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Disrupted rich club and robustness of brain network in erectile dysfunction patients owing predominantly to psychological factors a structural and functional neuroimaging 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; 2: Nanjing Brain Hospital, The Affiliated Hospital of Nanjing Medical University; 3: Research Centre for Learning Science, Southeast University

Objectives: Human brain was a complex network of structurally and functionally interconnected regions. Recent neuroimaging studies had showed that disruption of brain connectivity were associated with psychological disorders. Abnormal rich club and robustness of functional and structural brain networks might have a key role in the pathophysiology of psychogenic erectile dysfunction (pED). To investigate the rich club organization and robustness property under targeted attack in structural and functional brain networks in pED and their roles in the erectile dysfunction owing predominantly to psychological factors.

Material and Methods: Both diffusion and functional magnetic resonance imaging were performed in pED patients and matched healthy controls (HC). Measures of rich club organization, including the rich club coefficient, structural and functional connectivity density and strength of rich club, feeder and local connections; measures of robustness property under targeted attack, including the relative size of largest component and normalized global efficiency, local efficiency, clustering.

Results: Both pED and HC showed structural and functional rich club organization. However, reduced rich club coefficient was found in pED when compared with that of HC. And the rich club of the structural brain network showed less different regions than that of functional network in pED. Moreover, decreased connectivity density and strength were only found in feeder connections of the functional brain network of pED, which potentially contributed to abnormal connectivity between hub and non-hub brain regions, resulting in a reduced communication and integration capacity among different brain regions. In addition, pED showed remarkably reduced resilient to targeted attack when compared to that of HC. And compared with the structural brain network, the stability of the functional brain network organization showed more vulnerable to targeted attack in pED.

Conclusions: Together, our results provided evidence that rich-club architecture was one of the bases of both structurally and functionally brain networks in pED. Furthermore, pED was characterized by a selective disruption of rich club organization and reduced robustness to attack. The abnormal hub regions and connections of the functional brain network, less stable organization of the structural brain network and the abnormal psychological factors might lead to the development of erectile dysfunction in pED. Our findings supported a central role for the impaired rich club and robustness in the potential mechanism underlying the development of erectile dysfunction in pED, which neither seen in psychiatry disease nor in HC.


Work supported by industry: no.

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