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Basaran AE, Arlt F, Güresir E, Vychopen M, Wach J. Sexual dysfunction after surgery for primary sporadic cranial meningiomas: prevalence and risk factors. J Neurooncol 2024:10.1007/s11060-024-04817-w. [PMID: 39254812 DOI: 10.1007/s11060-024-04817-w] [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: 08/04/2024] [Accepted: 08/28/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Although postoperative quality of life (QoL) has been studied in relation to a variety of aspects following meningioma resection, the impact of meningiomas on sexual life has not been investigated. The aim of this study is to determine the impact of cranial meningioma surgery on patients' postoperative sexual life. METHODS A standardized questionnaire, anonymous and based on the Arizona Sexual Experiences Scale (ASEX), was sent to 87 patients who had been selected for participation in the study based on the following criteria: a postoperative Karnofsky performance of ≥ 80 and below 60 years of age at diagnosis. RESULTS 53 patients (53/87; 61%) responded to the survey. The study identified eleven patients (20.8%) who reported sexual dysfunction (SD) according to ASEX criteria. Six of these patients were women (55%) and five were men (45%). Univariable analysis revealed that SD was observed with greater frequency in patients with non-skull base tumors (p = 0.006) and in those with a left-hemispheric meningioma (p = 0.046). Multivariable analysis revealed that non-skull base tumor location is the only independent factor being associated with SD (OR = 5.71, 95% CI = 1.02-31.81, p = 0.047). CONCLUSION This first investigation of sexual functioning post-surgery for cranial meningiomas indicates that SD is a prevalent issue among non-skull base meningioma patients. Consequently, we recommend that pre- and postoperative sexual health should be further addressed in future QoL investigations of cranial meningioma patients.
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Affiliation(s)
- Alim Emre Basaran
- Department of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany.
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany.
| | - Felix Arlt
- Department of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany
| | - Erdem Güresir
- Department of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany
| | - Martin Vychopen
- Department of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany
| | - Johannes Wach
- Department of Neurosurgery, University Hospital Leipzig, Liebigstraße 20, 04103, Leipzig, Germany
- Comprehensive Cancer Center Central Germany, Partner Site Leipzig, Leipzig, Germany
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Ouerchefani R, Ouerchefani N, Ben Rejeb MR, Le Gall D. Exploring behavioural and cognitive dysexecutive syndrome in patients with focal prefrontal cortex damage. APPLIED NEUROPSYCHOLOGY. ADULT 2024; 31:443-463. [PMID: 35244518 DOI: 10.1080/23279095.2022.2036152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This study's objectives were to characterize the frequency and profile of behavioral and cognitive dysexecutive syndromes in patients with focal prefrontal cortex damage and how these syndromes overlap. We also examined the contribution of the prefrontal brain regions to these syndromes. Therefore, thirty patients with prefrontal cortex damage and thirty control subjects were compared on their performances using the GREFEX battery assessing the dysexecutive syndromes. The results showed that combined behavioral and cognitive dysexecutive syndrome was observed in 53.33%, while pure cognitive dysexecutive syndrome was observed in 20% and behavioral in 26.67%. Also, almost all behavioral and cognitive dysexecutive disorders discriminated frontal patients from controls. Moreover, correlations and regression analyses between task scores in both domains of dysexecutive syndromes showed that the spectrum of behavioral disorders was differentially associated with cognitive impairment of initiation, inhibition, generation, deduction, coordination, flexibility and the planning process. Furthermore, the patterns of cognitive and behavioral dysexecutive syndrome were both predictors of impairment in daily living activities and loss of autonomy. Finally, frontal regions contributing to different dysexecutive syndromes assessed by MRI voxel lesion symptom analysis indicate several overlapping regions centered on the ventromedial and dorsomedial prefrontal cortex for both domains of dysexecutive syndrome. This study concludes that damage to the frontal structures may lead to a diverse set of changes in both cognitive and behavioral domains which both contribute to loss of autonomy. The association of the ventromedial and dorsomedial prefrontal regions to both domains of dysexecutive syndrome suggests a higher integrative role of these regions in processing cognition and behavior.
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Affiliation(s)
- Riadh Ouerchefani
- High Institute of Human Sciences, Department of Psychology, University of Tunis El Manar, Tunis, Tunisia
- Univ Angers, Université de Nantes, LPPL, SFR Confluences, Angers, France
| | | | - Mohamed Riadh Ben Rejeb
- Faculty of Human and Social Science of Tunisia, Department of Psychology, University of Tunis I, Tunis, Tunisia
| | - Didier Le Gall
- Univ Angers, Université de Nantes, LPPL, SFR Confluences, Angers, France
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Briken P, Bőthe B, Carvalho J, Coleman E, Giraldi A, Kraus SW, Lew-Starowicz M, Pfaus JG. Assessment and treatment of compulsive sexual behavior disorder: a sexual medicine perspective. Sex Med Rev 2024; 12:355-370. [PMID: 38529667 PMCID: PMC11214846 DOI: 10.1093/sxmrev/qeae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/02/2024] [Accepted: 02/03/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION The addition of compulsive sexual behavior disorder (CSBD) into the ICD-11 chapter on mental, behavioral, or neurodevelopmental disorders has greatly stimulated research and controversy around compulsive sexual behavior, or what has been termed "hypersexual disorder," "sexual addiction," "porn addiction," "sexual compulsivity," and "out-of-control sexual behavior." OBJECTIVES To identify where concerns exist from the perspective of sexual medicine and what can be done to resolve them. METHODS A scientific review committee convened by the International Society for Sexual Medicine reviewed pertinent literature and discussed clinical research and experience related to CSBD diagnoses and misdiagnoses, pathologizing nonheteronormative sexual behavior, basic research on potential underlying causes of CSBD, its relationship to paraphilic disorder, and its potential sexual health consequences. The panel used a modified Delphi method to reach consensus on these issues. RESULTS CSBD was differentiated from other sexual activity on the basis of the ICD-11 diagnostic criteria, and issues regarding sexual medicine and sexual health were identified. Concerns were raised about self-labeling processes, attitudes hostile to sexual pleasure, pathologizing of nonheteronormative sexual behavior and high sexual desire, mixing of normative attitudes with clinical distress, and the belief that masturbation and pornography use represent "unhealthy" sexual behavior. A guide to CSBD case formulation and care/treatment recommendations was proposed. CONCLUSIONS Clinical sexologic and sexual medicine expertise for the diagnosis and treatment of CSBD in the psychiatric-psychotherapeutic context is imperative to differentiate and understand the determinants and impact of CSBD and related "out-of-control sexual behaviors" on mental and sexual well-being, to detect forensically relevant and nonrelevant forms, and to refine best practices in care and treatment. Evidence-based, sexual medicine-informed therapies should be offered to achieve a positive and respectful approach to sexuality and the possibility of having pleasurable and safe sexual experiences.
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Affiliation(s)
- Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center, Hamburg-Eppendorf, Hamburg 20251, Germany
| | - Beáta Bőthe
- Department of Psychology, Université de Montréal, Montréal, QC H3C 3J7, Canada
- Centre de Recherche Interdisciplinaire Sur Les Problèmes Conjugaux Et Les Agressions Sexuelles, Montréal, QC H3C 3J7, Canada
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro 3810-193, Portugal
| | - Eli Coleman
- Eli Coleman Institute for Sexual and Gender Health, University of Minnesota, Minneapolis, MN 55454, United States
| | - Annamaria Giraldi
- Sexological Clinic, Mental Health Center, Copenhagen University Hospital, Mental Health Services, Copenhagen CPH 2200, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen 2200, Denmark
| | - Shane W Kraus
- Department of Psychology, University of Nevada Las Vegas, Las Vegas, NV 5030, United States
| | - Michał Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw 01-809, Poland
| | - James G Pfaus
- Center for Sexual Health and Intervention, Czech National Institute of Mental Health, Klecany 25067, Czech Republic
- Department of Psychology and Life Sciences, Faculty of Humanities, Charles University, Prague 18200, Czech Republic
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4
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Zhang X, Niu P, Su M, Zhou L, Huang Y, Chen J, Liu S. Topological differences of striato-thalamo-cortical circuit in functional brain network between premature ejaculation patients with and without depression. Brain Behav 2024; 14:e3585. [PMID: 38849981 PMCID: PMC11161395 DOI: 10.1002/brb3.3585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 03/26/2024] [Accepted: 04/20/2024] [Indexed: 06/09/2024] Open
Abstract
INTRODUCTION Premature ejaculation (PE), a common male sexual dysfunction, often accompanies by abnormal psychological factors, such as depression. Recent neuroimaging studies have revealed structural and functional brain abnormalities in PE patients. However, there is limited neurological evidence supporting the comorbidity of PE and depression. This study aimed to explore the topological changes of the functional brain networks of PE patients with depression. METHODS Resting-state functional magnetic resonance imaging (rs-fMRI) data were acquired from 60 PE patients (30 with depression and 30 without depression) and 29 healthy controls (HCs). Functional brain networks were constructed for all participants based on rs-fMRI data. The nodal parameters including nodal centrality and efficiency were calculated by the method of graph theory analysis and then compared between groups. In addition, the results were corrected for multiple comparisons by family-wise error (FWE) (p < .05). RESULTS PE patients with depression had increased degree centrality and global efficiency in the right pallidum, as well as increased degree centrality in the right thalamus when compared with HCs. PE patients without depression showed increased degree centrality in the right pallidum and thalamus, as well as increased global efficiency in the right precuneus, pallidum, and thalamus when compared with HCs. PE patients with depression demonstrated decreased degree centrality in the right pallidum and thalamus, as well as decreased global efficiency in the right precuneus, pallidum, and thalamus when compared to those without depression. All the brain regions above survived the FWE correction. CONCLUSION The results suggested that increased and decreased functional connectivity, as well as the capability of global integration of information in the brain, might be related to the occurrence of PE and the comorbidity depression in PE patients, respectively. These findings provided new insights into the understanding of the pathological mechanisms underlying PE and those with depression.
