BackgroundAlthough genital sensations are an essential aspect of sexual behavior, the cortical somatosensory representation of genitalia in women and men remain poorly known and contradictory results have been reported.ObjectiveTo conduct a systematic review of studies based on electrophysiological and functional neuroimaging studies, with the aim to identify insights brought by modern methods since the early descriptions of the sensory homunculus in the primary somatosensory cortex (SI).ResultsThe review supports the interpretation that there are two distinct representations of genital sensations in SI, one on the medial surface and the other on the lateral surface. In addition, the review suggests that the secondary somatosensory cortex and the posterior insula support a representation of the affective aspects of genital sensation.ConclusionIn view of the erogenous character of sensations originating in the genitalia, future studies on this topic should systematically assess qualitatively as well as quantitatively the sexually stimulating and/or sexually pleasurable characteristics of sensations felt by subjects in response to experimental stimuli.

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Structural and functional neuroimaging techniques have recently been used to investigate the mechanisms of sexual attraction to children, a hallmark of pedophilic disorder, and have reported many contradictory or non-replicated findings. Here, our purpose was to identify through functional magnetic resonance imaging the brain responses of 25 male outpatients with pedophilic disorder to visual stimuli depicting children (VSc) and to compare them with 24 male healthy controls matched on sexual orientation (to female or male adults), age, and handedness. No region was differentially activated across the two groups in response to VSc. However, as shown by a random-effects statistical analysis (cluster-level p-corrected < 0.05), in patients with pedophilia, but not in controls, the presentation of VSc induced a bilateral activation in the lateral occipital and temporal cortices, in particular in the right inferior temporal gyrus, as well as an activation in the declive of the cerebellar vermis. In addition, in patients the level of bilateral activation in the above-mentioned regions was positively correlated with ratings of perceived sexual arousal elicited by VSc. These results implicate these regions as possible candidate areas mediating sexual arousal in patients with pedophilic disorder.