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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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Zhan L, Gao Y, Huang L, Zhang H, Huang G, Wang Y, Sun J, Xie Z, Li M, Jia X, Cheng L, Yu Y. Brain functional connectivity alterations of Wernicke's area in individuals with autism spectrum conditions in multi-frequency bands: A mega-analysis. Heliyon 2024; 10:e26198. [PMID: 38404781 PMCID: PMC10884452 DOI: 10.1016/j.heliyon.2024.e26198] [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: 08/06/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/27/2024] Open
Abstract
Characterized by severe deficits in communication, most individuals with autism spectrum conditions (ASC) experience significant language dysfunctions, thereby impacting their overall quality of life. Wernicke's area, a classical and traditional brain region associated with language processing, plays a substantial role in the manifestation of language impairments. The current study carried out a mega-analysis to attain a comprehensive understanding of the neural mechanisms underpinning ASC, particularly in the context of language processing. The study employed the Autism Brain Image Data Exchange (ABIDE) dataset, which encompasses data from 443 typically developing (TD) individuals and 362 individuals with ASC. The objective was to detect abnormal functional connectivity (FC) between Wernicke's area and other language-related functional regions, and identify frequency-specific altered FC using Wernicke's area as the seed region in ASC. The findings revealed that increased FC in individuals with ASC has frequency-specific characteristics. Further, in the conventional frequency band (0.01-0.08 Hz), individuals with ASC exhibited increased FC between Wernicke's area and the right thalamus compared with TD individuals. In the slow-5 frequency band (0.01-0.027 Hz), increased FC values were observed in the left cerebellum Crus II and the right lenticular nucleus, pallidum. These results provide novel insights into the potential neural mechanisms underlying communication deficits in ASC from the perspective of language impairments.
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Affiliation(s)
- Linlin Zhan
- School of Western Studies, Heilongjiang University, Harbin, China
| | - Yanyan Gao
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Lina Huang
- Department of Radiology, Changshu No. 2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Hongqiang Zhang
- Department of Radiology, Changshu No. 2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Guofeng Huang
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Yadan Wang
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Jiawei Sun
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Zhou Xie
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Mengting Li
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Xize Jia
- College of Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Lulu Cheng
- School of Foreign Studies, China University of Petroleum (East China), Qingdao, China
- Shanghai Center for Research in English Language Education, Shanghai International Studies University, Shanghai, China
| | - Yang Yu
- Psychiatry Department, The Second Affiliated Hospital Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
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Abdel Hady DA, Abd El-Hafeez T. Revolutionizing core muscle analysis in female sexual dysfunction based on machine learning. Sci Rep 2024; 14:4795. [PMID: 38413786 PMCID: PMC10899583 DOI: 10.1038/s41598-024-54967-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/19/2024] [Indexed: 02/29/2024] Open
Abstract
The purpose of this study is to investigate the role of core muscles in female sexual dysfunction (FSD) and develop comprehensive rehabilitation programs to address this issue. We aim to answer the following research questions: what are the roles of core muscles in FSD, and how can machine and deep learning models accurately predict changes in core muscles during FSD? FSD is a common condition that affects women of all ages, characterized by symptoms such as decreased libido, difficulty achieving orgasm, and pain during intercourse. We conducted a comprehensive analysis of changes in core muscles during FSD using machine and deep learning. We evaluated the performance of multiple models, including multi-layer perceptron (MLP), long short-term memory (LSTM), convolutional neural network (CNN), recurrent neural network (RNN), ElasticNetCV, random forest regressor, SVR, and Bagging regressor. The models were evaluated based on mean squared error (MSE), mean absolute error (MAE), and R-squared (R2) score. Our results show that CNN and random forest regressor are the most accurate models for predicting changes in core muscles during FSD. CNN achieved the lowest MSE (0.002) and the highest R2 score (0.988), while random forest regressor also performed well with an MSE of 0.0021 and an R2 score of 0.9905. Our study demonstrates that machine and deep learning models can accurately predict changes in core muscles during FSD. The neglected core muscles play a significant role in FSD, highlighting the need for comprehensive rehabilitation programs that address these muscles. By developing these programs, we can improve the quality of life for women with FSD and help them achieve optimal sexual health.
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Affiliation(s)
- Doaa A Abdel Hady
- Department of Physical Therapy for Women's Health, Faculty of Physiotherapy, Deraya University, EL-Minia, Egypt.
| | - Tarek Abd El-Hafeez
- Department of Computer Science, Faculty of Science, Minia University, EL-Minia, Egypt.
- Computer Science Unit, Deraya University, EL-Minia, Egypt.
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Xing SY, Lu JM, Jiang YH, Wang T, Du GJ, Yang BB, Gao QQ, Wang B, Wu N, Xu CL, Song T, Dai YT. Abnormal cortical surface-based spontaneous and functional connectivity in the whole brain in lifelong premature ejaculation patients. Asian J Androl 2023; 25:699-703. [PMID: 37800899 DOI: 10.4103/aja202349] [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: 05/18/2023] [Accepted: 08/22/2023] [Indexed: 10/07/2023] Open
Abstract
Recent research has highlighted structural and functional abnormalities in the cerebral cortex of patients with premature ejaculation (PE). These anomalies could play a pivotal role in the physiological mechanisms underlying PE. This study leveraged functional magnetic resonance imaging (fMRI), a noninvasive technique, to explore these neural mechanisms. We conducted resting-state fMRI scans on 36 PE patients and 22 healthy controls (HC), and collected data on Premature Ejaculation Diagnostic Tool (PEDT) scores and intravaginal ejaculation latency time (IELT). Employing a surface-based regional homogeneity (ReHo) approach, we analyzed local neural synchronous spontaneous activity, diverging from previous studies that utilized a volume-based ReHo method. Areas with significant ReHo differences between PE and HC groups underwent surface-based functional connectivity (FC) analysis. Significant discrepancies in ReHo and FC across the cortical surface were observed in the PE cohort. Notably, PE patients exhibited decreased ReHo in the left triangular inferior frontal gyrus and enhanced ReHo in the right middle frontal gyrus. The latter showed heightened connectivity with the left lingual gyrus and the right orbital superior frontal gyrus. Furthermore, a correlation between ReHo and FC values with PEDT scores and IELT was found in the PE group. Our findings, derived from surface-based fMRI data, underscore specific brain regions linked to the neurobiological underpinnings of PE.
