y, Liu T, Chen J, Chen Y. Effects of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress. Sex Med 2023; 11:qfad019. [PMID: 37256219 PMCID: PMC10225468 DOI: 10.1093/sexmed/qfad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/10/2023] [Accepted: 04/11/2023] [Indexed: 06/01/2023] Open
Abstract
Background Few studies have investigated psychogenic sexual dysfunction including psychogenic erectile dysfunction (pED); the effect of tadalafil on sexual behavior of male rats induced by chronic unpredictable mild stress (CUMS) remains unclear. Aim The aim was to explore the influence of CUMS on sexual behavior of male rats and the effects of tadalafil on that. Methods Adult male rats were divided into 3 groups, including the normal group without CUMS, the model group with 6 weeks' CUMS, and the tadalafil group with treatment of tadalafil during CUMS. CUMS consists of water deprivation, food deprivation, stroboscopic lightning, white noise, cage tilting, weeding packing, and housing 2 unfamiliar rats. The apomorphine test and vaginal smear test were conducted with the aim to screen out male rats with good erectile function and make preparation for the sexual behavior test, respectively. Outcomes At the end of the study period, the level of anhedonia and sexual function were evaluated by the sucrose preference test, sexual behavior test, and measurement of serum testosterone, dopamine, and 5-HT. Results Sucrose preference showed significant decrease in rats after CUMS. The intromission ratio and total intromission frequency decreased significantly, while the mount latency and ejaculation latency prolonged significantly in CUMS-induced rats when compared with normal rats. Meanwhile, the treatment of tadalafil reversed the level of anhedonia and sexual function in CUMS-induced rats. However, there were no statistical differences in the levels of serum testosterone, dopamine, and 5-HT among groups. Clinical Implications The study constructed an animal model that can provide clinical insights into the mechanism of psychogenic sexual dysfunction and supports the application of tadalafil in pED therapy. Strengths and Limitations We found that CUMS-induced rats exhibited anhedonia and poor sexual function that could be prevented by tadalafil administration. Future research needs to construct the standard of pED model and explore the mechanism of tadalafil on central nervous system. Conclusion Tadalafil could prevent the changes of depression and poor sexual function in rats induced by CUMS, and the method of CUMS and the sexual behavior test should be used in the future for pED modeling.
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Affiliation(s)
| | | | - Ziheng Zhang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Ziyang Han
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Yongsheng Jiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Yu Qiao
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
- Department of Reproductive Center, Affiliated Huai'an No. 1 People's Hospital of Nanjing Medical University, Huai'an 223001, China
| | - Tao Liu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
| | - Jianhuai Chen
- Corresponding author: Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China. ;
| | - Yun Chen
- Corresponding author: Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China. ;
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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 T, Yuan P, Cui Y, Yuan W, Jiang D. Convergent and Divergent Structural Connectivity of Brain White Matter Network Between Patients With Erectile Dysfunction and Premature Ejaculation: A Graph Theory Analysis Study. Front Neurol 2022; 13:804207. [PMID: 35273555 PMCID: PMC8902049 DOI: 10.3389/fneur.2022.804207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 01/20/2022] [Indexed: 11/13/2022] Open
Abstract
Background Sexual dysfunction, namely, erectile dysfunction (ED) and premature ejaculation (PE), has been found to be associated with abnormal structural connectivity in the brain. Previous studies have mainly focused on a single disorder, however, convergent and divergent structural connectivity patterns of the brain network between ED and PE remain poorly understood. Methods T1-weighted structural data and diffusion tensor imaging data of 28 patients with psychological ED, 28 patients with lifelong PE (LPE), and 28 healthy controls (HCs) were obtained to map the white matter (WM) brain networks. Then, the graph-theoretical method was applied to investigate the differences of network properties (small-world measures) of the WM network between patients with ED and LPE. Furthermore, nodal segregative and integrative parameters (nodal clustering coefficient and characteristic path length) were also explored between these patients. Results Small-world architecture of the brain networks were identified for both psychological ED and LPE groups. However, patients with ED exhibited increased average characteristic path length of the brain network when compared with patients with LPE and HCs. No significant difference was found in the average characteristic path length between patients with LPE and HCs. Moreover, increased nodal characteristic path length was found in the right middle frontal gyrus (orbital part) of patients with ED and LPE when compared with HCs. In addition, patients with ED had increased nodal characteristic path length in the right middle frontal gyrus (orbital part) when compared with patients with LPE. Conclusion Together, our results demonstrated that decreased integration of the right middle frontal gyrus (orbital part) might be a convergent neuropathological basis for both psychological ED and LPE. In addition, patients with ED also exhibited decreased integration in the whole WM brain network, which was not found in patients with LPE. Therefore, altered integration of the whole brain network might be the divergent structural connectivity patterns for psychological ED and LPE.