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Affiliation(s)
- Xinyue Zhang
- School of Medicine & Holistic Integrative MedicineNanjing University of Chinese MedicineNanjingChina
| | - Peining Niu
- Department of AndrologySiyang County Traditional Chinese Medicine Hospital Affiliated to Yangzhou University School of MedicineSuqiangChina
| | - Mengqing Su
- School of Chinese Medicine, School of Integrated Chinese and Western MedicineNanjing University of Chinese MedicineNanjingChina
| | - Li Zhou
- School of Chinese Medicine, School of Integrated Chinese and Western MedicineNanjing University of Chinese MedicineNanjingChina
| | - Yunke Huang
- Women's HospitalZhejiang University School of MedicineZhejiangChina
| | - Jianhuai Chen
- Department of AndrologyJiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese MedicineNanjingChina
| | - Shaowei Liu
- Department of RadiologyJiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese MedicineNanjingChina
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Tayim N, Barbosa P, Panicker J. Hypersexuality in neurological disorders: A systematic review. BMJ MENTAL HEALTH 2024; 27:e300998. [PMID: 38777563 PMCID: PMC11116864 DOI: 10.1136/bmjment-2024-300998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND Hypersexuality (HS) accompanying neurological conditions remains poorly characterized despite profound psychosocial impacts. Objective We aimed to systematically review the literature on HS in patients with neurological disorders. Study selection and analysis We conducted a systematic review to identify studies that reported HS in neurological disorders. HS was defined as a condition characterized by excessive and persistent preoccupation with sexual thoughts, urges, and behaviors that cause significant distress or impairment in personal, social, or occupational functioning. Data on demographics, assessment techniques, associated elements, phenotypic manifestations, and management strategies were also extracted. Findings The final analysis included 79 studies on HS, encompassing 32 662 patients across 81 cohorts with neurological disorders. Parkinson's disease was the most frequently studied condition (55.6%), followed by various types of dementia (12.7%). Questionnaires were the most common assessment approach for evaluating HS, although the techniques varied substantially. Alterations in the dopaminergic pathways have emerged as contributing mechanisms based on the effects of medication cessation. However, standardized treatment protocols still need to be improved, with significant heterogeneity in documented approaches. Critical deficiencies include risks of selection bias in participant sampling, uncontrolled residual confounding factors, and lack of blinded evaluations of reported outcomes. Conclusions and clinical implications Despite growth in the last decade, research on HS remains limited across neurological conditions, with lingering quality and methodological standardization deficits. Key priorities include advancing assessment tools, elucidating the underlying neurobiology, and formulating management guidelines. PROSPERO REGISTRATION NUMBER CRD42017036478.
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Affiliation(s)
- Natalie Tayim
- Department of Psychology, Doha Institute for Graduate Studies, Doha, Qatar
| | - Pedro Barbosa
- Movement Disorders Group, Department of Neurology, University of Sao Paulo, Sao Paulo, Brazil
| | - Jalesh Panicker
- Uro-Neurology, National Hospital for Neurology and Neurosurgery, London, UK
- Faculty of Brain Sciences, UCL Queen Square Institute of Neurology, London, UK
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Mbiydzenyuy NE, Joanna Hemmings SM, Shabangu TW, Qulu-Appiah L. Exploring the influence of stress on aggressive behavior and sexual function: Role of neuromodulator pathways and epigenetics. Heliyon 2024; 10:e27501. [PMID: 38486749 PMCID: PMC10937706 DOI: 10.1016/j.heliyon.2024.e27501] [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: 05/27/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/17/2024] Open
Abstract
Stress is a complex and multifaceted phenomenon that can significantly influence both aggressive behavior and sexual function. This review explores the intricate relationship between stress, neuromodulator pathways, and epigenetics, shedding light on the various mechanisms that underlie these connections. While the role of stress in both aggression and sexual behavior is well-documented, the mechanisms through which it exerts its effects are multifarious and not yet fully understood. The review begins by delving into the potential influence of stress on the Hypothalamic-Pituitary-Adrenal (HPA) axis, glucocorticoids, and the neuromodulators involved in the stress response. The intricate interplay between these systems, which encompasses the regulation of stress hormones, is central to understanding how stress may contribute to aggressive behavior and sexual function. Several neuromodulator pathways are implicated in both stress and behavior regulation. We explore the roles of norepinephrine, serotonin, oxytocin, and androgens in mediating the effects of stress on aggression and sexual function. It is important to distinguish between general sexual behavior, sexual motivation, and the distinct category of "sexual aggression" as separate constructs, each necessitating specific examination. Additionally, epigenetic mechanisms emerge as crucial factors that link stress to changes in gene expression patterns and, subsequently, to behavior. We then discuss how epigenetic modifications can occur in response to stress exposure, altering the regulation of genes associated with stress, aggression, and sexual function. While numerous studies support the association between epigenetic changes and stress-induced behavior, more research is necessary to establish definitive links. Throughout this exploration, it becomes increasingly clear that the relationship between stress, neuromodulator pathways, and epigenetics is intricate and multifaceted. The review emphasizes the need for further research, particularly in the context of human studies, to provide clinical significance and to validate the existing findings from animal models. By better understanding how stress influences aggressive behavior and sexual function through neuromodulator pathways and epigenetic modifications, this research aims to contribute to the development of innovative protocols of precision medicine and more effective strategies for managing the consequences of stress on human behavior. This may also pave way for further research into risk factors and underlying mechanisms that may associate stress with sexual aggression which finds application not only in neuroscience, but also law, ethics, and the humanities in general.
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Affiliation(s)
- Ngala Elvis Mbiydzenyuy
- Basic Science Department, School of Medicine, Copperbelt University, P.O Box 71191, Ndola, Zambia
- Division of Medical Physiology, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
| | - Sian Megan Joanna Hemmings
- Division of Molecular Biology & Human Genetics, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
| | - Thando W. Shabangu
- Division of Medical Physiology, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
| | - Lihle Qulu-Appiah
- Division of Medical Physiology, Biomedical Science Research Institute, Stellenbosch University, Private Bag X1, Matieland, 7602, Cape Town South Africa
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Tripathi M, Wankhade L, Mohindra S, Kumar S, Chauhan R. Sexual Dysfunction after Clipping of Ruptured Intracranial Aneurysms. Neurol India 2024; 72:110-116. [PMID: 38443011 DOI: 10.4103/neuroindia.ni_1917_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 11/25/2021] [Indexed: 03/07/2024]
Abstract
BACKGROUND Sexual dysfunction significantly affects interpersonal relationships and overall quality of life. It remains a matter of concern for risk assessment and counseling in patients with ruptured intracranial aneurysms. OBJECTIVE To assess the sexual dysfunctions in patients undergoing clipping for ruptured intracranial aneurysms and comparative evaluation among different anterior circulation aneurysms. METHOD We prospectively included 40 male patients of ruptured intracranial aneurysms of anterior circulation (age range: 20-60 years; sexually active preoperatively), managed with craniotomy and clipping. We evaluated the sexual outcome in patients with excellent Glasgow outcome score (GOS) five at a minimum one year of follow-up. Patients with GOS-5 status at follow-up were broadly classified into two groups: Anterior communicating artery aneurysm (Acom), and non-Acom) aneurysms. We valued sexual outcome with Subjective Sexual Arousal Scale for Men at follow-up, and compared in the two groups. RESULTS Mean age of patients was 44.78 ± 9.51 years. Besides 20 Acom aneurysms, other groups included 11 middle cerebral artery aneurysms, five internal carotid artery aneurysms, three posterior communicating artery aneurysms, and one distal anterior cerebral artery aneurysm. The mean follow-up was 24.45 ± 13.58 months. Patients with non-Acom aneurysms had an overall better outcome in the sexual performance domain "P = 0.015," mental satisfaction domain "P = 0.009," and sexual assertiveness domain "P = 0.007." However, there was no statistical difference in partner communication domain "P = 0.593," and partner relationship domain "P = 0.378." Overall, the sexual outcome was inferior in patients treated for Acom aneurysms compared to other anterior circulation aneurysms. CONCLUSIONS In cases of aneurysmal subarachnoid hemorrhage, sexual dysfunctions are common even after good clinical outcomes. The study revealed prominent differences in outcomes on the sexual quality of life in patients harboring Acom aneurysms as compared to anterior circulation aneurysms located off-midline.
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Affiliation(s)
- Manjul Tripathi
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
- National Institute of Health Research (NIHR) Global Health Research Group on Neurotrauma, University of Cambridge, Cambridge, UK
| | - Lomesh Wankhade
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Sandeep Mohindra
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Santosh Kumar
- Department of Urology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Rajeev Chauhan
- Department of Anesthesiology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Qiu Q, Chen J, Xu N, Zhou X, Ye C, Liu M, Liu Z. Effects of autonomic nervous system disorders on male infertility. Front Neurol 2023; 14:1277795. [PMID: 38125834 PMCID: PMC10731586 DOI: 10.3389/fneur.2023.1277795] [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: 08/15/2023] [Accepted: 09/29/2023] [Indexed: 12/23/2023] Open
Abstract
The male reproductive functions are largely regulated by the autonomic nervous system. Male sexual behavior and fertility primarily depend on the normal function of the higher neural centers related to the autonomic nervous system, the hypothalamic-pituitary-gonadal axis, the autonomic nervous components within the spinal cord and spinal nerves, and certain somatic nerves in the pelvic floor. In this review article, we will summarize the role of the autonomic nervous system in regulating male reproductive capabilities and fertility, its impact on male infertility under abnormal conditions, including the role of drug-induced autonomic nervous dysfunctions on male infertility. The main purpose of this article was to provide an overview of the effects of autonomic nervous dysfunction on male reproductive function and shed light on the potential therapeutic target for male infertility.
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Affiliation(s)
- Qixiang Qiu
- Center for Molecular Pathology, The First Affiliated Hospital, Gannan Medical University, Ganzhou, Jiangxi, China
- Department of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Jincong Chen
- Center for Reproductive Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Nengquan Xu
- Department of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Xiaolong Zhou
- Department of Basic Medicine, Gannan Medical University, Ganzhou, Jiangxi, China
| | - Chenlian Ye
- Department of Gynaecology and Obstetrics, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Min Liu
- Center for Reproductive Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Zhaoxia Liu
- Center for Reproductive Medicine, The First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
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9
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Ziogas A, Habermeyer E, Santtila P, Poeppl TB, Mokros A. Neuroelectric Correlates of Human Sexuality: A Review and Meta-Analysis. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:497-596. [PMID: 32016814 DOI: 10.1007/s10508-019-01547-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 07/17/2019] [Accepted: 09/04/2019] [Indexed: 05/15/2023]
Abstract
Many reviews on sexual arousal in humans focus on different brain imaging methods and behavioral observations. Although neurotransmission in the brain is mainly performed through electrochemical signals, there are no systematic reviews of the electrophysiological correlates of sexual arousal. We performed a systematic search on this subject and reviewed 255 studies including various electrophysiological methods. Our results show how neuroelectric signals have been used to investigate genital somatotopy as well as basic genital physiology during sexual arousal and how cortical electric signals have been recorded during orgasm. Moreover, experiments on the interactions of cognition and sexual arousal in healthy subjects and in individuals with abnormal sexual preferences were analyzed as well as case studies on sexual disturbances associated with diseases of the nervous system. In addition, 25 studies focusing on brain potentials during the interaction of cognition and sexual arousal were eligible for meta-analysis. The results showed significant effect sizes for specific brain potentials during sexual stimulation (P3: Cohen's d = 1.82, N = 300, LPP: Cohen's d = 2.30, N = 510) with high heterogeneity between the combined studies. Taken together, our review shows how neuroelectric methods can consistently differentiate sexual arousal from other emotional states.
