Altered brain networks in psychogenic erectile dysfunction a resting-state fMRI study
Chen, J1; Chen, Y1; Chen, T1; Gao, Q1; Dai, Y1; Yao, Z2; Lu, Q3
1: Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School,China; 2: Nanjing Brain Hospital, The Affiliated Hospital of Nanjing Medical University, China; 3: Research Centre for Learning Science, Southeast University, China
Objectives: Various neuroimaging studies had identified changes of cerebral activity and structures during the processes of sexual arousal. The identified brain regions were also believed to regulate emotional and cognitive processes. Yet, little was known about the neural mechanisms underlying psychogenic erectile dysfunction (pED). Moreover, brain mechanisms mediating the processing of sexual arousal by these psychological processes were unclear.
Material and Methods: To investigate the above issue, graph theory was applied to evaluate the topological properties of functional brain networks among 24 pED patients and 26 healthy controls.
Results: Abnormal metrics and correlations with clinical characteristics were further analyzed. Our results showed that pED had higher small-worldness and more modules. Furthermore, pED showed altered path length and strength of the right superior frontal gyrus (dorsolateral), superior parietal gyrus, parahippocampal gyrus and left temporal pole (superior temporal gyrus), postcentral gyrus, mainly located in the cognitive control and emotional regulation subnetworks. And the altered parameters of the small-worldness and right parahippocampal gyrus were related with the clinical characteristics of pED.
Conclusions: In summary, this study investigated the topological organization of the brain networks in pED. We found that pED showed small-world topology and modularized structure. However, the small-worldness and modules of pED were higher compared with HC and the abnormal brain regions mainly implicated in the fronto-parietal network and prefronto-limbic circuit. The disturbances of the optimal topological organization were reflected by the decreasing transfers of information within implicated in processing the cognitive and emotional components of sexual arousal. Moreover, the altered small-worldness and strength of parahippocampal gyrus were correlated with the clinical characteristics of pED. Hence, the assessment of cognitive and emotional states of pED by the scales of depression and anxiety or by neuroimaging method was essential for andrologists or urologists. The impaired cognition and emotion might be biomarkers for clinical diagnosis and might help to develop new therapies for pED. Overall, these findings provided evidence for the disrupted organization in the subnetworks underlying the cognitive and emotional processes of sexual arousal in pED.
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