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Affiliation(s)
- Si-Yan Xing
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Jia-Ming Lu
- Department of Radiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Yue-Hui Jiang
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Tong Wang
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing 210046, China
| | - Guang-Jun Du
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Bai-Bing Yang
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Qing-Qiang Gao
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Bin Wang
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Ning Wu
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Chun-Lu Xu
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Tao Song
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
| | - Yu-Tian Dai
- Department of Andrology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, China
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Hámori G, File B, Fiáth R, Pászthy B, Réthelyi JM, Ulbert I, Bunford N. Adolescent ADHD and electrophysiological reward responsiveness: A machine learning approach to evaluate classification accuracy and prognosis. Psychiatry Res 2023; 323:115139. [PMID: 36921508 DOI: 10.1016/j.psychres.2023.115139] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/12/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023]
Abstract
We evaluated event-related potential (ERP) indices of reinforcement sensitivity as ADHD biomarkers by examining, in N=306 adolescents (Mage=15.78, SD=1.08), the extent to which ERP amplitude and latency variables measuring reward anticipation and response (1) differentiate, in age- and sex-matched subsamples, (i) youth with vs. without ADHD, (ii) youth at-risk for vs. not at-risk for ADHD, and, in the with ADHD subsample, (iii) youth with the inattentive vs. the hyperactive/impulsive (H/I) and combined presentations. We further examined the extent to which ERP variables (2) predict, in the ADHD subsample, substance use (i) concurrently and (ii) prospectively at 18-month follow-up. Linear support vector machine analyses indicated ERPs weakly differentiate youth with/without (65%) - and at-risk for/not at-risk for (63%) - ADHD but better differentiate ADHD presentations (78%). Regression analyses showed in adolescents with ADHD, ERPs explain a considerable proportion of variance (50%) in concurrent alcohol use and, controlling for concurrent marijuana and tobacco use, explain a considerable proportion of variance (87 and 87%) in, and predict later marijuana and tobacco use. Findings are consistent with the dual-pathway model of ADHD. Results also highlight limitations of a dichotomous, syndromic classification and indicate differences in neural reinforcement sensitivity are a promising ADHD prognostic biomarker.
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Affiliation(s)
- György Hámori
- Clinical and Developmental Neuropsychology Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Műegyetem rkp. 3., Budapest H-1111, Hungary
| | - Bálint File
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary; Theoretical Neuroscience and Complex Systems Research Group, Wigner Research Centre for Physics, Konkoly-Tege Miklós út 29-33, Budapest 1121, Hungary
| | - Richárd Fiáth
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary
| | - Bea Pászthy
- Department of Paediatrics, Semmelweis University, Faculty of Medicine, Bókay János u. 53-54, Budapest 1083, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Faculty of Medicine, Balassa u. 6, Budapest 1083, Hungary
| | - István Ulbert
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary
| | - Nóra Bunford
- Clinical and Developmental Neuropsychology Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary.
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6
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Changes of insular function in lifelong premature ejaculation patients before and after SSRI administration. Psychopharmacology (Berl) 2022; 239:3953-3962. [PMID: 36344824 DOI: 10.1007/s00213-022-06268-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Lifelong premature ejaculation (PE) is regarded as one of the most common male sexual dysfunction. We aimed to detect whether insula-related brain functional networks are altered in lifelong PE patients and whether such alterations are "normalised" after selective serotonin reuptake inhibitors (SSRI) administration. METHODS Twenty-three drug-naive lifelong PE patients and 30 healthy controls (HC) were recruited in current study. All subjects underwent resting-state functional magnetic resonance imaging (fMRI) scan at first. One hour after dapoxetine administration, all patients underwent fMRI scanning again. The degree centrality (DC), amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) analysis, and ROI-based functional connectivity (FC) analysis were applied to calculate the abnormalities in insula-related functions among three groups. RESULTS Compared to HC group, PE patients at baseline showed significantly altered DC, ALFF, and ReHo value of the bilateral insula, which subsequently showed a "normalised" trend after dapoxetine administration. Additionally, compared to HC group, PE patients at baseline showed significantly decreased FC between insula and precentral gyrus, inferior frontal gyrus, middle/inferior temporal gyrus, and caudate, while patients after dapoxetine administration showed increased insula-related FC in anterior cingulate cortex and decreased FC in thalamus and middle/inferior temporal gyrus. The main effects of dapoxetine were located in precentral gyrus, inferior frontal gyrus, caudate, and limbic system. CONCLUSIONS Our findings report altered brain mechanism of insula in lifelong PE patients and also indicate that dapoxetine can "normalise" the abnormal function of the insula to certain extent in lifelong PE patients.
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Artificial Intelligence Applications in Urology: Reporting Standards to Achieve Fluency for Urologists. Urol Clin North Am 2022; 49:65-117. [PMID: 34776055 PMCID: PMC9147289 DOI: 10.1016/j.ucl.2021.07.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The growth and adoption of artificial intelligence has led to impressive results in urology. As artificial intelligence grows more ubiquitous, it is important to establish artificial intelligence literacy in the workforce. To this end, we present a narrative review of the literature of artificial intelligence and machine learning in urology and propose a checklist of reporting standards to improve readability and evaluate the current state of the literature. The listed article demonstrated heterogeneous reporting of methodologies and outcomes, limiting generalizability of research. We hope that this review serves as a foundation for future evaluation of medical research in artificial intelligence.
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Geng B, Gao M, Piao R, Liu C, Xu K, Zhang S, Zeng X, Liu P, Wang Y. Multivariate Pattern Analysis of Lifelong Premature Ejaculation Based on Multiple Kernel Support Vector Machine. Front Psychiatry 2022; 13:906404. [PMID: 35958632 PMCID: PMC9357875 DOI: 10.3389/fpsyt.2022.906404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aimed to develop an effective support vector machine (SVM) classifier based on the multi-modal data for detecting the main brain networks involved in group separation of premature ejaculation (PE). METHODS A total of fifty-two patients with lifelong PE and 36 matched healthy controls were enrolled in this study. Structural MRI data, functional MRI data, and diffusion tensor imaging (DTI) data were used to process SPM12, DPABI4.5, and PANDA, respectively. A total of 12,735 features were reduced by the Mann-Whitney U test. The resilience nets method was further used to select features. RESULTS Finally, 36 features (3 structural MRI, 7 functional MRI, and 26 DTI) were chosen in the training dataset. We got the best SVM model with an accuracy of 97.5% and an area under the curve (AUC) of 0.986 in the training dataset as well as an accuracy of 91.4% and an AUC of 0.966 in the testing dataset. CONCLUSION Our findings showed that the majority of the brain abnormalities for the classification was located within or across several networks. This study may contribute to the neural mechanisms of PE and provide new insights into the pathophysiology of patients with lifelong PE.
