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The results of several studies have shown that homosexual men have an increased prevalence of non-right-handedness and atypical patterns of hemispheric functional asymmetry. Non-right-handedness in men has been associated with increased size of the corpus callosum (CC), particularly of the isthmus, which is the posterior region of the callosal body connecting parietotemporal cortical regions. We hypothesized that isthmal area would be greater in homosexual men, even among right handers. Twelve homosexual and ten heterosexual healthy young men, all consistently right-handed, underwent a research-designed magnetic resonance imaging scan. We found that the isthmal area was larger in the homosexual group, adding to the body of findings of structural brain differences between homosexual and heterosexual men. This result suggests that right-handed homosexual men have less marked functional asymmetry compared to right-handed heterosexual men. The results also indicate that callosal anatomy and laterality for motoric functions are dissociated in homosexual men. A logistic regression analysis to predict sexual orientation category correctly classified 21 of the 22 men (96% correct classification) based on area of the callosal isthmus, a left-hand performance measure, water level test score, and a measure of abstraction ability. Our findings indicate that neuroanatomical structure and cognition are associated with sexual orientation in men and support the hypothesis of a neurobiological basis in the origin of sexual orientation.

ObjectiveMedically unexplained somatic complaints are highly prevalent, and lead to significant impairment and disability. The number of effective treatment modalities for somatic symptom and related disorders (SSDs) or somatoform disorders (SDs) remains limited. To date, there is no formal indication for electroconvulsive therapy (ECT) in SSD or SD. We report on the largest case series to date regarding the effectiveness of ECT in patients with SSD and SD.MethodsA retrospective chart review of all patients treated with an index course of ECT at the Neuropsychiatric Program at the University of British Columbia Hospital from 2000 to 2010 was conducted. The primary outcomes consisted of changes in pseudoneurologic symptoms, pain symptoms, cardiopulmonary symptoms, and gastrointestinal symptoms. Complaints were examined pre- and post-ECT.ResultsTwenty-eight participants were included in this study. Twenty-one participants received right unilateral ECT. Six received bifrontal ECT. One received bitemporal ECT. Eighteen of 21 participants reported improvement in pseudoneurologic symptoms; eleven of 14 participants reported improvement in pain symptoms; one participant reported improvement in cardiopulmonary symptoms; and one of two participants reported improvement in gastrointestinal symptoms. This paper discusses the putative mechanism of action of ECT in the treatment of SD/SSD.ConclusionThis retrospective study suggests that ECT could be included as part of the existing treatment for refractory SSD and SD, particularly in refractory cases with comorbid mood disorders.

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