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Affiliation(s)
- Anastasios Ziogas
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Alleestrasse 61A, 8462, Rheinau, Switzerland.
| | - Elmar Habermeyer
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Pekka Santtila
- Department of Arts & Sciences, New York University-Shanghai, Shanghai, China
| | - Timm B Poeppl
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, RWTH Aachen University, Aachen, Germany
| | - Andreas Mokros
- Department of Forensic Psychiatry, University Hospital of Psychiatry Zurich, Zurich, Switzerland
- Faculty of Psychology, Fern Universität in Hagen (University of Hagen), Hagen, Germany
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10
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Desai A, Chen R, Cayetano A, Jayasena CN, Minhas S. Understanding and treating ejaculatory dysfunction in men with diabetes mellitus. Andrology 2023; 11:379-398. [PMID: 35933708 DOI: 10.1111/andr.13262] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 01/24/2023]
Abstract
Diabetes mellitus is a rapidly rising metabolic disorder with important systemic complications. Global figures have demonstrated the prevalence of diabetes mellitus has almost quadrupled from 108 million in 1980 to 422 million in 2014, with a current prevalence of over 525 million. Of the male sexual dysfunction resulting from diabetes mellitus, significant focus is afforded to erectile dysfunction. Nevertheless, ejaculatory dysfunction constitutes important sexual sequelae in diabetic men, with up to 35%-50% of men with diabetes mellitus suffering from ejaculatory dysfunction. Despite this, aspects of its pathophysiology and treatment are less well understood than erectile dysfunction. The main disorders of ejaculation include premature ejaculation, delayed ejaculation, anejaculation and retrograde ejaculation. Although ejaculatory dysfunction in diabetes mellitus can have complex multifactorial aetiology, understanding its pathophysiological mechanisms has facilitated the development of therapies in the management of ejaculatory dysfunction. Most of our understanding of its pathophysiology is derived from diabetic animal models; however, observational studies in humans have also provided useful information in elucidating important associative factors potentially contributing to ejaculatory dysfunction in diabetic men. These have provided the potential for more tailored treatment regimens in patients depending on the ejaculatory disorder, other co-existing sequelae of diabetes mellitus, specific metabolic factors as well as the need for fertility treatment. However, evidence for treatment of ejaculatory dysfunction, especially delayed ejaculation and retrograde ejaculation, is based on low-level evidence comprising small sample-size series and retrospective or cross-sectional studies. Whilst promising findings from large randomised controlled trials have provided strong evidence for the licensed treatment of premature ejaculation, similar robust studies are needed to accurately elucidate factors predicting ejaculatory dysfunction in diabetes mellitus, as well as for the development of pharmacotherapies for delayed ejaculation and retrograde ejaculation. Similarly, more contemporary robust data are required for fertility outcomes in these patients, including methods of sperm retrieval and assisted reproductive techniques in retrograde ejaculation.
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Affiliation(s)
- Ankit Desai
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
| | - Runzhi Chen
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
| | - Axel Cayetano
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
| | - Channa N Jayasena
- Department of Reproductive Endocrinology, Imperial Healthcare NHS Trust, London, UK
| | - Suks Minhas
- Department of Andrology, Imperial Healthcare NHS Trust, London, UK
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Yang Y, Qu L, Mu L, Yao J, Su C, Zheng Q, Zheng H, Zhang P, Li Y. Electroacupuncture for psychogenic erectile dysfunction: A resting-state functional magnetic resonance imaging study exploring the alteration of fractional amplitude of low frequency fluctuation. Front Hum Neurosci 2023; 17:1116202. [PMID: 37063106 PMCID: PMC10098132 DOI: 10.3389/fnhum.2023.1116202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Accepted: 03/16/2023] [Indexed: 04/18/2023] Open
Abstract
Background Psychogenic erectile dysfunction (PED) can seriously affect emotional and marital wellbeing. Electroacupuncture (EA) seems an effective method for treating PED. However, the central mechanisms underlying PED and the beneficial effects of EA treatment are unclear. The purpose of this study was to explore the central mechanisms of PED and to examine the impact of EA on erectile function. Methods We recruited 14 PED patients and 14 matched normal controls (NCs). PED patients underwent twice rs-fMRI scans, respectively, pre- and post-treatment. The NCs only completed one rs-fMRI scan. We used the fractional amplitude of low frequency fluctuation (fALFF) to compare spontaneous neural activity between the PED patients and NCs, and to examine the differences between the pre- and post-EA treatment scans in the PED patients. Results Scores on the IIEF5, QEQ, and SEAR improved after EA treatment. Compared with the NCs, PED patients showed increased fALFF in the right posterior cingulate cortex (PCC), right dorsolateral prefrontal cortex (DLPFC), right supplementary motor area (SMA), and left middle occipital gyrus. Most of these regions are closely implicated in sexual inhibition. The results of the correlation analysis results indicated that the fALFF of the right PCC was negatively correlated with IIEF5 scores. After treatment, fALFF values were substantially lower in the left triangular part of the inferior frontal gyrus, right DLPFC, right SMA, bilateral PCC and the orbital part of the middle frontal gyrus, and higher in the left middle temporal gyrus and left caudate nucleus. These regions mainly belong to the default mode network (DMN), executive control network and primary sensory motor network. The results of the correlation analysis indicated a positive association between the changes in IIEF5 score and changes in the fALFF value in the right PCC after EA treatment. Conclusion In conclusion, our study highlights that PED patients have abnormal patterns of activity in the right PCC, right DLPFC, and right SMA mainly involved in the DMN, executive central network, and sensory motor network which could lead to a higher levels of sexual inhibition. EA might regulate the process of sexual inhibition to improve erection function in PED patients probably by modulating spontaneous brain activity in the DMN, executive central network, and sensory motor network.
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Affiliation(s)
- Yuqing Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Liu Qu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Linxuan Mu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Junpeng Yao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Chengguo Su
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Huabin Zheng
- Department of Acupuncture and Moxibustion, The Hospital of Chengdu University of Chinese Medicine, Chengdu, Sichuan, China
| | - Peihai Zhang
- Department of Urology/Andrology, The Hospital of Chengdu University of Chinese Medicine, Chengdu, Sichuan, China
- Peihai Zhang,
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
- *Correspondence: Ying Li,
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Turner D, Briken P, Grubbs J, Malandain L, Mestre-Bach G, Potenza MN, Thibaut F. The World Federation of Societies of Biological Psychiatry guidelines on the assessment and pharmacological treatment of compulsive sexual behaviour disorder. DIALOGUES IN CLINICAL NEUROSCIENCE 2022; 24:10-69. [PMID: 37522807 PMCID: PMC10408697 DOI: 10.1080/19585969.2022.2134739] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/18/2022] [Accepted: 10/03/2022] [Indexed: 11/18/2022]
Abstract
OBJECTIVES The current guidelines aim to evaluate the role of pharmacological agents in the treatment of patients with compulsive sexual behaviour disorder (CSBD). They are intended for use in clinical practice by clinicians who treat patients with CSBD. METHODS An extensive literature search was conducted using the English-language-literature indexed on PubMed and Google Scholar without time limit, supplemented by other sources, including published reviews. RESULTS Each treatment recommendation was evaluated with respect to the strength of evidence for its efficacy, safety, tolerability, and feasibility. Psychoeducation and psychotherapy are first-choice treatments and should always be conducted. The type of medication recommended depended mainly on the intensity of CSBD and comorbid sexual and psychiatric disorders. There are few randomised controlled trials. Although no medications carry formal indications for CSBD, selective-serotonin-reuptake-inhibitors and naltrexone currently constitute the most relevant pharmacological treatments for the treatment of CSBD. In cases of CSBD with comorbid paraphilic disorders, hormonal agents may be indicated, and one should refer to previously published guidelines on the treatment of adults with paraphilic disorders. Specific recommendations are also proposed in case of chemsex behaviour associated with CSBD. CONCLUSIONS An algorithm is proposed with different levels of treatment for different categories of patients with CSBD.
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Affiliation(s)
- Daniel Turner
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Joshua Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Leo Malandain
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
| | - Gemma Mestre-Bach
- Facultad de Ciencias de la Salud, Universidad Internacional de La Rioja, La Rioja, Spain
| | - Marc N. Potenza
- Departments of Psychiatry and Neuroscience and Child Study Center, Yale School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - Florence Thibaut
- Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier) AP-HP, Paris, France
- INSERM U1266, Institute of Psychiatry and Neurosciences, University of Paris Cité, Paris, France
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13
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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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Mukku SSR, Jagtap N, Muliyala KP, Sivakumar PT, Sinha P, Mangalore S, Varghese M. Is Thalamic Lesion a Contributing Factor for Inappropriate Sexual Behavior in Older Adults with Cognitive Impairment? J Neurosci Rural Pract 2022; 13:343-347. [PMID: 35694053 PMCID: PMC9187375 DOI: 10.1055/s-0042-1744470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Thalamus is a group of nuclei located deep inside the brain, well known for its sensory and cognitive functions. However, its role in the reward and behavior regulation is less explored. In this case series, we have presented four cases with inappropriate sexual behaviors (ISB) that are temporally related to thalamic infarction. We have discussed about the limbic part of thalamus and its extensive connections with other regions in regulating sexual behaviors. Although in all the four cases described there was underlying cognitive impairment that can itself increase the risk of ISB, there was potential contributing role of thalamic lesions.
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Affiliation(s)
| | - Namrata Jagtap
- Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Krishna Prasad Muliyala
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - P. T. Sivakumar
- Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Preeti Sinha
- Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sandhya Mangalore
- Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Mathew Varghese
- Geriatric Clinic and Services, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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15
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Batzu L, Titova N, Bhattacharyya KB, Chaudhuri KR. The pathophysiology of sexual dysfunction in Parkinson's disease: An overview. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2022; 162:21-34. [PMID: 35397787 DOI: 10.1016/bs.irn.2022.01.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Sexual dysfunction is a common, poorly recognized, poorly discussed (often because of cultural perceptions and sensitivities), bothersome and neglected aspect of the range of non-motor symptoms of Parkinson's disease (PD). The spectrum of sexual dysfunction in PD ranges from hyposexuality-based disturbances to hypersexuality-dominated behaviors in the context of drug-induced impulse control disorder. The pathophysiological mechanisms underlying PD-related sexual dysfunction, specifically for hyposexual disorders, are thus heterogeneous and still not fully understood. However, central and peripheral neural mechanisms secondary to the hallmark pathological alterations of the disease (alpha-synuclein deposition and nigrostriatal degeneration) and to the associated network and neurotransmitter dysfunctions, together with the effects of dopaminergic therapies, seem to play an important role in the development of sexual disturbances. In this chapter, we therefore review the neuroanatomical and neurophysiological basis of sexual function in humans, and we provide insights on the pathophysiological mechanisms of hyposexuality and hypersexuality in PD.