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Affiliation(s)
- Bowen Geng
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Ming Gao
- Department of Urology, Xi'An Daxing Hospital Affiliated to Yan'an University, Xi'an, China
| | - Ruiqing Piao
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Chengxiang Liu
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Ke Xu
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Shuming Zhang
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Xiao Zeng
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Peng Liu
- Life Science Research Center, School of Life Sciences and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Sciences and Technology, Xidian University, Xi'an, China
| | - Yanzhu Wang
- Department of Urology, Xi'An Daxing Hospital Affiliated to Yan'an University, Xi'an, China
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Zhao H, Xu Z, Zhu Y, Xue R, Wang J, Ren J, Wang W, Duan W, Zheng M. The Construction of a Risk Prediction Model Based on Neural Network for Pre-operative Acute Ischemic Stroke in Acute Type A Aortic Dissection Patients. Front Neurol 2021; 12:792678. [PMID: 35002934 PMCID: PMC8734591 DOI: 10.3389/fneur.2021.792678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 11/30/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: To establish a pre-operative acute ischemic stroke risk (AIS) prediction model using the deep neural network in patients with acute type A aortic dissection (ATAAD). Methods: Between January 2015 and February 2019, 300 ATAAD patients diagnosed by aorta CTA were analyzed retrospectively. Patients were divided into two groups according to the presence or absence of pre-operative AIS. Pre-operative AIS risk prediction models based on different machine learning algorithm was established with clinical, transthoracic echocardiography (TTE) and CTA imaging characteristics as input. The performance of the difference models was evaluated using the receiver operating characteristic (ROC), precision-recall curve (PRC) and decision curve analysis (DCA). Results: Pre-operative AIS was detected in 86 of 300 patients with ATAAD (28.7%). The cohort was split into a training (211, 70% patients) and validation cohort (89, 30% patients) according to stratified sampling strategy. The constructed deep neural network model had the best performance on the discrimination of AIS group compare with other machine learning model, with an accuracy of 0.934 (95% CI: 0.891-0.963), 0.921 (95% CI: 0.845-0.968), sensitivity of 0.934, 0.960, specificity of 0.933, 0.906, and AUC of 0.982 (95% CI: 0.967-0.997), 0.964 (95% CI: 0.932-0.997) in the training and validation cohort, respectively. Conclusion: The established risk prediction model based on the deep neural network method may have the big potential to evaluate the risk of pre-operative AIS in patients with ATAAD.
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Affiliation(s)
- Hongliang Zhao
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ziliang Xu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Yuanqiang Zhu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Ruijia Xue
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jing Wang
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | | | | | - Weixun Duan
- Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Minwen Zheng
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Functional Connectivity of Nucleus Accumbens Is Associated with Lifelong Premature Ejaculation in Male Adults : A Resting-state fMRI Study. Clin Neuroradiol 2021; 32:655-663. [PMID: 34714363 DOI: 10.1007/s00062-021-01105-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Ejaculation represents a crucial component of sexual behavior in men, which is involved in reward functions of certain brain areas including the nucleus accumbens (NAcc). Lifelong premature ejaculation (PE) is one of the most prevalent sexual dysfunctions in men. It is suggested to be related to abnormal brain function. This study aimed to explore changes of the functional connectivity patterns of NAcc and possible correlations of the neuroimaging abnormalities with clinical features in lifelong PE patients. METHODS The sample consisted with 42 lifelong PE patients and 30 healthy controls. All participants underwent functional magnetic resonance imaging scans and clinical symptoms. The functional connectivity (FC) approach was applied to investigate differences of NAcc-seed intrinsic connectivity between two groups and correlation analysis was used to access possible relationships between the imaging findings and clinical features, such as premature ejaculation diagnostic tool (PEDT) or intravaginal ejaculatory latency time (IELT). RESULTS Results showed that lifelong PE patients had decreased FC between the NAcc and thalamus, superior temporal pole, superior temporal cortex (STC), inferior frontal gyrus (IFG), orbitofrontal cortex, caudate and putamen. A significantly negative correlation between the PEDT score and NAcc-STC connectivity (r = -0.46) was found in lifelong PE patients, while IELT score positively correlated with the NAcc-IFG connectivity (r = 0.48) and NAcc-thalamus connectivity (r = 0.46). CONCLUSION The findings may facilitate a more sophisticated understanding of neural mechanisms of lifelong PE, particularly associated with the NAcc-related intrinsic connectivity during the resting state.
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Lu J, Chen Q, Li D, Zhang W, Xing S, Wang J, Zhang X, Liu J, Qing Z, Dai Y, Zhang B. Reconfiguration of Dynamic Functional Connectivity States in Patients With Lifelong Premature Ejaculation. Front Neurosci 2021; 15:721236. [PMID: 34588948 PMCID: PMC8473781 DOI: 10.3389/fnins.2021.721236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 08/19/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Neuroimaging has demonstrated altered static functional connectivity in patients with premature ejaculation (PE), while studies examining dynamic changes in spontaneous brain activity in PE patients are still lacking. We aimed to explore the reconfiguration of dynamic functional connectivity (DFC) states in lifelong PE (LPE) patients and to distinguish LPE patients from normal controls (NCs) using a machine learning method based on DFC state features. Methods: Thirty-six LPE patients and 23 NCs were recruited. Resting-state functional magnetic resonance imaging (fMRI) data, the clinical rating scores on the Chinese Index of PE (CIPE), and intravaginal ejaculatory latency time (IELT) were collected from each participant. DFC was calculated by the sliding window approach. Finally, the Lagrangian support vector machine (LSVM) classifier was applied to distinguish LPE patients from NCs using the DFC parameters. Two DFC state metrics (reoccurrence times and transition frequencies) were introduced and we assessed the correlations between DFC state metrics and clinical variables, and the accuracy, sensitivity, and specificity of the LSVM classifier. Results: By k-means clustering, four distinct DFC states were identified. The LPE patients showed an increase in the reoccurrence times for state 3 (p < 0.05, Bonferroni corrected) but a decrease for state 1 (p < 0.05, Bonferroni corrected) compared to the NCs. Moreover, the LPE patients had significantly less frequent transitions between state 1 and state 4 (p < 0.05, uncorrected) while more frequent transitions between state 3 and state 4 (p < 0.05, uncorrected) than the NCs. The reoccurrence times and transition frequencies showed significant associations with the CIPE scores and IELTs. The accuracy, sensitivity, and specificity of the LSVM classifier were 90.35, 87.59, and 85.59%, respectively. Conclusion: LPE patients were more inclined to be in DFC states reinforced intra-network and inter-network connection. These features correlated with clinical syndromes and can classify the LPE patients from NCs. Our results of reconfiguration of DFC states may provide novel insights for the understanding of central etiology underlying LPE, indicate neuroimaging biomarkers for the evaluation of clinical severity of LPE.