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Affiliation(s)
- Tielong Zhang
- Department of Urology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Peng Yuan
- Department of Intervention, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Yonghua Cui
- Department of Neurosurgery, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Weibiao Yuan
- Department of Radiology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
| | - Daye Jiang
- Department of Urology, The Affiliated Jianhu Hospital of Nantong University, Jianhu People's Hospital, Yancheng, China
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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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Chen J, Wu J, Huang X, Sun R, Xiang Z, Xu Y, Chen S, Xu W, Yang J, Chen Y. Differences in structural connectivity between diabetic and psychological erectile dysfunction revealed by network-based statistic: A diffusion tensor imaging study. Front Endocrinol (Lausanne) 2022; 13:892563. [PMID: 35966068 PMCID: PMC9365033 DOI: 10.3389/fendo.2022.892563] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/01/2022] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Type 2 diabetes mellitus (T2DM) has been found to be associated with abnormalities of the central and peripheral vascular nervous system, which were considered to be involved in the development of cognitive impairments and erectile dysfunction (ED). In addition, altered brain function and structure were identified in patients with ED, especially psychological ED (pED). However, the similarities and the differences of the central neural mechanisms underlying pED and T2DM with ED (DM-ED) remained unclear. METHODS Diffusion tensor imaging data were acquired from 30 T2DM, 32 ED, and 31 DM-ED patients and 47 healthy controls (HCs). Then, whole-brain structural networks were constructed, which were mapped by connectivity matrices (90 × 90) representing the white matter between 90 brain regions parcellated by the anatomical automatic labeling template. Finally, the method of network-based statistic (NBS) was applied to assess the group differences of the structural connectivity. RESULTS Our NBS analysis demonstrated three subnetworks with reduced structural connectivity in DM, pED, and DM-ED patients when compared to HCs, which were predominantly located in the prefrontal and subcortical areas. Compared with DM patients, DM-ED patients had an impaired subnetwork with increased structural connectivity, which were primarily located in the parietal regions. Compared with pED patients, an altered subnetwork with increased structural connectivity was identified in DM-ED patients, which were mainly located in the prefrontal and cingulate areas. CONCLUSION These findings highlighted that the reduced structural connections in the prefrontal and subcortical areas were similar mechanisms to those associated with pED and DM-ED. However, different connectivity patterns were found between pED and DM-ED, and the increased connectivity in the frontal-parietal network might be due to the compensation mechanisms that were devoted to improving erectile function.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jindan Wu
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Rui Sun
- Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shi Chen
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Weilong Xu
- Department of Endocrinology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People’s Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, People’s Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture, Artux, Xinjiang, China
- *Correspondence: Yun Chen, ; Jie Yang,
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
- *Correspondence: Yun Chen, ; Jie Yang,
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Ma Z, Ren F, Huang X, Yang X, Li H, Li G, Chang D, Yin T, Zhang P. Decreased gray matter volume of the anterior insular cortex in patients with psychogenic erectile dysfunction: A voxel-based morphometry study. J Psychiatr Res 2021; 145:125-131. [PMID: 34920162 DOI: 10.1016/j.jpsychires.2021.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 11/08/2021] [Accepted: 12/10/2021] [Indexed: 01/03/2023]
Abstract