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Affiliation(s)
- Lucia Batzu
- Clinical Director Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Nataliya Titova
- Department of Neurology, Neurosurgery and Medical Genetics, Federal State Autonomous Educational Institution of Higher Education "N.I. Pirogov Russian National Research Medical University" of the Ministry of Health of the Russian Federation, Moscow, Russia; Department of Neurodegenerative Diseases, Federal State Budgetary Institution 'Federal Center of Brain and Neurotechnologies' of the Ministry of Health of the Russian Federation, Moscow, Russia
| | | | - K Ray Chaudhuri
- Clinical Director Parkinson's Foundation Centre of Excellence, King's College Hospital, London, United Kingdom; Department of Basic and Clinical Neurosciences, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom.
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16
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Ota K, Kimura M, Kawamoto M. Cerebral blood flow imaging in MR-negative SARS-CoV-2-related encephalitis with abnormal psychosis. Eur J Nucl Med Mol Imaging 2022; 49:2450-2451. [PMID: 35175375 PMCID: PMC8852877 DOI: 10.1007/s00259-022-05728-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/13/2022] [Indexed: 12/04/2022]
Affiliation(s)
- Kazuma Ota
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Masamune Kimura
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Michi Kawamoto
- Department of Neurology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
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17
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Kim NN. Testosterone and Female Sexual Desire: Direct or Indirect Effects? J Sex Med 2021; 19:5-7. [PMID: 34848139 DOI: 10.1016/j.jsxm.2021.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Noel N Kim
- Institute for Sexual Medicine, San Diego, CA, USA.
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18
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Jahn K, Kurz B, Sinke C, Kneer J, Riemer O, Ponseti J, Walter M, Beier KM, Walter H, Frieling H, Schiffer B, Kruger THC. Serotonin system-associated genetic and epigenetic changes in pedophilia and child sexual offending. J Psychiatr Res 2021; 145:60-69. [PMID: 34871921 DOI: 10.1016/j.jpsychires.2021.11.042] [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: 07/29/2021] [Revised: 11/19/2021] [Accepted: 11/24/2021] [Indexed: 11/23/2022]
Abstract
Numerous studies have shown associations between anomalies of the serotonergic system and impulsive behavior, depression, or traumatic life events. However, it is currently unknown, whether pedophilia or child sexual offending (CSO) is also related to alterations of the serotonergic system. Using a two by two factorial paradigm within a multisite consortium (NeMUP*) study cohort, we analyzed whether the SLC6A4-linked polymorphic region (SLC6A4LPR) or the SLC6A4 (transporter) and HTR3A (receptor) promotor methylation rates differed with regard to a pedophilic preference and/or child sexual offending. Methylation rates of HTR3A showed significant differences between child sexual offenders and non-offenders, with child sexual offenders showing lower methylation rates. Moreover, HTR3A methylation rates showed significant negative correlations with the Child Trauma Questionnaire (CTQ) subscale "sexual violence", and the number of sexual offenses committed. Interestingly, we also found pedophilia-related alterations in 5HT3A as well as SLC6A4 methylation rates. For HTR3A we detected significant higher methylation rates in subjects with a pedophilic sexual preference, whereas for SLC6A4 methylation rates were reduced, indicating a possible downregulation of the serotonergic system in total. Although there were no significant group differences concerning the SLC6A4LPR, we found a significant correlation of the SLC6A4 methylation rate with this polymorphism in pedophilia. The present study suggests an involvement of epigenetic alterations of the serotonergic system in pedophilia and child sexual offending as well as own experience of sexual violence. While such an environmental factor may account for the epigenetic changes seen in child sexual offending, this was not seen in pedophilia. These findings will hopefully inspire further research in this underinvestigated field which should aim at validating and extending these initial results.
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Affiliation(s)
- Kirsten Jahn
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Laboratory of Molecular Psychiatry, Hannover, Medical School, Hannover, Germany
| | - Bernadett Kurz
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Christopher Sinke
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover, Medical School, Hannover, Germany
| | - Jonas Kneer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover, Medical School, Hannover, Germany
| | - Ole Riemer
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Laboratory of Molecular Psychiatry, Hannover, Medical School, Hannover, Germany
| | - Jorge Ponseti
- Institute of Sexual Medicine and Forensic Psychiatry and Psychotherapy, Medical School, Kiel University, Kiel, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany; Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - Klaus M Beier
- Institute of Sexology and Sexual Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Henrik Walter
- Division of Mind and Brain Research, Department of Psychiatry and Psychotherapy, CCM, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany
| | - Helge Frieling
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Laboratory of Molecular Psychiatry, Hannover, Medical School, Hannover, Germany; Center for Systems Neurosciences, Hannover, Germany
| | - Boris Schiffer
- Division of Forensic Psychiatry, Department of Psychiatry, Psychotherapy and Preventive Medicine, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Tillmann H C Kruger
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover, Medical School, Hannover, Germany; Center for Systems Neurosciences, Hannover, Germany.
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Peleg LC, Rabinovitch D, Lavie Y, Rabbie DM, Horowitz I, Fruchter E, Gruenwald I. Post-SSRI Sexual Dysfunction (PSSD): Biological Plausibility, Symptoms, Diagnosis, and Presumed Risk Factors. Sex Med Rev 2021; 10:91-98. [PMID: 34627736 DOI: 10.1016/j.sxmr.2021.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 06/24/2021] [Accepted: 07/06/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Post-SSRI sexual-dysfunction (PSSD) is an iatrogenicsyndrome, the underlying neurobiological mechanisms of which areunclear. Symptom onset follows cessation of serotonergicantidepressants i.e. Selective Serotonin and Norepinephrine ReuptakeInhibitors (SSRI's, SNRI's), and Tricyclic antidepressants (TCA's). PSSDsymptoms include genital anesthesia, erectile dysfunction andorgasmic/ejaculatory anhedonia, and should be differentiated fromdepression-related sexual-dysfunction. Recently, accumulated data of numerous case-reports suggest additional non-sexual symptoms including, anhedonia, apathy, and blunted affect. PSSD gained official recognition after the European medical agency concluded that PSSD is a medical condition that persists after discontinuation of SSRI's and SNRI's. OBJECTIVE To review possible underlying neurobiological mechanisms ofthis syndrome, update information on the pathophysiology, present a listof potential risk-factors and discuss potential management options forPSSD. METHODS Extensive literature review on the main symptom-patterns ofthis disorder was undertaken using PubMed. It includes introductoryexplications of relevant neurobiology with the objective of generatinghypothesis. RESULTS Precipitating factors for PSSD include previous exposure to certain drugs, genetic predisposition, psychological stress or chemical stressful reaction to antidepressants along pre-existing medical conditions affecting neuroplasticity. Different theories have been proposed to explain the pathophysiology of PSSD: epigenetic gene expression, dopamine-serotonin interactions, serotonin neurotoxicity and hormonal changes. The diagnosis of PSSD is by excluding all other etiologies of sexual-dysfunction. Treatment is challenging, and many strategies have been suggested without definitive outcomes. We offerthe contours of a future neurobiological research agenda, and propose several underlying mechanisms for the various symptoms of PSSD which could be the foundation for a future treatment algorithm. CONCLUSION There is a need for well-designed neurobiological research in this domain, as well as in the prevalence, pathophysiology, and treatment of PSSD. Practitioners should be alert to the distinctive features of PSSD. Misdiagnosing this syndrome might lead to harmful Sexual Medicine Reviews. Peleg LC, Rabinovitch D, Lavie Y, et al. Post-SSRI Sexual Dysfunction (PSSD): Biological Plausibility, Symptoms, Diagnosis, and Presumed Risk Factors. Sex Med Rev 2021;XX:XXX-XXX.
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Affiliation(s)
| | | | | | - Deya M Rabbie
- Ahram Canadian University, Neuropharmacology, 6th of October City, Egypt
| | - Itai Horowitz
- Rambam Healthcare Campus, Psychiatry Department, Haifa, Israel
| | | | - Ilan Gruenwald
- Rambam Healthcare Campus, Neuro-Urology Unit, Haifa, Israel.
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20
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Alam MA, Qiu C, Shen H, Wang YP, Deng HW. A generalized kernel machine approach to identify higher-order composite effects in multi-view datasets, with application to adolescent brain development and osteoporosis. J Biomed Inform 2021; 120:103854. [PMID: 34237438 DOI: 10.1016/j.jbi.2021.103854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 05/28/2021] [Accepted: 06/28/2021] [Indexed: 10/20/2022]
Abstract
In recent years, a comprehensive study of complex disease with multi-view datasets (e.g., multi-omics and imaging scans) has been a focus and forefront in biomedical research. State-of-the-art biomedical technologies are enabling us to collect multi-view biomedical datasets for the study of complex diseases. While all the views of data tend to explore complementary information of disease, analysis of multi-view data with complex interactions is challenging for a deeper and holistic understanding of biological systems. In this paper, we propose a novel generalized kernel machine approach to identify higher-order composite effects in multi-view biomedical datasets (GKMAHCE). This generalized semi-parametric (a mixed-effect linear model) approach includes the marginal and joint Hadamard product of features from different views of data. The proposed kernel machine approach considers multi-view data as predictor variables to allow a more thorough and comprehensive modeling of a complex trait. We applied GKMAHCE approach to both synthesized datasets and real multi-view datasets from adolescent brain development and osteoporosis study. Our experiments demonstrate that the proposed method can effectively identify higher-order composite effects and suggest that corresponding features (genes, region of interests, and chemical taxonomies) function in a concerted effort. We show that the proposed method is more generalizable than existing ones. To promote reproducible research, the source code of the proposed method is available at.