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Affiliation(s)
- Jiaming Lu
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Qian Chen
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Danyan Li
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Radiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China
| | - Wen Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Siyan Xing
- Department of Andrology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Junxia Wang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xin Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Jiani Liu
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Zhao Qing
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yutian Dai
- Department of Andrology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Zhang
- Department of Radiology, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China.,Department of Radiology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, China.,Institute of Brain Science, Nanjing University, Nanjing, China
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12
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Machine-learning-based diagnosis of drug-naive adult patients with attention-deficit hyperactivity disorder using mismatch negativity. Transl Psychiatry 2021; 11:484. [PMID: 34537812 PMCID: PMC8449778 DOI: 10.1038/s41398-021-01604-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 08/23/2021] [Accepted: 09/01/2021] [Indexed: 02/08/2023] Open
Abstract
Relatively little is investigated regarding the neurophysiology of adult attention-deficit/hyperactivity disorder (ADHD). Mismatch negativity (MMN) is an event-related potential component representing pre-attentive auditory processing, which is closely associated with cognitive status. We investigated MMN features as biomarkers to classify drug-naive adult patients with ADHD and healthy controls (HCs). Sensor-level features (amplitude and latency) and source-level features (source activation) of MMN were investigated and compared between the electroencephalograms of 34 patients with ADHD and 45 HCs using a passive auditory oddball paradigm. Correlations between MMN features and ADHD symptoms were analyzed. Finally, we applied machine learning to differentiate the two groups using sensor- and source-level features of MMN. Adult patients with ADHD showed significantly lower MMN amplitudes at the frontocentral electrodes and reduced MMN source activation in the frontal, temporal, and limbic lobes, which were closely associated with MMN generators and ADHD pathophysiology. Source activities were significantly correlated with ADHD symptoms. The best classification performance for adult ADHD patients and HCs showed an 81.01% accuracy, 82.35% sensitivity, and 80.00% specificity based on MMN source activity features. Our results suggest that abnormal MMN reflects the adult ADHD patients' pathophysiological characteristics and might serve clinically as a neuromarker of adult ADHD.
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Huang Y, Peng D, Geng H, Dai Y, Jiang H, Zhang X. Endogenous Deficiency of Brain-Derived Neurotrophic Factor Induces the Downregulation of Tryptophan Hydroxylase-2 Expression in Raphe Nuclei of Rapid Ejaculator Rats. J Sex Med 2021; 18:1491-1499. [PMID: 37057442 DOI: 10.1016/j.jsxm.2021.07.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 07/03/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Premature ejaculation (PE) is one of the most common ejaculatory disorders. Recent studies have suggested a close relationship between the serotonin (5-hydroxytryptamine [5-HT]) system and brain-derived neurotrophic factor (BDNF), raising the question of whether BDNF plays a role in ejaculation regulation. To our knowledge, no previous studies have explored BDNF level of the central nervous system in ejaculatory disorders. At the same time, the interaction of central BDNF and 5-HT systems has not been undertaken in ejaculation regulation field. AIM The aim of this study was to investigate the interaction between BDNF and 5-HT levels in raphe nuclei which contains the serotonergic neurons in a rat animal model with different ejaculatory behavior. METHODS Eighteen male rats were selected and classified as "sluggish," "normal," and "rapid" ejaculators on the basis of ejaculation frequency during copulatory behavioral testing. BDNF and 5-HT levels were determined by enzyme-linked immunosorbent assay (ELISA). Real-Time Quantitative PCR and Western blot analyses were used to measure the mRNA level of Tryptophan Hydroxylase-2 (TPH2) gene and the expression of TPH2 protein (the rate-limiting enzyme in central 5-HT synthesis) in raphe nuclei, respectively. OUTCOMES Male rat sexual behavior, the levels of BDNF and 5-HT in raphe nuclei of rats with different ejaculatory behavior, the mRNA level of gene encoding TPH2 and the expression of TPH2 protein in raphe nuclei. RESULTS The primary finding of our study was that BDNF concentration was significantly decreased in raphe nuclei of rapid ejaculators. There was a strong positive correlation between the levels of BDNF and 5-HT (r = 0.944, P < .001). Further results showed that decreased TPH2 gene expression accompanied by TPH2 protein was shown in rapid ejaculators with lower BDNF level. CLINICAL IMPLICATIONS With refinement of current knowledge, BDNF may eventually serve as a promising biomarker in patients with PE. STRENGTHS & LIMITATIONS There are no previous studies examining the interaction of the brain BDNF and 5-HT in ejaculation regulation field. The main limitation is the limited sample size. CONCLUSION BDNF may act via increasing the synthesis of central 5-HT in the process of ejaculation regulation. Our results suggest lack of endogenous BDNF induces the downregulation of TPH2 gene expression and the decrease of 5-HT synthesis in raphe nuclei of rapid ejaculator rats.