This study aimed to explore the gray matter morphological alteration and its correlation with the severity of symptoms in patients with psychogenic erectile dysfunction (pED). Fifty patients with pED and 50 healthy controls (HCs) were included. The whole-brain voxel-based morphometry analysis was conducted to compare the differences in gray matter volume (GMV) between patients with pED and HCs. And then, the region-of-interest-based correlation analyses were performed between the GMV of these regions with the most pronounced between-group differences and clinical symptoms in patients. The results demonstrated that patients with pED manifested decreased GMV in the bilateral anterior insula (aINS), bilateral precentral gyrus, left postcentral gyrus, bilateral anterior cingulate cortex, bilateral middle cingulate cortex, bilateral fusiform gyrus, and cerebellum when compared to HCs. Taking the bilateral aINS as the region-of-interest, the results of voxel-based correlation analyses showed that the GMV of the bilateral aINS were positively correlated with the International Index of Erectile Function 5 (IIEF-5) and Quality of Erection Questionnaire score, and the GMV of right aINS was positively associated with duration and sexual craving score in patients with pED. Furthermore, the significant correlations between the total GMV of the right aINS and IIEF-5 and sexual craving score, as well as between the total GMV of the left aINS and sexual craving score were also detected. In conclusion, these results suggested that the decreased GMV of aINS might be a critical neuropathological characteristic of pED, which provided new evidence for understanding the neurobiological basis of pED from the perspective of brain structure alterations.
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Affiliation(s)
- Ziyang Ma
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Feiqiang Ren
- Department of Urology, Chongqing Hospital of Traditional Chinese Medicine Hospital, Chongqing, 400021, China
| | - Xiaopeng Huang
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Xuemei Yang
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Hao Li
- Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China
| | - Guangsen Li
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Degui Chang
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China
| | - Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610075, China; Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, China.
| | - Peihai Zhang
- Department of Andrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China; TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, 610072, China.
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10
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Peihong M, Tao Y, Zhaoxuan H, Sha Y, Li C, Kunnan X, Jingwen C, Likai H, Yuke T, Yuyi G, Fumin W, Zilei T, Ruirui S, Fang Z. Alterations of White Matter Network Properties in Patients With Functional Constipation. Front Neurol 2021; 12:627130. [PMID: 33841301 PMCID: PMC8024587 DOI: 10.3389/fneur.2021.627130] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/05/2021] [Indexed: 12/21/2022] Open
Abstract
Background: The abnormalities in brain function and structure of patients with functional constipation (FC) have been identified using multiple neuroimaging studies and have confirmed the abnormal processing of visceral sensation at the level of the central nervous system (CNS) as an important reason for FC. As an important basis for central information transfer, the role of the white matter (WM) networks in the pathophysiology of FC has not been investigated. This study aimed to explore the topological organization of WM networks in patients with FC and its correlation with clinical variables. Methods and Analysis: In this study, 70 patients with FC and 45 age- and gender-matched healthy subjects (HS) were recruited. Diffusion tensor imaging (DTI) data and clinical variables were acquired from each participant. WM networks were constructed using the deterministic fiber tracking approach, and the global and nodal properties of the WM networks were compared using graph theory analysis between patients with FC and HS. The relationship between the representative nodal characteristics-nodal betweenness and clinical parameters was assessed using partial correlation analysis. Results: Patients with FC showed increased nodal characteristics in the left superior frontal gyrus (orbital part), right middle frontal gyrus (orbital part), and right anterior cingulate and paracingulate (P < 0.05, corrected for false discovery rate) and decreased nodal characteristics in the left caudate and left thalamus (P < 0.05, corrected for false discovery rate) compared with HS. The duration of FC was negatively correlated with the nodal betweenness of the left thalamus (r = -0.354, P = 0.04, corrected for false discovery rate). Conclusion: The results indicated the alternations in WM networks of patients with FC and suggested the abnormal visceral sensation processing in the CNS from the perspective of large-scale brain WM network.