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Affiliation(s)
- Md Ashad Alam
- Tulane Center for Biomedical Informatics and Genomics, Tulane University, New Orleans, LA 70112, USA; Division of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA 70112, USA.
| | - Chuan Qiu
- Tulane Center for Biomedical Informatics and Genomics, Tulane University, New Orleans, LA 70112, USA; Division of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Hui Shen
- Tulane Center for Biomedical Informatics and Genomics, Tulane University, New Orleans, LA 70112, USA; Division of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Yu-Ping Wang
- Tulane Center for Biomedical Informatics and Genomics, Tulane University, New Orleans, LA 70112, USA; Department of Biomedical Engineering, Tulane University, New Orleans, LA 70118, USA
| | - Hong-Wen Deng
- Tulane Center for Biomedical Informatics and Genomics, Tulane University, New Orleans, LA 70112, USA; Division of Biomedical Informatics and Genomics, Deming Department of Medicine, Tulane University, New Orleans, LA 70112, USA
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21
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Local Genital Arousal: Mechanisms for Vaginal Lubrication. CURRENT SEXUAL HEALTH REPORTS 2021. [DOI: 10.1007/s11930-021-00305-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Dickenson JA, Diamond L, King JB, Jenson K, Anderson JS. Understanding heterosexual women's erotic flexibility: the role of attention in sexual evaluations and neural responses to sexual stimuli. Soc Cogn Affect Neurosci 2021; 15:447-465. [PMID: 32415978 PMCID: PMC7308660 DOI: 10.1093/scan/nsaa058] [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: 01/18/2018] [Revised: 02/10/2020] [Accepted: 04/13/2020] [Indexed: 11/13/2022] Open
Abstract
Many women experience desires, arousal and behavior that run counter to their sexual orientation (orientation inconsistent, 'OI'). Are such OI sexual experiences cognitively and neurobiologically distinct from those that are consistent with one's sexual orientation (orientation consistent, 'OC')? To address this question, we employed a mindful attention intervention-aimed at reducing judgment and enhancing somatosensory attention-to examine the underlying attentional and neurobiological processes of OC and OI sexual stimuli among predominantly heterosexual women. Women exhibited greater neural activity in response to OC, compared to OI, sexual stimuli in regions associated with implicit visual processing, volitional appraisal and attention. In contrast, women exhibited greater neural activity to OI, relative to OC, sexual stimuli in regions associated with complex visual processing and attentional shifting. Mindfully attending to OC sexual stimuli reduced distraction, amplified women's evaluations of OC stimuli as sexually arousing and deactivated the superior cerebellum. In contrast, mindfully attending to OI sexual stimuli amplified distraction, decreased women's evaluations of OI stimuli as sexually arousing and augmented parietal and temporo-occipital activity. Results of the current study constrain hypotheses of female erotic flexibility, suggesting that sexual orientation may be maintained by differences in attentional processing that cannot be voluntarily altered.
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Affiliation(s)
- Janna A Dickenson
- Human Sexuality, California Institute of Integral Studies, San Francisco, CA 94103, USA.,Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Lisa Diamond
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Jace B King
- Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.,Program in Neuroscience, University of Utah, Salt Lake City, UT 84108, USA
| | - Kay Jenson
- Department of Psychology, University of Utah, Salt Lake City, UT 84112, USA
| | - Jeffrey S Anderson
- Department of Radiology and Imaging Sciences, School of Medicine, University of Utah, Salt Lake City, UT 84132, USA.,Program in Neuroscience, University of Utah, Salt Lake City, UT 84108, USA.,Department of Bioengineering, University of Utah, Salt Lake City, UT 84108, USA
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23
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Prado CSDC, Lopes PMG, Moll J, DeSalles A, de Oliveira-Souza R. A case of developmental pedophilia unmasked by frontotemporal dementia. Neurocase 2021; 27:129-137. [PMID: 33856971 DOI: 10.1080/13554794.2021.1886310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 65-year-old right-handed man gradually became socially indifferent and less active. Four years later, he was indicted for molesting children on multiple occasions. Psychomotor slowness and executive impairment contrasted with sparing of language, semantic memory, visuospatial perception, construction praxis, and right-left orientation. Neuroimaging showed asymmetric atrophy of dorsomedial frontal and anterior temporal lobes, and hypoperfusion of medial prefrontal cortex consistent with a diagnosis of behavioral variant of frontotemporal dementia. Further information revealed that the patient exhibited pedophilic behavior several years prior to symptom onset. We conclude that preexisting developmental pedophilia was "unmasked" by the underlying progressive frontotemporal degeneration.
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Affiliation(s)
- Catarina Sodré de Castro Prado
- Department of Neurology, Gaffrée e Guinle University Hospital, the Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Pedro Maranhão Gomes Lopes
- Department of Neurology, Gaffrée e Guinle University Hospital, the Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Jorge Moll
- Division of Clinical and Experimental Neurology, The D'Or Institute for Research & Education (Idor), Rio de Janeiro, RJ, Brazil
| | - Antonio DeSalles
- Professor Emeritus of Neurosurgery and Radiation Oncology, UCLA School of Medicine; and Department of Neurosurgery and Radiotherapy, Director of NeuroSapiens, Neurosurgery at the D'Or-São Luiz Hospitals Network, São Paulo, SP, Brazil
| | - Ricardo de Oliveira-Souza
- Department of Neurology, Gaffrée e Guinle University Hospital, the Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Division of Clinical and Experimental Neurology, The D'Or Institute for Research & Education (Idor), Rio de Janeiro, RJ, Brazil
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24
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Olfaction Is Associated With Sexual Motivation and Satisfaction in Older Men and Women. J Sex Med 2021; 18:295-302. [DOI: 10.1016/j.jsxm.2020.12.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/10/2020] [Accepted: 12/02/2020] [Indexed: 01/17/2023]
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25
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Amezcua-Gutiérrez C, Hernández-González M, Guasti AF, Aguilar MAC, Guevara MA. Observing Erotic Videos with Heterosexual Content Induces Different Cerebral Responses in Homosexual and Heterosexual Men. JOURNAL OF HOMOSEXUALITY 2021; 68:138-156. [PMID: 31430230 DOI: 10.1080/00918369.2019.1648079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
To determine the cerebral functionality associated with the perception and processing of erotic stimuli in men with different sexual orientation, this work evaluated the electroencephalographic activity (EEG) from several cortical areas, as well as subjective arousal in homosexual and heterosexual men during observation of an erotic film with heterosexual content. The heterosexual men rated the erotic video with higher general and sexual arousal than the homosexual participants. During observation of the neutral and erotic videos, both groups showed a decreased amplitude of the alpha band in prefrontal and parietal cortices, indicating increased attention. When watching the erotic video, the homosexual men showed an increased amplitude of the theta and fast bands only in the prefrontal cortex, which could be related to the cognitive processing of the erotic stimulus. These EEG results should broaden our knowledge of the cortical mechanisms related to the different perception and processing of erotic stimuli in men with different sexual orientations.
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Affiliation(s)
| | | | | | - Manuel Alejandro Cruz Aguilar
- National Institute of Psychiatry, "Ramón de la Fuente Muñiz", Neuroscience Research Direction, Chronobiology and Sleep Laboratory , Mexico, México
| | - Miguel Angel Guevara
- Institute of Neuroscience, CUCBA, University of Guadalajara , Guadalajara, Jalisco, México
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26
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Ahmed RM, Halliday G, Hodges JR. Hypothalamic symptoms of frontotemporal dementia disorders. HANDBOOK OF CLINICAL NEUROLOGY 2021; 182:269-280. [PMID: 34266598 DOI: 10.1016/b978-0-12-819973-2.00019-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Frontotemporal dementia (FTD) has traditionally been regarded as a disease of cognition and behavior, but emerging evidence suggests that the disease also affects body functions including changes in eating behavior and metabolism, autonomic function, sleep behavior, and sexual function. Central to these changes are potentially complex neural networks involving the hypothalamus, with hypothalamic atrophy shown in behavioral variant FTD. The physiological changes found in FTD are reviewed and the key neural networks and neuroendocrine changes mediating these changes in function discussed, including the ability to use these changes as biomarkers to aid in disease diagnosis, monitoring disease progression, and as potential treatment targets.
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Affiliation(s)
- Rebekah M Ahmed
- Memory and Cognition Clinic, Department of Clinical Neurosciences, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Glenda Halliday
- Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - John R Hodges
- Central Sydney Medical School and Brain & Mind Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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27
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Keever MR, Zhang P, Bolt CR, Antonson AM, Rymut HE, Caputo MP, Houser AK, Hernandez AG, Southey BR, Rund LA, Johnson RW, Rodriguez-Zas SL. Lasting and Sex-Dependent Impact of Maternal Immune Activation on Molecular Pathways of the Amygdala. Front Neurosci 2020; 14:774. [PMID: 32848554 PMCID: PMC7431923 DOI: 10.3389/fnins.2020.00774] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 07/01/2020] [Indexed: 12/23/2022] Open
Abstract
The prolonged and sex-dependent impact of maternal immune activation (MIA) during gestation on the molecular pathways of the amygdala, a brain region that influences social, emotional, and other behaviors, is only partially understood. To address this gap, we investigated the effects of viral-elicited MIA during gestation on the amygdala transcriptome of pigs, a species of high molecular and developmental homology to humans. Gene expression levels were measured using RNA-Seq on the amygdala for 3-week-old female and male offspring from MIA and control groups. Among the 403 genes that exhibited significant MIA effect, a prevalence of differentially expressed genes annotated to the neuroactive ligand-receptor pathway, glutamatergic functions, neuropeptide systems, and cilium morphogenesis were uncovered. Genes in these categories included corticotropin-releasing hormone receptor 2, glutamate metabotropic receptor 4, glycoprotein hormones, alpha polypeptide, parathyroid hormone 1 receptor, vasointestinal peptide receptor 2, neurotensin, proenkephalin, and gastrin-releasing peptide. These categories and genes have been associated with the MIA-related human neurodevelopmental disorders, including schizophrenia and autism spectrum disorders. Gene network reconstruction highlighted differential vulnerability to MIA effects between sexes. Our results advance the understanding necessary for the development of multifactorial therapies targeting immune modulation and neurochemical dysfunction that can ameliorate the effects of MIA on offspring behavior later in life.
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Affiliation(s)
- Marissa R. Keever
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Pan Zhang
- Illinois Informatics Institute, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Courtni R. Bolt
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Adrienne M. Antonson
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Haley E. Rymut
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Megan P. Caputo
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Alexandra K. Houser
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Alvaro G. Hernandez
- High-throughput Sequencing and Genotyping Unit, Roy J. Carver Biotechnology Center, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Bruce R. Southey
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Laurie A. Rund
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Rodney W. Johnson
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Sandra L. Rodriguez-Zas
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Illinois Informatics Institute, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Neuroscience Program, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Department of Statistics, University of Illinois at Urbana-Champaign, Urbana, IL, United States
- Carl R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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28
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Mohandass A, Krishnan V, Gribkova ED, Asuthkar S, Baskaran P, Nersesyan Y, Hussain Z, Wise LM, George RE, Stokes N, Alexander BM, Cohen AM, Pavlov EV, Llano DA, Zhu MX, Thyagarajan B, Zakharian E. TRPM8 as the rapid testosterone signaling receptor: Implications in the regulation of dimorphic sexual and social behaviors. FASEB J 2020; 34:10887-10906. [PMID: 32609392 PMCID: PMC7496617 DOI: 10.1096/fj.202000794r] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/20/2020] [Accepted: 06/08/2020] [Indexed: 01/19/2023]
Abstract
Testosterone regulates dimorphic sexual behaviors in all vertebrates. However, the molecular mechanism underlying these behaviors remains unclear. Here, we report that a newly identified rapid testosterone signaling receptor, Transient Receptor Potential Melastatin 8 (TRPM8), regulates dimorphic sexual and social behaviors in mice. We found that, along with higher steroid levels in the circulation, TRPM8-/- male mice exhibit increased mounting frequency indiscriminate of sex, delayed sexual satiety, and increased aggression compared to wild-type controls, while TRPM8-/- females display an increased olfaction-exploratory behavior. Furthermore, neuronal responses to acute testosterone application onto the amygdala were attenuated in TRPM8-/- males but remained unchanged in females. Moreover, activation of dopaminergic neurons in the ventral tegmental area following mating was impaired in TRPM8-/- males. Together, these results demonstrate that TRPM8 regulates dimorphic sexual and social behaviors, and potentially constitutes a signalosome for mediation of sex-reward mechanism in males. Thus, deficiency of TRPM8 might lead to a delayed sexual satiety phenomenon.