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Affiliation(s)
- Yuanyuan Huang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Dangwei Peng
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hao Geng
- Department of Obstetrics and Gynecology, Reproductive Medicine Center, The First Affiliated Hospital of Anhui Medical University, Hefei, China; NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Anhui Medical University, Hefei, China; Key Laboratory of Population Health Across Life Cycle, Anhui Medical University, Hefei, China
| | - Yutian Dai
- Department of Andrology, Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, China.
| | - Hui Jiang
- Department of Andrology, Peking University Third Hospital, Beijing, China.
| | - Xiansheng Zhang
- Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
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14
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Abnormal degree centrality in lifelong premature ejaculation patients: an fMRI study. Brain Imaging Behav 2021; 15:1412-1419. [PMID: 32767047 DOI: 10.1007/s11682-020-00340-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Lifelong premature ejaculation (PE) is one of the most prevalent male sexual dysfunctions. It is still not well known about the possible neural mechanisms of lifelong PE. This study tried to investigate the abnormal characteristics of brain functional networks of lifelong PE and to assess relationships of PE-related functional abnormalities with clinical symptoms. Functional magnetic resonance imaging (fMRI) data and clinical symptoms were collected from 45 lifelong PE patients and 37 healthy controls (HCs) since 2016, including disease and sexual life history, intravaginal ejaculatory latency time measured by stopwatch and other scales. The degree centrality (DC) approach were applied to distinguish altered brain functions between the two groups (p < 0.05, false discovery rate corrected). Correlation analysis was then performed to examine relationships between the imaging findings and clinical symptoms (p < 0.05, Bonferroni corrected). Results showed that compared with HCs, lifelong PE patients had increased DC value in the medial prefrontal cortex (mPFC), precuneus and primary somatosensory cortex (SI) as well as decreased DC value in the insula and orbitofrontal cortex. After controlling for anxiety and depression levels, the significant difference in the mPFC was not found. The DC value in the SI positively correlated with premature ejaculation diagnostic tool (PEDT) score in the patients. The present findings indicate that lifelong PE patients have altered DC in brain regions involved in sensation, motivation and inhibitory control processing. Our study may improve our understanding and provide a new sight into the further research of lifelong PE.
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15
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Feng N, Gao M, Wu J, Yang G, Piao R, Liu P. Higher inter-hemispheric homotopic connectivity in lifelong premature ejaculation patients: a pilot resting-state fMRI study. Quant Imaging Med Surg 2021; 11:3234-3243. [PMID: 34249649 DOI: 10.21037/qims-20-1103] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/23/2021] [Indexed: 12/25/2022]
Abstract
Background Lifelong premature ejaculation (PE) is one common male sexual dysfunction and is implicated in widespread structural and functional abnormalities of bilateral hemispheres. However, whether the inter-hemisphere functional connectivity (FC) of lifelong PE patients was altered still remain unclear. Methods Thirty-four lifelong PE patients and 30 healthy controls (HCs) were enrolled in this study and all underwent T1-weighted and resting-state functional MRI (fMRI) scan. The voxel-mirrored homotopic connectivity (VMHC) measure and independent sample t-test were applied to examine the alterations of VMHC values in the patients relative to HCs with the significant threshold at P<0.05, false discovery rates corrected. Correlation analysis was adopted to calculate the relationships between the imaging results and clinical characteristics of patients (P<0.05, Bonferroni corrected). Receiver operating characteristic (ROC) curve analysis was performed to investigate the possible biomarkers for distinguishing the patients from the HCs using the VMHC values of inter-group differences. Results The results revealed that compared with HCs, lifelong PE patients had higher VMHC values in the precentral gyrus (PG), primary somatosensory cortex (S1), supplementary motor area (SMA), precuneus, middle temporal cortex (MTC), superior temporal pole (STP), thalamus, caudate and middle cingulate cortex (MCC). Correlation analysis showed that the mean VMHC values in the S1 negatively correlated with intravaginal ejaculation latency time (IELT) in the patient group. Furthermore, the caudate revealed the well classification power from the ROC analysis. Conclusions The present study showed the abnormal inter-hemisphere interaction and integration of information involved in ejaculation inhibitory control, sensorimotor mediation and self-reference processing including the thalamus, caudate, MCC, widespread parietal cortex and temporal cortex in lifelong PE patients compared with HCs. Correlation analysis and ROC analysis revealed the importance of S1 and caudate in lifelong PE. Notably, the ROC result of caudate might show the core roles of caudate played in the pathophysiology of lifelong PE.
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Affiliation(s)
- Nana Feng
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Ming Gao
- Xi'an Daxing Hospital of Shaanxi University of Chinese Medicine, Xi'an, China.,Department of Andrology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiayu Wu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Guang Yang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Ruiqing Piao
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
| | - Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China
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16
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Gao S, Chen J, Xu Y, Liu S, Lu C, Guan Y, Yang X. Altered Structural and Functional Connectivity Contribute to Rapid Ejaculation: Insights from a Multimodal Neuroimaging Study. Neuroscience 2021; 471:93-101. [PMID: 34216696 DOI: 10.1016/j.neuroscience.2021.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 01/01/2023]
Abstract
Little is known about how the aberrant structural and functional connectivity relates to the rapid ejaculation. Data of diffusion tensor imaging and resting state functional magnetic resonance imaging were acquired from 32 PE patients and 38 healthy controls (HCs). Firstly, we investigated the structural connectivity (SC) disruptions of PE patients using the method of graph theoretical analysis. Brain regions with impaired nodal strength were then defined as regions of interest (ROI). Secondly, the corresponding functional connectivity (FC) changes were explored. Finally, the correlation analyses were performed between brain areas with abnormal connectivity and clinical characteristics. Structural analysis revealed that PE patients had increased nodal strength in the right superior frontal gyrus (dorsolateral), left middle frontal gyrus, right superior frontal gyrus (medial), right superior frontal gyrus (medial orbital) and decreased nodal strength in the left amygdala. FC analysis revealed that PE patients had decreased FC values in the default mode network, visual recognition network and subcortical network, as well as increased FC values in the attention network. Moreover, correlation analysis revealed that the nodal strength of right superior frontal gyrus (dorsolateral) was negatively associated with the intra-vaginal ejaculation latency, while FC values between the left middle frontal gyrus and middle occipital gyrus were positively related to the total scores of the premature ejaculation diagnostic tool (PEDT). Our results indicated that PE might be associated with the abnormal SC of areas in the prefrontal-amygdala pathway and aberrant FC in certain functional brain networks, especially in default mode network.
