Introduction Premature ejaculation (PE) is a highly prevalent male sexual dysfunction. Previous studies have found abnormal activity in the sympathetic nervous system and penile sensory pathway of PE. Few studies have investigated the neural mechanisms underlying PE. Aim The aim of this study was to examine whether the altered cortico-subcortical network topological properties of the brain white matter structural network could be used to differentiate patients with PE from healthy control (HC) subjects. Methods Diffusion tensor images data were collected from 32 patients with PE and 35 HC participants. Then, brain white matter structural networks were reconstructed from image acquisition. Main Outcome Measure Furthermore, nodal measures were calculated and hub regions were identified using the graph-theoretical methods. Results For cortical brain regions, increased strength, global efficiency, and decreased shortest path length were found in the right superior frontal gyrus (medial), and superior frontal gyrus (medial orbital) were found in patients with PE. In addition, patients with PE also showed decreased strength in the right rolandic operculum and decreased shortest path length, and increased global efficiency in the right inferior frontal gyrus (triangular part). For subcortical brain structures, patients with PE were associated with decreased shortest path length and increased global efficiency in the left insula and right caudate nucleus. Finally, the results showed that 9 PE-specific hub regions were identified in patients compared with HCs, including 7 cortical regions and 2 subcortical regions. Clinical Implications Our results provide new understanding about the pathology of PE and enhances the understanding of PE pathology. Strength & Limitations Our results offer biological markers for understanding the physiopathology of PE. However, our study is a cross-sectional design, longitudinal design studies need to explore the causal relationships between aberrant topological characteristics and PE. Conclusion Our results provide new insights into the neural mechanism of PE involving cortico-subcortical network changes, which could serve as a potential biomarker to differentiate individuals with PE from HCs.

Recent research has shown that premature ejaculation (PE) is associated with negative psychological effects (e.g., depression) and the decline of control over ejaculation is accompanied by structural and functional abnormalities in specific brain areas and connections. However, little is known about the alterations of topological organization in the brain network of patients with PE and its relationship with depressive symptom. We acquired diffusion tensor images, sexual function and depression assessment in 16 lifelong PE patients with depressive symptom, 16 lifelong PE patients without depression and 32 age-and education-matched healthy controls (HC). The differences in nodal centrality and different hub regions among the three groups were compared. Correlation analyses were conducted between the nodal centrality of brain regions displaying significant group differences and the clinical parameters of PE patients. PE patients with depression had increased nodal degree in the right middle frontal gyrus (orbital part) (ORBmid.R) (survived FDR-correction) compared with HC and PE without depression. PE patients with depression also had increased nodal degree in the left and right posterior cingulate gyrus (PCG.L; PCG.R) compared with HC. In addition, PE with depression had increased nodal betweenness in ORBmid.R compared with HC and PE without depression. Moreover PE with depression had decreased nodal participation in the right rolandic operculum (ROL.R), postcentral gyrus (PoCG.R) and supramarginal gyrus (SMG.R) compared with HC, and had decreased nodal participation in ROL.R and the right inferior parietal gyrus (IPL.R) compared with PE without depression, while PE without depression had increased nodal participation in the left precuneus (PCUN.L) compared with HC. The degree and betweenness of ORBmid.R were positively correlated with the total scores of Beck depression inventory (BDI) while the participation of IPL.R had a negative association with the total scores of BDI. Different hubs were found among PE patients with and without depression and HC based on nodal degree, betweenness and 1906 | CHEN Et al.

Background: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a chronic disease with a variety of psychosocial and somatic symptoms. CP/CPPS has substantial health care costs with unclear etiology, which may be caused by psychosocial factors. Moreover, previous studies suggested that cognitive processes played a crucial role in the perception of somatic pain. Therefore, the aim of this meta-analysis was to analyze the psychosocial characteristics in men with CP/CPPS, especially the symptom of pain catastrophizing.Methods: Relevant publications were searched in different databases including PubMed, MEDLINE, EMBASE, Google Scholar and the Cochran Library using the search terms of "Chronic prostatitis", "Chronic pelvic pain syndrome", "Psychosocial" and "Catastrophizing". The prevalence of psychological factors and pain catastrophizing in men with CP/CPPS were extracted and calculated.Results: Ten studies inclusive of 1,308 patients were included. Analysis of NIH-CPSI scores showed that the severity of CP/CPPS was 23.20 (95% CI: 21.13-25.28). The severity of pain catastrophizing was 13.81 (95% CI: 9.83-17.79) estimated by coping strategies questionnaire (CSQ), while the severity of pain catastrophizing was 24.83 (95% CI: 9.19-40.47) estimated by pain catastrophizing scale (PCS).The prevalence of psychosocial symptom was 0.43 (95% CI: 0.32-0.55), while the prevalence of pain catastrophizing was 0.26 (95% CI: 0.21-0.31). Conclusions:The psychological factors and pain catastrophizing in men with CP/CPPS was serious. Furthermore, the prevalence of psychosocial symptom and pain catastrophizing was high. There might be a link between pain catastrophizing and somatic symptoms in CPPS. Thus, further prospective studies are needed to evaluate the importance of psychosocial factors in symptom severity of CP/CPPS.