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Affiliation(s)
- Adithya Mohandass
- College of Health Sciences, School of Pharmacy, University of Wyoming, Laramie, WY, USA
| | - Vivek Krishnan
- College of Health Sciences, School of Pharmacy, University of Wyoming, Laramie, WY, USA
| | - Ekaterina D Gribkova
- Department of Molecular and Integrative Physiology, Neuroscience Program and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Swapna Asuthkar
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL, USA
| | - Padmamalini Baskaran
- College of Health Sciences, School of Pharmacy, University of Wyoming, Laramie, WY, USA
| | - Yelena Nersesyan
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL, USA
| | - Zahir Hussain
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL, USA.,Department of Physiology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Leslie M Wise
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL, USA
| | - Robert E George
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL, USA
| | - Nadarra Stokes
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL, USA
| | | | - Alejandro M Cohen
- Biological Mass Spectrometry Core Facility, Life Sciences Research Institute, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Evgeny V Pavlov
- Department of Molecular Pathobiology, New York University College of Dentistry, New York, NY, USA
| | - Daniel A Llano
- Department of Molecular and Integrative Physiology, Neuroscience Program and Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, Urbana, IL, USA
| | - Michael X Zhu
- Department of Integrative Biology and Pharmacology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Baskaran Thyagarajan
- College of Health Sciences, School of Pharmacy, University of Wyoming, Laramie, WY, USA
| | - Eleonora Zakharian
- Department of Cancer Biology and Pharmacology, University of Illinois College of Medicine, Peoria, IL, USA
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29
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Calabrò RS, Cacciola A, Bruschetta D, Milardi D, Quattrini F, Sciarrone F, la Rosa G, Bramanti P, Anastasi G. Neuroanatomy and function of human sexual behavior: A neglected or unknown issue? Brain Behav 2019; 9:e01389. [PMID: 31568703 PMCID: PMC6908863 DOI: 10.1002/brb3.1389] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/03/2019] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Sexual desire, arousal, and orgasm are mediated by complex, yet still not fully understood, interactions of the somatic and autonomic nervous systems operating at the central and peripheral levels. Disruption of endocrine, neural, or vascular response, caused by aging, medical illness, neurological diseases, surgery, or drugs, can lead to sexual dysfunctions, thus significantly affecting patients' quality of life. PURPOSE This narrative review aims at characterizing the involvement of the central nervous system in human sexual behavior. METHODS A literature search was conducted using PubMed in its entirety up to June 2018, analyzing the studies dealing with the neurobiological and neurophysiological basis of human sexuality. RESULTS Sexual behavior is regulated by both subcortical structures, such as the hypothalamus, brainstem, and spinal cord, and several cortical brain areas acting as an orchestra to finely adjust this primitive, complex, and versatile behavior. At the central level, dopaminergic and serotonergic systems appear to play a significant role in various factors of sexual response, although adrenergic, cholinergic, and other neuropeptide transmitter systems may contribute as well. CONCLUSIONS Providing healthcare professionals with information concerning sexual behavior may overcome useless and sometimes dangerous barriers and improve patient management, since sexual well-being is considered one of the most important aspects of one's quality of life.
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Affiliation(s)
| | | | - Daniele Bruschetta
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | - Demetrio Milardi
- IRCCS Centro Neurolesi "Bonino Pulejo", Messina, Italy.,Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
| | | | | | | | | | - Giuseppe Anastasi
- Department of Biomedical, Dental Sciences and Morphological and Functional Images, University of Messina, Messina, Italy
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30
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Rodriguez-Nieto G, Emmerling F, Dewitte M, Sack AT, Schuhmann T. The Role of Inhibitory Control Mechanisms in the Regulation of Sexual Behavior. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:481-494. [PMID: 30671876 PMCID: PMC6373525 DOI: 10.1007/s10508-018-1283-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Revised: 07/11/2018] [Accepted: 07/28/2018] [Indexed: 05/31/2023]
Abstract
Sexual behavior is the open manifestation of a complex interplay between psychophysiological mechanisms that either facilitate or inhibit sexual thoughts, desires, and associated behaviors. Whereas sexual excitation has been widely studied, less is known about the impact of inhibitory control mechanisms that enable individuals to refrain from sexual cognition and behavior. The present study examined: (1) the relationship between general and sexual inhibitory mechanisms (as measured through self-reports and computer-based tasks), (2) the relation between sexual inhibitory processes at cognitive and motor-motivational levels and with sexual inhibition as an individual trait, and (3) the predictive value of these parameters on sexual thoughts (cognition) and behavior. We demonstrate that general inhibitory control (i.e., the ability to suppress any preponderant response) and the specific inhibition of sexual responses represent distinct processes that require at least partly different control mechanisms. Similarly, the ability to inhibit sexual visual input and the ability to suppress sexually driven responses seem to be two independent processes. The different inhibitory processes distinctively predicted the frequency of sexual thoughts and sexual behavior. We propose that these different inhibitory mechanisms are at play during different phases of sexual regulation (before and after the generation and unfolding of sexual arousal) and that a specific deficit in one of these processes may underlie the distinctive symptomatology and comorbidity of sexual disorders.
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Affiliation(s)
- Geraldine Rodriguez-Nieto
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands.
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands.
| | - Franziska Emmerling
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
- Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Marieke Dewitte
- Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Alexander T Sack
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
| | - Teresa Schuhmann
- Department of Cognitive Neuroscience, Faculty of Psychology and Neuroscience, Maastricht University, Oxfordlaan 55, 6229 EV, Maastricht, The Netherlands
- Maastricht Brain Imaging Center, Maastricht University, Maastricht, The Netherlands
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31
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Rodriguez-Nieto G, Sack AT, Dewitte M, Emmerling F, Schuhmann T. Putting out the blaze: The neural mechanisms underlying sexual inhibition. PLoS One 2019; 14:e0208809. [PMID: 30601828 PMCID: PMC6314635 DOI: 10.1371/journal.pone.0208809] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 11/25/2018] [Indexed: 11/29/2022] Open
Abstract
The successful inhibition of sexual thoughts, desires, and behaviors represents an essential ability for adequate functioning in our daily life. Evidence derived from lesion studies indicates a link between sexual inhibition and the general ability for behavioral and cognitive control. This is further supported by the high comorbidity of sexual compulsivity with other inhibition-related disorders. Here, we aimed at investigating whether sexual and general inhibition recruit overlapping or distinct neural correlates in the brain. Furthermore, we investigated the specificity of two different kinds of sexual inhibition: inhibition of sexually driven motor responses and inhibition of sexual incoming information. To this end, 22 healthy participants underwent functional Magnetic Resonance Imaging (fMRI) while performing a task requiring general response inhibition (Go/No-go), as well as cognitive and motivational sexual inhibition (Negative Affective Priming and Approach-Avoidance task). Our within-subject within-session design enabled the direct statistical comparison between general and sexual inhibitory mechanisms. The general inhibition task recruited mainly prefrontal and insular regions, replicating previous findings. In contrast, the two types of sexual inhibition activated both common and distinct neural networks. Whereas cognitive sexual inhibition engaged the inferior frontal gyrus, the orbitofrontal cortex and the fusiform gyrus, motivational sexual inhibition was characterized by a hypoactivation in the anterolateral prefrontal cortex. Both types of sexual inhibition recruited the inferior frontal gyrus and the inferotemporal cortex. However, the activity of the inferior frontal gyrus did not correlate with behavioral inhibitory scores. These results support the hypothesis of inhibitory processing being an emergent property of a functional network.
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Affiliation(s)
- Geraldine Rodriguez-Nieto
- Brain Stimulation and Cognition Lab, Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Alexander T. Sack
- Brain Stimulation and Cognition Lab, Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Marieke Dewitte
- Department of Clinical Psychological Science, Maastricht University, Maastricht, Netherlands
| | | | - Teresa Schuhmann
- Brain Stimulation and Cognition Lab, Department of Cognitive Neuroscience, Maastricht University, Maastricht, Netherlands
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32
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Amezcua-Gutiérrez C, Marisela HG, Fernández Guasti A, Aguilar MAC, Guevara MA. Observing Erotic Videos With Heterosexual Content Induces Different Cerebral Responses in Homosexual and Heterosexual Men. JOURNAL OF HOMOSEXUALITY 2018; 67:639-657. [PMID: 30526443 DOI: 10.1080/00918369.2018.1550331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
To determine the cerebral functionality associated with the perception and processing of erotic stimuli in men with different sexual orientation, this work evaluated the electroencephalographic activity (EEG) from several cortical areas, as well as subjective arousal in homosexual and heterosexual men during observation of an erotic film with heterosexual content. The heterosexual men rated the erotic video with higher general and sexual arousal than the homosexual participants. During observation of the neutral and erotic videos, both groups showed a decreased amplitude of the alpha band in prefrontal and parietal cortices, indicating increased attention. When watching the erotic video, the homosexual men showed an increased amplitude of the theta and fast bands only in the prefrontal cortex, which could be related to the cognitive processing of the erotic stimulus. These EEG results should broaden our knowledge of the cortical mechanisms related to the different perception and processing of erotic stimuli in men with different sexual orientations.