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Affiliation(s)
- Songzhan Gao
- Department of Andrology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jianhuai Chen
- 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
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Lu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yichun Guan
- Department of Reproductive Medicine, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
| | - Xianfeng Yang
- Department of Andrology, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
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Geng B, Gao M, Wu J, Yang G, Liu C, Piao R, Zhang S, Xu K, Yuan J, Liu P. Smaller volume and altered functional connectivity of the amygdala in patients with lifelong premature ejaculation. Eur Radiol 2021; 31:8429-8437. [PMID: 33928418 DOI: 10.1007/s00330-021-08002-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 04/04/2021] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To analyze the abnormal amygdala structure and function in lifelong premature ejaculation (PE) patients compared with healthy controls (HCs). METHODS Forty-four lifelong PE patients and thirty-one HCs were enrolled in this study. Each subject was diagnosed with PE using a Premature Ejaculation Diagnostic Tool (PEDT) and intravaginal ejaculation latency time (IELT) score. Based on t-tests and Pearson correlation analysis, the voxel-based morphometry and functional connectivity (FC) analyses were applied to evaluate brain structural and functional changes by using T1-weighted and resting-state functional magnetic resonance imaging scans. RESULTS Lifelong PE patients had decreased gray matter volume in the bilateral amygdala and increased FC between the amygdala and precuneus, posterior cingulate cortex (PCC), and middle temporal cortex (MTC), as well as decreased FC between the amygdala and precentral gyrus, insula, and inferior frontal gyrus. Moreover, significantly negative correlations between the IELT score and the mean z-score from amygdala-MTC (r = -0.49) and amygdala-PCC (r = -0.48) FC were found in lifelong PE patients. CONCLUSIONS Our study investigated the abnormal amygdala-related structure and connectivity patterns in PE patients, which might provide novel perspective for understanding the crucial role of the amygdala in the neural mechanism of PE. KEY POINTS • As one of the most common diseases in men, PE may be related to abnormal brain mechanisms. • Functional and structural magnetic resonance imaging used to explore amygdala abnormalities in PE patients. • The correlation between clinical scores and functional connectivity was used to assess the reasonability of the results.
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Affiliation(s)
- Bowen Geng
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ming Gao
- Xi'An DaXing Hospital of Shaanxi University of Chinese Medicine, Xi'an, China.,Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China
| | - Jiayu Wu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Guang Yang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Chengxiang Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ruiqing Piao
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Shuming Zhang
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Ke Xu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China.,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, 710071, Shaanxi, China. .,Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China.
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Xia JD, Chen F, Zhang QJ, Wang YM, Dai YT, Song NH, Wang ZJ, Zhang B, Yang J. Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation. J Sex Med 2020; 18:275-283. [PMID: 33358559 DOI: 10.1016/j.jsxm.2020.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/22/2020] [Accepted: 11/20/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although some recent neuroimaging studies have indicated the abnormal brain structure or function in patients with lifelong premature ejaculation (LPE), whether and how the abnormal thalamic function participates in processing sexual behavioral information are still unclear in patients with LPE. AIM The aim of this study was to assess the changes in the thalamus metabolism and structural integrity in patients with LPE. METHODS We performed a multimodal magnetic resonance approach in a 3.0 T system, including proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging, and volumetric analysis to detect the differences in thalamic metabolism and structure between 20 patients with LPE and 15 healthy controls. OUTCOMES We analyzed and correlated the clinical symptoms of the subjects with significant 1H-MRS-based features. Peak areas of N-acetylaspartate, choline, creatine (Cr), and glutamate/glutamine (Glu) were calculated with the LCModel software. RESULTS Diffusion tensor imaging and volumetric analysis of thalami showed no differences between the 2 groups. On the contrary, 1H-MRS study disclosed that both Glu concentrations and Glu/Cr ratio values in the thalami of patients with LPE were remarkably increased when compared with healthy controls (P < .01 for both variables). In addition, both the intravaginal ejaculatory latency time score and Chinese Index of Sexual Function for Premature Ejaculation-5 score were negatively related to increased Glu concentrations and Glu/Cr ratio values. CLINICAL IMPLICATIONS Glutamatergic activity changes of thalamus may be an underlying indicator for evaluating sensory conduction efficiency in patients with LPE. STRENGTHS & LIMITATIONS The present study first found the abnormal thalamic metabolism in patients with LPE and contributed to a better understanding of the LPE etiology. Limitations include a cross-sectional study design with small samples and no examination of other brain areas. CONCLUSION Our findings show that the increase in glutamatergic activity of thalamus is related to LPE, suggesting that the increased Glu neurotransmission in the thalamus may contribute to the development of premature ejaculation. Xia J-D, Chen F, Zhang Q-J, et al. Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation. J Sex Med 2021;18:275-283.
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Affiliation(s)
- Jia-Dong Xia
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Fei Chen
- Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, Jiangsu, China
| | - Qi-Jie Zhang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ya-Min Wang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yu-Tian Dai
- Department of Andrology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Ning-Hong Song
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zeng-Jun Wang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Bing Zhang
- Department of Radiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China
| | - Jie Yang
- Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
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19
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Spontaneous Ejaculation: A Focused Review for the Clinicians. Sex Med Rev 2020; 9:406-422. [PMID: 33262094 DOI: 10.1016/j.sxmr.2020.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/25/2020] [Accepted: 11/01/2020] [Indexed: 01/23/2023]
Abstract
INTRODUCTION The process of ejaculation has important meanings not only for its association with orgasm but also for the timing to ejaculate in the context of sexual activity. Spontaneous (involuntary) ejaculation (SE) without any sexual stimulation is a distressing symptom. Our understanding of SE is limited. Unfortunately, many physicians are not aware of these cases. OBJECTIVES The objective of this study is to describe the etiopathogenesis, clinical features, diagnosis, and treatment options for SE. METHODS We searched the literature for publications on "SE," "spontaneous emission" or "involuntary ejaculation," and factors influencing SE in the PUBMED/MEDLINE, Scopus, Cochrane Library, EMBASE, PsycINFO, ProQuest, Academic Search Complete database, Google Scholar, and CINAHL databases from inception to August 2020. RESULTS The literature search yielded 36 relevant publications reporting on 43 patients with SE. Attempts to explain the cause of pathologic SE have included 4 etiological groups (spinal cord lesions, psychological causes, rabies, and drug-induced). The underlying mechanisms responsible for induction of SE may include increased adrenergic activity, overactivity in dopaminergic system, decreased serotonergic activity, damage of descending inhibitory pathway, or penile hyperexcitability. SE may occur in the absence of an identifiable trigger or may be triggered by non-sexual circumstances (micturition, defecation, glans touch, anxiety, panic attack, or school examinations). Treatment options include psychoanalytic treatment, paroxetine, citalopram, sertraline, silodosin, and anxiolytics. In drug-induced SE, dose reduction and drug withdrawal with or without switching to another drug may relief SE. CONCLUSIONS SE is one of the least reported ejaculatory dysfunction. The key feature shared in common by these men is SE without any sexual thoughts or fantasies, may be triggered by non-sexual contexts, rarely associated with orgasm or erection. Treatment by psychoanalytic treatment and pharmacotherapy may be helpful. Further research might explore the definite underlying mechanisms. Abdel-Hamid IA, Ali OI. Spontaneous Ejaculation: A Focused Review for the Clinicians. Sex Med Rev 2021;9:406-422.