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Affiliation(s)
- Ma Peihong
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yin Tao
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - He Zhaoxuan
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yang Sha
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chen Li
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xie Kunnan
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Chen Jingwen
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hou Likai
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Teng Yuke
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guo Yuyi
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wang Fumin
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tian Zilei
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Sun Ruirui
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zeng Fang
- Acupuncture and Tuina School, The Third Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture and Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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11
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Chen J, Yang J, Xiang Z, Huang X, Lu C, Liu S, Chen Y, Hu J. Graph theory analysis reveals premature ejaculation is a brain disorder with altered structural connectivity and depressive symptom: A DTI‐based connectome study. Eur J Neurosci 2020; 53:1905-1921. [PMID: 33217076 DOI: 10.1111/ejn.15048] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/15/2020] [Accepted: 11/15/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Jianhuai Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Jie Yang
- Department of Urology Jiangsu Provincial People's HospitalFirst Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Ziliang Xiang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Xinfei Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Chao Lu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Shaowei Liu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Yun Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Jun Hu
- Department of Radiology Nanjing Brain HospitalAffiliated Hospital of Nanjing Medical University Nanjing China
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12
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Huang X, Chen J, Liu S, Gong Q, Liu T, Lu C, Qin Z, Cui H, Chen Y, Zhu Y. Impaired frontal‐parietal control network in chronic prostatitis/chronic pelvic pain syndrome revealed by graph theoretical analysis: A DTI study. Eur J Neurosci 2020; 53:1060-1071. [PMID: 32896914 DOI: 10.1111/ejn.14962] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 08/28/2020] [Accepted: 08/29/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Xinfei Huang
- 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
| | - Shaowei Liu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Qingkuo Gong
- 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
| | - Chao Lu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Zhan Qin
- Department of Andrology Guangdong Provincial Hospital of Chinese Medicine Zhuhai China
| | - Hongliang Cui
- Department of Urology Nantong Hospital of Traditional Chinese Medicine Nantong China
| | - Yun Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Yongkang Zhu
- Department of General Surgery Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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13
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Chen J, Wu W, Xiang Z, Wang Q, Huang X, Lu C, Liu S, Chen Y, Yang J. Aberrant default mode network and auditory network underlying the sympathetic skin response of the penis (PSSR) of patients with premature ejaculation: A resting-state fMRI study. Andrology 2020; 9:277-287. [PMID: 32996293 DOI: 10.1111/andr.12914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Hyperactivity of the sympathetic nervous system is considered as an important component involved in the pathological mechanisms of premature ejaculation (PE). However, the neural mechanisms of PE with high sympathetic activity are still not well understood. METHODS The activity of the sympathetic innervations in the penis was evaluated by the sympathetic skin response of the penis (PSSR) with an electromyograph and evoked potential equipment. Resting-state functional magnetic resonance imaging (fMRI) data were acquired from 18 PE patients with high sympathetic activity (sPE), 17 PE patients with normal sympathetic activity (nsPE), and 24 healthy controls (HC). We investigated the neural basis of sPE based on the measure of regional homogeneity (ReHo). Moreover, the correlations between brain regions with altered ReHo and PEDT scores and PSSR latencies in the patient group were explored. RESULTS Altered ReHo values among three groups were found in the temporal, cingulated, and parietal cortex in the default mode network (DMN), as well as the temporal cortex in the auditory network (AUD). Compared with HC, Patients with sPE had increased ReHo values of brain regions in DMN, AUD, and decreased ReHo values of brain regions in DMN. In addition, increased ReHo values were found in DMN of patients with nsPE, while decreased ReHo values were found in DMN and the attention network (AN). Moreover, sPE patients had increased ReHo values in AUD and decreased ReHo values in DMN when compared with nsPE patients. Finally, altered ReHo values of brain regions in DMN and AUD were associated with PEDT scores and PSSR latencies in the patient group. CONCLUSION Our results suggested that PE patients had abnormal ReHo values in DMN, AUD, and AN. Patients with sPE were characterized by increased neuronal activity in AUD and decreased activity in DMN. This highlighted the significances of DMN, AUD, and AN in the pathophysiology of PE and also provided potential neuroimaging biomarkers for distinguishing sPE from nsPE and HC.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wanke Wu