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Affiliation(s)
| | | | | | - Manuel Alejandro Cruz Aguilar
- Dirección de Investigaciones en Neurociencias, Laboratorio de Cronobiología y Sueño, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñiz", México City, México
| | - Miguel Angel Guevara
- Institute of Neuroscience, CUCBA, University of Guadalajara, Guadalajara, Jalisco, México
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33
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Understanding how Age-Related Decline in Testosterone Affects Male Sexual Behavior: Neurosteroids as the Missing Piece. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0175-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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34
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Ahmed RM, Goldberg ZL, Kaizik C, Kiernan MC, Hodges JR, Piguet O, Irish M. Neural correlates of changes in sexual function in frontotemporal dementia: implications for reward and physiological functioning. J Neurol 2018; 265:2562-2572. [DOI: 10.1007/s00415-018-9024-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 08/13/2018] [Accepted: 08/17/2018] [Indexed: 01/31/2023]
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35
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Gray M, Zillioux J, Khourdaji I, Smith RP. Contemporary management of ejaculatory dysfunction. Transl Androl Urol 2018; 7:686-702. [PMID: 30211060 PMCID: PMC6127532 DOI: 10.21037/tau.2018.06.20] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Although erectile dysfunction is the most common disorder of male sexual health, ejaculatory dysfunction is the most common form of sexual dysfunction experienced by men. Ejaculatory dysfunction covers a broad range of disorders that we have divided into four main categories: premature ejaculation, delayed ejaculation (DE)/anorgasmia, unsatisfactory sensation of ejaculation (including painful ejaculation and ejaculatory anhedonia), and absent ejaculate (including retrograde ejaculation and aspermia). We also cover several special scenarios including hematospermia, spinal cord injury and fertility with anejaculation. In this paper, we will review the anatomy and pathophysiology of normal ejaculation to establish the baseline knowledge of how this pathway can go awry. We will then briefly review the critical diagnostic criteria, pertinent steps in evaluation, risk factors, and causes (if known) for each of the ejaculatory disorders. Finally, the bulk of the paper will discuss current management strategies of each disorder.
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Affiliation(s)
- Marisa Gray
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | | | - Iyad Khourdaji
- Department of Urology, University of Virginia, Charlottesville, VA, USA
| | - Ryan P Smith
- Department of Urology, University of Virginia, Charlottesville, VA, USA
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36
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Localization of an epileptic orgasmic feeling to the right amygdala, using intracranial electrodes. Cortex 2018; 109:347-351. [PMID: 30126613 DOI: 10.1016/j.cortex.2018.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/26/2018] [Accepted: 07/11/2018] [Indexed: 11/22/2022]
Abstract
The limbic system has well-known functions in the regulation of human emotions and behaviour in general and sexual behaviour in particular. However, it is not clear which components of the limbic system are involved in orgasmic feelings. Although orgasmic aura can be elicited by direct electrical stimulation of the right mesial temporal lobe, the location of spontaneous and isolated orgasmic auras have not yet been reported in the literature. Here, we report on the first case of spontaneous orgasmic aura associated with a discharge in the right amygdala, following an investigation with depth electrodes in a woman with temporal lobe epilepsy. Her ictal orgasmic feeling reportedly felt the same as her physiological orgasms. This case sheds light on the amygdala's key role in human sexual function.
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Mokhber N, Azarpazhooh MR, Prakash A, Zamprogna Ballès JA, Prakash A. The medical-legal aspect of sexual deviant behaviors due to brain lesions: A case report and narrative review of the literature. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2018; 58:117-121. [PMID: 29853002 DOI: 10.1016/j.ijlp.2018.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 12/24/2017] [Accepted: 01/20/2018] [Indexed: 06/08/2023]
Abstract
We reported a case of sexual assault in a 60-year-old male with no history of mental illness. The lack of memory about the time of the assault and the patient's uncharacteristic behaviour suggested sexual deviant behaviour secondary to a brain lesion. Further investigations revealed a lentiform stroke. A possibility of abnormal sexual behaviour due to an epileptic seizure and/or a destructive brain lesion is suggested. We summarized the history of our patient in this paper and provided a review of the medico-legal aspects of hypersexuality and sexual deviant behaviors due to brain disorders.
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Affiliation(s)
- Naghmeh Mokhber
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Mahmoud Reza Azarpazhooh
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Ajay Prakash
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Julie A Zamprogna Ballès
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
| | - Arun Prakash
- Western University, Southwest Centre for Forensic Mental Health Care, 401 Sunset Dr. St. Thomas, ON N5R3C6, Canada.
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Seok JW, Sohn JH. Gray matter deficits and altered resting-state connectivity in the superior temporal gyrus among individuals with problematic hypersexual behavior. Brain Res 2018; 1684:30-39. [PMID: 29421186 DOI: 10.1016/j.brainres.2018.01.035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 01/10/2018] [Accepted: 01/30/2018] [Indexed: 10/18/2022]
Abstract
Neuroimaging studies on the characteristics of hypersexual disorder have been accumulating, yet alternations in brain structures and functional connectivity in individuals with problematic hypersexual behavior (PHB) has only recently been studied. This study aimed to investigate gray matter deficits and resting-state abnormalities in individuals with PHB using voxel-based morphometry and resting-state connectivity analysis. Seventeen individuals with PHB and 19 age-matched healthy controls participated in this study. Gray matter volume of the brain and resting-state connectivity were measured using 3T magnetic resonance imaging. Compared to healthy subjects, individuals with PHB had significant reductions in gray matter volume in the left superior temporal gyrus (STG) and right middle temporal gyrus. Individuals with PHB also exhibited a decrease in resting-state functional connectivity between the left STG and left precuneus and between the left STG and right caudate. The gray matter volume of the left STG and its resting-state functional connectivity with the right caudate both showed significant negative correlations with the severity of PHB. The findings suggest that structural deficits and resting-state functional impairments in the left STG might be linked to PHB and provide new insights into the underlying neural mechanisms of PHB.
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Affiliation(s)
- Ji-Woo Seok
- Department of Counselling Psychology, Honam University, Gwangju, South Korea; Bioimaging Research Team, Korean Basic Science Institute, Cheongju, South Korea
| | - Jin-Hun Sohn
- Department of Psychology, Brain Research Institute, Chungnam National University, Daejeon, South Korea.
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Epprecht L, Messerli M, Samuel R, Seule M, Weber J, Fournier JY, Surbeck W. Sexual Dysfunction After Good-Grade Aneurysmal Subarachnoid Hemorrhage. World Neurosurg 2017; 111:e449-e453. [PMID: 29288108 DOI: 10.1016/j.wneu.2017.12.091] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 12/13/2017] [Accepted: 12/14/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess the consequences of aneurysmal subarachnoid hemorrhage (aSAH) on sexual pleasure in patients with an otherwise favorable neurologic outcome. METHODS Anonymous, standardized questionnaires concerning sexual function, including the International Index of Erectile Function (IIEF), Female Sexual Function Index (FSFI), and a statement on subjective change in sexual pleasure after aSAH, were completed by 33 patients treated at the Cantonal Hospital St Gallen between 2005 and 2013. All had favorable neurologic outcomes (Glasgow Outcome Scale score 4 or 5). RESULTS Ten patients (31.3%) reported a subjective worsening of sexual pleasure after aSAH. Sexual dysfunction according to FSFI criteria affected 9 of the 19 female patients (47.4%). All 19 women had a hypoactive sexual desire disorder. Erectile dysfunction was present in 7 of the 14 male patients (50%). Patients with World Federation of Neurosurgical Societies (WFNS) grade 2 aSAH were significantly more likely to report a subjective worsening of sexual experience after hemorrhage than those with WFNS grade 1. CONCLUSIONS This is the first known evaluation of sexual health following aSAH with otherwise favorable neurologic outcomes, and confirms that sexual dysfunction is common in this population. Sexual health should be explored during follow-up with these patients.
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Affiliation(s)
- Lorenz Epprecht
- Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Department of Otorhinolaryngology Head and Heck Surgery, University Hospital Zurich, Zürich, Switzerland
| | - Michael Messerli
- Department of Radiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Robin Samuel
- Integrative Research Unit on Social and Individual Development, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Martin Seule
- Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Johannes Weber
- Department of Radiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Jean-Yves Fournier
- Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Werner Surbeck
- Department of Neurosurgery, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital of the University of Zurich, Zurich, Switzerland.
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The damaged cortices and the uncontrolled Id: A case of post-measles hyper-sexuality. Asian J Psychiatr 2017; 30:157-158. [PMID: 28946115 DOI: 10.1016/j.ajp.2017.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Accepted: 09/05/2017] [Indexed: 11/21/2022]
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Moreno A, Laoch A, Zasler ND. Changing the culture of neurodisability through language and sensitivity of providers: Creating a safe place for LGBTQIA+ people. NeuroRehabilitation 2017; 41:375-393. [DOI: 10.3233/nre-172187] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Alexander Moreno
- Faculty of Human Sciences, Department of Sexology, Université du Québec à Montréal (UQÀM), Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Canada
| | - Ari Laoch
- Virginia Commonwealth University, Richmond, VA, USA
| | - Nathan D. Zasler
- Concussion Care Centre of Virginia, Ltd. and Tree of Life Services, Inc., Henrico, VA, USA
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Grenier-Genest A, Gérard M, Courtois F. Stroke and sexual functioning: A literature review. NeuroRehabilitation 2017; 41:293-315. [DOI: 10.3233/nre-001481] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Marina Gérard
- Department of Psychology, Université du Québec à Montréal, Montreal, QC, Canada
| | - Frédérique Courtois
- Department of Sexology, Université du Québec à Montréal, Montreal, QC, Canada
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Levin RJ, Both S, Georgiadis J, Kukkonen T, Park K, Yang CC. The Physiology of Female Sexual Function and the Pathophysiology of Female Sexual Dysfunction (Committee 13A). J Sex Med 2017; 13:733-59. [PMID: 27114190 DOI: 10.1016/j.jsxm.2016.02.172] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 01/01/2023]
Abstract
INTRODUCTION The article consists of six sections written by separate authors that review female genital anatomy, the physiology of female sexual function, and the pathophysiology of female sexual dysfunction but excluding hormonal aspects. AIM To review the physiology of female sexual function and the pathophysiology of female sexual dysfunction especially since 2010 and to make specific recommendations according to the Oxford Centre for evidence based medicine (2009) "levels of evidence" wherever relevant. CONCLUSION Recommendations were made for particular studies to be undertaken especially in controversial aspects in all six sections of the reviewed topics. Despite numerous laboratory assessments of female sexual function, genital assessments alone appear insufficient to characterise fully the complete sexual response.