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Chen J, Wu W, Xiang Z, Wang Q, Huang X, Lu C, Liu S, Chen Y, Yang J. Aberrant default mode network and auditory network underlying the sympathetic skin response of the penis (PSSR) of patients with premature ejaculation: A resting-state fMRI study. Andrology 2020; 9:277-287. [PMID: 32996293 DOI: 10.1111/andr.12914] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Hyperactivity of the sympathetic nervous system is considered as an important component involved in the pathological mechanisms of premature ejaculation (PE). However, the neural mechanisms of PE with high sympathetic activity are still not well understood. METHODS The activity of the sympathetic innervations in the penis was evaluated by the sympathetic skin response of the penis (PSSR) with an electromyograph and evoked potential equipment. Resting-state functional magnetic resonance imaging (fMRI) data were acquired from 18 PE patients with high sympathetic activity (sPE), 17 PE patients with normal sympathetic activity (nsPE), and 24 healthy controls (HC). We investigated the neural basis of sPE based on the measure of regional homogeneity (ReHo). Moreover, the correlations between brain regions with altered ReHo and PEDT scores and PSSR latencies in the patient group were explored. RESULTS Altered ReHo values among three groups were found in the temporal, cingulated, and parietal cortex in the default mode network (DMN), as well as the temporal cortex in the auditory network (AUD). Compared with HC, Patients with sPE had increased ReHo values of brain regions in DMN, AUD, and decreased ReHo values of brain regions in DMN. In addition, increased ReHo values were found in DMN of patients with nsPE, while decreased ReHo values were found in DMN and the attention network (AN). Moreover, sPE patients had increased ReHo values in AUD and decreased ReHo values in DMN when compared with nsPE patients. Finally, altered ReHo values of brain regions in DMN and AUD were associated with PEDT scores and PSSR latencies in the patient group. CONCLUSION Our results suggested that PE patients had abnormal ReHo values in DMN, AUD, and AN. Patients with sPE were characterized by increased neuronal activity in AUD and decreased activity in DMN. This highlighted the significances of DMN, AUD, and AN in the pathophysiology of PE and also provided potential neuroimaging biomarkers for distinguishing sPE from nsPE and HC.
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Affiliation(s)
- Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Wanke Wu
- Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Lu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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21
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Chen J, Yang J, Huang X, Wang Q, Lu C, Liu S, Chen Y, Ni L. Brain Functional Biomarkers Distinguishing Premature Ejaculation From Anejaculation by ALFF: A Resting-State fMRI Study. J Sex Med 2020; 17:2331-2340. [PMID: 33023837 DOI: 10.1016/j.jsxm.2020.09.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/24/2020] [Accepted: 09/09/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Premature ejaculation (PE) and anejaculation (AJ) are 2 opposite disorders of male ejaculatory dysfunction. Recent studies have demonstrated that the process of ejaculation is mediated by certain neural circuits in the brain. However, different mechanisms between PE and AJ are still unclear. AIM Therefore, we used resting-state functional magnetic resonance imaging (fMRI) to explore the underlying neural mechanisms in patients with PE and AJ by measuring the amplitude of low-frequency fluctuations (ALFF). METHODS Resting-state fMRI data were acquired in 17 PE, 20 AJ patients and 23 matched healthy controls (HC). MAIN OUTCOME MEASURE Differences of ALFF values among the 3 groups were compared. We also explored the correlations between brain regions showing altered ALFF values and scores of Premature Ejaculation Diagnostic Tool (PEDT) in the PE group. RESULTS There were widespread differences of ALFF values among the 3 groups, which included left anterior cingulate gyrus, precentral and postcentral gyrus, paracentral lobule, superior temporal gyrus, calcarine fissure, putamen; right postcentral gyrus, paracentral lobule, middle temporal gyrus, putamen. Compared with HC, PE patients had greater ALFF in the right inferior frontal gyrus (opercular part), AJ patients had greater ALFF in the left postcentral gyrus. In addition, PE patients exhibited greater ALFF in the left Rolandic operculum, anterior cingulate gyrus, inferior frontal gyrus (orbital part), putamen, and right putamen when compared with AJ patients, as well as decreased ALFF in the right postcentral gyrus. Moreover, positive correlations were found between ALFF of left postcentral gyrus, inferior frontal gyrus (orbital part), right inferior frontal gyrus (opercular part), and PEDT scores. CLINICAL IMPLICATIONS The differences in central pathophysiological mechanisms between PE and AJ might be useful for improving the clinical diagnosis of ejaculation dysfunction. STRENGTH & LIMITATIONS Our results showed that the method of fMRI could identify the differences of ALFF between PE and AJ and that these alterations in ALFF were related to clinical function. However, this was a relatively small sample study, and further multimodal neuroimaging studies with large samples were needed. CONCLUSION The findings demonstrated that altered ALFF of frontal, parietal cortex, and putamen might help distinguish premature ejaculation from anejaculation. Abnormal function of these brain regions might play a critical role in the physiopathology of ejaculatory dysfunction of patients. Chen J, Yang J, Huang X, et al. Brain Functional Biomarkers Distinguishing Premature Ejaculation From Anejaculation by ALFF: A Resting-State fMRI Study. J Sex Med 2020;17:2331-2340.