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Lu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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14
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Variation in Brain Subcortical Network Topology Between Men With and Without PE: A Diffusion Tensor Imaging Study. J Sex Med 2020; 17:48-59. [DOI: 10.1016/j.jsxm.2019.10.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 10/07/2019] [Accepted: 10/12/2019] [Indexed: 01/27/2023]
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15
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Chen J, Yang J, Huang X, Ni L, Fan Q, Liu T, Yao Z, Chen Y. Reduced segregation and integration of structural brain network associated with sympathetic and dorsal penile nerve activity in anejaculation patients: a graph‐based connectome study. Andrology 2019; 8:392-399. [PMID: 31610095 DOI: 10.1111/andr.12715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/11/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - J. Yang
- Department of Urology Jiangsu Provincial People's Hospital First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - L. Ni
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Q. Fan
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - T. Liu
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Z. Yao
- Department of Psychiatry Nanjing Brain Hospital Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Y. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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16
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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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17
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Chen J, Huang X, Lu C, Liu T, Dai Y, Yao Z, Chen Y. Graph analysis of
DTI
‐based connectome: decreased local efficiency of subcortical regions in
PE
patients with high sympathetic activity. Andrology 2019; 8:400-406. [PMID: 31532583 DOI: 10.1111/andr.12701] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - C. Lu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - T. Liu
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Y. Dai
- Department of Andrology Nanjing Drum Tower Hospital Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Z. Yao
- Department of Psychiatry Nanjing Brain Hospital Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Y. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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18
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Yin T, Li Z, Xiong J, Lan L, Sun R, Ren F, Zhang P. Neuroimaging biomarkers of psychogenic erectile dysfunction: protocol for a systematic review. BMJ Open 2019; 9:e030061. [PMID: 31455711 PMCID: PMC6720482 DOI: 10.1136/bmjopen-2019-030061] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION Erectile dysfunction (ED) is the most common male sexual disorder that severely impacts the sexual performance and quality of life of men. As the main subtype of ED, psychogenic ED (pED) has been demonstrated to be a genitourinary disease and also associated with alterations in both brain structure and function. However, the scattered neuroimaging evidence from individual studies has not yet been integrated, and the central pathological alterations associated with pED remain unclear. The objective of this systematic review is to integrate and assess the evidence of the impact of pED on brain structure and function. METHODS AND ANALYSIS Five databases (PubMed, EMBASE, Web of Science, China Biology Medicine Database and China National Knowledge Infrastructure (CNKI)) will be systematically searched from inception to 1 October 2019 (the anticipated completion date of this review), with language restricted to English and Chinese. Studies focusing on the structural or functional alterations in patients with pED will be retrieved. The study selection process will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and quality assessment will be conducted with a customised checklist. After data extraction, a qualitative review will be performed to synthesise the structural and functional brain alterations as well as the correlations between the altered cerebral structures and functions and the clinical characteristics of patients with pED. If the collected data make it feasible, an activation likelihood estimation meta-analysis will also be launched. ETHICS AND DISSEMINATION Ethical approval is not required as primary data will not be collected. This review will be published in a peer-reviewed journal and presented at conferences. PROSPERO REGISTRATION NUMBER CRD42019117206.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhengjie Li
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture-Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Xiong
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lei Lan
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture-Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Acupuncture-Brain Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Feiqiang Ren
- Clinical Medicine School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihai Zhang
- Urology and Andrology Department, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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19
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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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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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