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Affiliation(s)
- Roy J Levin
- Reader in Physiology (Retired), Department of Biomedical Science, University of Sheffield, Sheffield, UK: Section 2.
| | - Stephanie Both
- Department of Psychosomatic Gynecology and Sexology, Leiden University Medical Center, Leiden, The Netherlands: Section 3
| | - Janniko Georgiadis
- Department of Neuroscience, University Medical Center, Groningen, University of Groningen, The Netherlands: Section 4
| | - Tuuli Kukkonen
- College of Social and Applied Human Science, University of Guelph, Guelph, ON, Canada: Section 6
| | - Kwangsung Park
- Department of Urology, Chonnan National University Medical School, Gwangju, Korea: Section 5
| | - Claire C Yang
- Department of Urology, University of Washington, Seattle, WA, USA: Section 1
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Forbes MK, Baillie AJ, Eaton NR, Krueger RF. A Place for Sexual Dysfunctions in an Empirical Taxonomy of Psychopathology. JOURNAL OF SEX RESEARCH 2017; 54:465-485. [PMID: 28121167 PMCID: PMC5433908 DOI: 10.1080/00224499.2016.1269306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Sexual dysfunctions commonly co-occur with various depressive and anxiety disorders. An emerging framework for understanding the classification of mental disorders suggests that such comorbidity is a manifestation of underlying dimensions of psychopathology (or "spectra"). In this review, we synthesize the evidence that sexual dysfunctions should be included in the empirical taxonomy of psychopathology as part of the internalizing spectrum, which accounts for comorbidity among the depressive and anxiety disorders. The review has four parts. Part 1 summarizes the empirical basis and utility of the empirical taxonomy of psychopathology. Part 2 reviews the prima facie evidence for the hypothesis that sexual dysfunctions are part of the internalizing spectrum (i.e., high rates of comorbidity; shared cognitive, affective, and temperament characteristics; common neural substrates and biomarkers; shared course and treatment response; and the lack of causal relationships between them). Part 3 critically analyzes and integrates the results of the eight studies that have addressed this hypothesis. Finally, Part 4 examines the implications of reconceptualizing sexual dysfunctions as part of the internalizing spectrum, and explores avenues for future research.
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Affiliation(s)
- Miriam K Forbes
- a Departments of Psychiatry and Psychology , University of Minnesota
| | - Andrew J Baillie
- b Centre for Emotional Health and Centre of Research Excellence in Mental Health and Substance Use , Macquarie University
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Poeppl TB, Langguth B, Rupprecht R, Laird AR, Eickhoff SB. A neural circuit encoding sexual preference in humans. Neurosci Biobehav Rev 2016; 68:530-536. [PMID: 27339689 DOI: 10.1016/j.neubiorev.2016.06.025] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 06/15/2016] [Accepted: 06/17/2016] [Indexed: 01/08/2023]
Abstract
Sexual preference determines mate choice for reproduction and hence guarantees conservation of species in mammals. Despite this fundamental role in human behavior, current knowledge on its target-specific neurofunctional substrate is based on lesion studies and therefore limited. We used meta-analytic remodeling of neuroimaging data from 364 human subjects with diverse sexual interests during sexual stimulation to quantify neural regions associated with sexual preference manipulations. We found that sexual preference is encoded by four phylogenetically old, subcortical brain structures. More specifically, sexual preference is controlled by the anterior and preoptic area of the hypothalamus, the anterior and mediodorsal thalamus, the septal area, and the perirhinal parahippocampus including the dentate gyrus. In contrast, sexual non-preference is regulated by the substantia innominata. We anticipate the identification of a core neural circuit for sexual preferences to be a starting point for further sophisticated investigations into the neural principles of sexual behavior and particularly of its aberrations.
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Affiliation(s)
- Timm B Poeppl
- University of Regensburg, Department of Psychiatry and Psychotherapy, Universitaetsstrasse 84, 93053 Regensburg, Germany.
| | - Berthold Langguth
- University of Regensburg, Department of Psychiatry and Psychotherapy, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Rainer Rupprecht
- University of Regensburg, Department of Psychiatry and Psychotherapy, Universitaetsstrasse 84, 93053 Regensburg, Germany
| | - Angela R Laird
- Florida International University, Department of Physics, 11200 SW 8th Street Miami, FL 33199, USA
| | - Simon B Eickhoff
- Heinrich Heine University, Institute of Clinical Neuroscience and Medical Psychology, Universitaetsstrasse 1, 40225 Düsseldorf, Germany; Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1), Wilhelm-Johnen-Strasse, 52428, Jülich, Germany
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Teive HAG, Moro A, Moscovich M, Munhoz RP. Increased sexual arousal in patients with movement disorders. ARQUIVOS DE NEURO-PSIQUIATRIA 2016; 74:303-6. [PMID: 27097003 DOI: 10.1590/0004-282x20150217] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 11/25/2015] [Indexed: 11/22/2022]
Abstract
UNLABELLED Increased of sexual arousal (ISA) has been described in different neurological diseases. The purpose of this study was present a case series of ISA in patients with movement disorders. METHOD Fifteen patients with different forms of movement disorders (Parkinson's disease, Huntington's disease, Tourette's syndrome, spinocerebellar ataxia type 3), were evaluated in the Movement Disorders Unit of the Federal University of Paraná. RESULTS Among Parkinson's disease patients there were seven cases with different forms of ISA due to dopaminergic agonist use, levodopa abuse, and deep brain stimulation (DBS). In the group with hyperkinetic disorders, two patients with Huntington's disease, two with Tourette's syndrome, and four with spinocerebellar ataxia type 3 presented with ISA. CONCLUSIONS ISA in this group of patients had different etiologies, predominantly related to dopaminergic treatment or DBS in Parkinson's disease, part of the background clinical picture in Huntington's disease and Tourette's syndrome, and probably associated with cultural aspects in patients with spinocerebellar ataxia type 3.
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Affiliation(s)
- Hélio A G Teive
- Departamento de Medicina Interna, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Adriana Moro
- Departamento de Medicina Interna, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Mariana Moscovich
- Departamento de Medicina Interna, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil
| | - Renato P Munhoz
- Movement Disorders Centre, Toronto Western Hospital, Toronto University, Toronto, ON, Canada
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Ahmed RM, Kaizik C, Irish M, Mioshi E, Dermody N, Kiernan MC, Piguet O, Hodges JR. Characterizing Sexual Behavior in Frontotemporal Dementia. J Alzheimers Dis 2015; 46:677-86. [DOI: 10.3233/jad-150034] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Rebekah M. Ahmed
- Neuroscience Research Australia, Sydney, Australia
- Prince of Wales Clinical School, The University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia
- Sydney Medical School, Brain & Mind Research Institute, University of Sydney, Australia
| | | | - Muireann Irish
- Neuroscience Research Australia, Sydney, Australia
- School of Psychology, The University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia
| | - Eneida Mioshi
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Nadene Dermody
- Neuroscience Research Australia, Sydney, Australia
- School of Psychology, The University of New South Wales, Sydney, Australia
| | - Matthew C. Kiernan
- Sydney Medical School, Brain & Mind Research Institute, University of Sydney, Australia
| | - Olivier Piguet
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, The University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia
| | - John R. Hodges
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, The University of New South Wales, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, The University of New South Wales, Sydney, Australia
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Georgiadis JR. Functional neuroanatomy of human cortex cerebri in relation to wanting sex and having it. Clin Anat 2015; 28:314-23. [DOI: 10.1002/ca.22528] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 01/27/2015] [Indexed: 12/29/2022]
Affiliation(s)
- Janniko R. Georgiadis
- Department of Neuroscience/Section Anatomy; University Medical Center Groningen (UMCG), University of Groningen; The Netherlands
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Abstract
BACKGROUND Although neurological and neurocognitive outcomes have previously been studied after resection of diffuse low-grade glioma (DLGG), the impact of surgery on sexual life has not been investigated. Our aim was to assess whether DLGG surgery could have consequences on sexual experience. METHODS Anonymous standardized questionnaires concerning sexual functioning, including the Arizona Sexual Experiences Scale (ASEX) and a subjective statement, were completed by 32 patients who underwent surgery for DLGG. All patients returned to a normal social and professional life following resection, with neither neurological deficits nor depression. No radiotherapy was administered, and patients who received chemotherapy were without treatment for at least 1 year. RESULTS Seventeen patients (53%) reported a postoperative sexual change, with subjective deterioration in 15 (88%) and improvement in 2 (12%). Sexual dysfunction according to ASEX affected 9 of 15 women (60%) and 5 of 17 men (29%). Right-sided resections were associated with more difficulties in reaching orgasm than left-sided resections (P < .02). Men with temporal lobe resection displayed more reduction in sexual drive (P < .003) and sexual arousal (P < .004) than women, resulting in significant higher overall ASEX scores for temporal lobe resections in men (P = .01). Men remaining on antiepileptic drugs who underwent right-sided resection displayed higher overall ASEX scores than women (P = .031). CONCLUSIONS This first evaluation of sexual life after surgery for DLGG suggests that sexual dysfunction is common in this population. Therefore, we suggest that sexual health should consistently be addressed during routine pre- and postoperative examination of patients with DLGG.
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Affiliation(s)
- Werner Surbeck
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland (W.S.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France (G.H., H.D.); Institute of Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, Montpellier, France (G.H., H.D.)
| | - Guillaume Herbet
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland (W.S.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France (G.H., H.D.); Institute of Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, Montpellier, France (G.H., H.D.)
| | - Hugues Duffau
- Department of Neurosurgery, Cantonal Hospital of St. Gallen, St. Gallen, Switzerland (W.S.); Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France (G.H., H.D.); Institute of Neuroscience of Montpellier, INSERM U1051, Team "Plasticity of Central Nervous System, Human Stem Cells and Glial Tumors," Saint Eloi Hospital, Montpellier University Medical Center, Montpellier, France (G.H., H.D.)
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Bronner G, Aharon-Peretz J, Hassin-Baer S. Sexuality in patients with Parkinson's disease, Alzheimer's disease, and other dementias. HANDBOOK OF CLINICAL NEUROLOGY 2015; 130:297-323. [PMID: 26003251 DOI: 10.1016/b978-0-444-63247-0.00017-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sexual dysfunction (SD) is common among patients with Parkinson's disease (PD), Alzheimer's disease (AD), and other dementias. Sexual functioning and well-being of patients with PD and their partners are affected by many factors, including motor disabilities, non-motor symptoms (e.g., autonomic dysfunction, sleep disturbances, mood disorders, cognitive abnormalities, pain, and sensory disorders), medication effects, and relationship issues. The common sexual problems are decreased desire, erectile dysfunction, difficulties in reaching orgasm, and sexual dissatisfaction. Hypersexuality is one of a broad range of impulse control disorders reported in PD, attributed to antiparkinsonian therapy, mainly dopamine agonists. Involvement of a multidisciplinary team may enable a significant management of hypersexuality. Data on SD in demented patients are scarce, mainly reporting reduced frequency of sex and erectile dysfunction. Treatment of SD is advised at an early stage. Behavioral problems, including inappropriate sexual behavior (ISB), are distressing for patients and their caregivers and may reflect the prevailing behavior accompanying dementia (disinhibition or apathy associated with hyposexuality). The neurobiologic basis of ISB is still only vaguely understood but assessment and intervention are recommended as soon as ISB is suspected. Management of ISB in dementia demands a thorough evaluation and understanding of the behavior, and can be treated by non-pharmacologic and pharmacologic interventions.
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Affiliation(s)
- Gila Bronner
- Sexual Medicine Center, Department of Urology, Sheba Medical Center, Tel-Hashomer, Israel.
| | | | - Sharon Hassin-Baer
- Parkinson's Disease and Movement Disorders Clinic, Sagol Neuroscience Center, Department of Neurology, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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