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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
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Lu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
| | - Liangyu Ni
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
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22
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Zhang T, Tang D, Cai H, Zhang B, Yang Y, Zhang C, Zhao W, Zhu J, Zhang X, Yu Y. Selective Functional Hyperconnectivity in the Middle Temporal Gyrus Subregions in Lifelong Premature Ejaculation. J Sex Med 2020; 17:1457-1466. [DOI: 10.1016/j.jsxm.2020.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 05/03/2020] [Accepted: 05/05/2020] [Indexed: 02/06/2023]
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23
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Gao M, Feng N, Guo B, Wu J, Sun J, Zhang L, Zeng X, Guo J, Yuan J, Liu P. Striatum-related Intrinsic Connectivity Deficits in Lifelong Premature Ejaculation Patients. Urology 2020; 143:159-164. [PMID: 32544552 DOI: 10.1016/j.urology.2020.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 05/13/2020] [Accepted: 06/01/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate abnormal intrinsic connectivity of striatum in lifelong premature ejaculation (PE) patients compared with healthy controls (HCs). METHODS Forty-seven lifelong PE patients and 30 healthy controls were enrolled in the present study and underwent resting-state functional magnetic resonance imaging. The functional connectivity (FC) analysis and 2-sample t tests were applied to investigate the alterations of striatum-related connectivity in patients compared with HCs (significant threshold at P < .05, false discovery rate corrected), and during which Fisher's r-to-z transformation was adopted and the resulting z values were used as the statistical FC values. Correlation analysis was performed to test possible relationships between the imaging findings and clinical characteristics in the patient group (P < .05, Bonferroni correction). RESULTS The results showed that compared with HCs, lifelong PE patients had significantly decreased FC between the right caudate and insula, superior temporal pole (STP) and orbitofrontal cortex (OFC) as well as decreased FC between the bilateral putamen and insula, STP and middle cingulate cortex (MCC). Meanwhile, patients had significantly increased FC between the left caudate and OFC, and increased FC between the right putamen and fusiform. The mean FC value from the caudate-OFC, caudate-insula, and caudate-STP connectivity negatively correlated with the Premature Ejaculation Diagnostic Tool score, separately. CONCLUSION The current study showed the functional abnormality of lifelong PE in multiple brain regions implicated in sensation, motivation, and ejaculation-related inhibitory control, which may improve our understanding of the abnormal striatum-related neural mechanisms in lifelong PE patients.
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Affiliation(s)
- Ming Gao
- Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China; Department of Andrology, XiYuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Nana Feng
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China; Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Boda Guo
- Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing 100730, China; Graduate School of Peking Union Medical College, Beijing 100730, China
| | - Jiayu Wu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China; Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jianhua Sun
- Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China
| | - Lei Zhang
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Xiao Zeng
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China; Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China
| | - Jun Guo
- Department of Andrology, XiYuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jianlin Yuan
- Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Peng Liu
- Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China; Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China.
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24
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Corona G, Jannini EA. Diffusion tensor imaging: A new valuable method for understanding male sexual functioning. Andrology 2020; 8:266-267. [DOI: 10.1111/andr.12768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Giovanni Corona
- Endocrinology Unit Medical Department Azienda Usl Maggiore‐Bellaria Hospital Bologna Italy
| | - Emmanuele A. Jannini
- Endocrinology and Medical Sexology (ENDOSEX) Department of Systems Medicine University of Rome Tor Vergata Rome Italy
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25
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Yin T, Liu Q, Ma Z, Li Z, Sun R, Ren F, Li G, Huang X, Chang D, Zhang P. Associations Between Altered Cerebral Activity Patterns and Psychosocial Disorders in Patients With Psychogenic Erectile Dysfunction: A Mediation Analysis of fMRI. Front Psychiatry 2020; 11:583619. [PMID: 33192729 PMCID: PMC7652753 DOI: 10.3389/fpsyt.2020.583619] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/09/2020] [Indexed: 12/24/2022] Open
Abstract
Previous studies had illustrated the significant neural pathological changes in patients with psychogenic erectile dysfunction (pED), while few works focused on the neural underpinning of the psychosocial status in patients with pED. This study aimed to investigate the associations among the altered cerebral activity patterns, impaired erectile function, and the disrupted psychosocial status in patients with pED. Thirty-two patients with pED and 28 healthy controls (HCs) were included. The amplitude of low-frequency fluctuations (ALFF), region-of-interest-based functional connectivity (FC), as well as Pearson correlation analyses and mediation analyses between neuroimaging outcomes and clinical outcomes were performed. Compared to HCs, patients with pED manifested lower erectile function, disrupted psychosocial status, as well as decreased ALFF in the left dorsolateral prefrontal cortex (dlPFC) and reduced FC between the left dlPFC and left angular gyrus, and left posterior cingulate cortex (PCC) and precuneus, which belonged to the default mode network (DMN). Moreover, both the ALFF of the left dlPFC and FC between the left dlPFC and left PCC and precuneus were significantly correlated with the sexual function and psychosocial status in patients with pED. The disrupted psychosocial status mediated the influence of atypical FC between dlPFC and DMN on decreased erectile function. This study widened our understanding of the important role of psychosocial disorders in pathological neural changes in patients with pED.
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Affiliation(s)
- Tao Yin
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture-Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Qi Liu
- Acupuncture and Tuina School, Shaanxi University of Chinese Medicine, Xian, China
| | - Ziyang Ma
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Clinical Medical School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhengjie Li
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture-Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ruirui Sun
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, China.,Acupuncture-Brain Science Research Center, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Feiqiang Ren
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Guangsen Li
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaopeng Huang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Degui Chang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Peihai Zhang
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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26
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Chen J, Yang J, Huang X, Ni L, Fan Q, Liu T, Yao Z, Chen Y. Reduced segregation and integration of structural brain network associated with sympathetic and dorsal penile nerve activity in anejaculation patients: a graph‐based connectome study. Andrology 2019; 8:392-399. [PMID: 31610095 DOI: 10.1111/andr.12715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/11/2019] [Accepted: 10/08/2019] [Indexed: 12/14/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - J. Yang
- Department of Urology Jiangsu Provincial People's Hospital First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - L. Ni
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Q. Fan
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - T. Liu
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Z. Yao
- Department of Psychiatry Nanjing Brain Hospital Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Y. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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27
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Chen J, Huang X, Lu C, Liu T, Dai Y, Yao Z, Chen Y. Graph analysis of
DTI
‐based connectome: decreased local efficiency of subcortical regions in
PE
patients with high sympathetic activity. Andrology 2019; 8:400-406. [PMID: 31532583 DOI: 10.1111/andr.12701] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 12/18/2022]
Affiliation(s)
- J. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - X. Huang
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - C. Lu
- Department of Radiology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - T. Liu
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
| | - Y. Dai
- Department of Andrology Nanjing Drum Tower Hospital Affiliated Hospital of Nanjing University Medical School Nanjing China
| | - Z. Yao
- Department of Psychiatry Nanjing Brain Hospital Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Y. Chen
- Department of Andrology Jiangsu Province Hospital of Chinese Medicine Affiliated Hospital of Nanjing University of Chinese Medicine Nanjing China
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