Impaired prefrontal-amygdala pathway, self-reported emotion and erection in psychogenic erectile dysfunction patients with normal nocturnal erection
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: The Affiliated Hospital of Nanjing Medical University; 3: Southeast University
Objectives: Neuroimaging studies had demonstrated that the prefrontal cortex (PFC) and amygdala were associated sexual arousal (SA). However, little was known about how the interactions between the prefrontal and cortex amygdala mediated the cognitive regulation of emotion and SA. We sought to determine whether nocturnal erection of psychogenic erectile dysfunction (pED) patients were normal and whether there were changes of topological organization in the prefrontal-amygdala pathway of brain network in pED. In addition, whether there were correlations between network property changes and self-reported emotion and erection.
Material and Methods: We used RigiScan device to evaluate erectile function of petients and employed diffusion MRI and graph theory to construct brain networks of 21 pED patients and 24 healthy controls. We considered 4 nodal metrics, their asymmetry scores and nocturnal penile tumescence (NPT) parameters, to evaluate the topological properties of brain networks of pED and its relationships with the impaired self-reported emotion and erection.
Results: All the pED patients showed normal nocturnal penile erection, however impaired slef-reported erection and negative emotion. In addition, patients showed lower connectivity degree and strength in the left prefrontal-amygdala pathway. We also found that pED exhibited lower left-greater-than-right asymmetry in the inferior frontal gyrus. Furthermore, patients showed more hub regions and lesser pivotal connections. Moreover, the degree of the left amygdala of pED showed significantly negative correlation with the self-reported erection and positive correlation with the self-reported negative emotion.
Conclusions: In this report, we used RigiScan device to evaluate erectile function and explored the self-reported emotion- and erection-related differences in the patterns of pED brain networks. We found that nocturnal erection of pED were normal, however, the prefrontal-amygdala pathway involved in the abnormal SA of pED were impaired. We concluded that the abnormal integration within the left prefrontal-amygdala pathway was associated with the impaired erection and negative emotion in pED. Together, these results showed normal nocturnal erection in pED. However, abnormalities of brain network organization in pED, particularly in the left prefrontal-amygdala pathway, were associated with the impaired self-reported erection and negative emotion.
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