Aberrant default mode network and auditory network underlying the sympathetic skin response of the penis (PSSR) of patients with premature ejaculation: A resting‐state fMRI study

Abstract

Introduction Hyperactivity of the sympathetic nervous system is considered as an important component involved in the pathological mechanisms of premature ejaculation (PE). However, the neural mechanisms of PE with high sympathetic activity are still not well understood. Methods The activity of the sympathetic innervations in the penis was evaluated by the sympathetic skin response of the penis (PSSR) with an electromyograph and evoked potential equipment. Resting‐state functional magnetic resonance imaging (fMRI) data were acquired from 18 PE patients with high sympathetic activity (sPE), 17 PE patients with normal sympathetic activity (nsPE), and 24 healthy controls (HC). We investigated the neural basis of sPE based on the measure of regional homogeneity (ReHo). Moreover, the correlations between brain regions with altered ReHo and PEDT scores and PSSR latencies in the patient group were explored. Results Altered ReHo values among three groups were found in the temporal, cingulated, and parietal cortex in the default mode network (DMN), as well as the temporal cortex in the auditory network (AUD). Compared with HC, Patients with sPE had increased ReHo values of brain regions in DMN, AUD, and decreased ReHo values of brain regions in DMN. In addition, increased ReHo values were found in DMN of patients with nsPE, while decreased ReHo values were found in DMN and the attention network (AN). Moreover, sPE patients had increased ReHo values in AUD and decreased ReHo values in DMN when compared with nsPE patients. Finally, altered ReHo values of brain regions in DMN and AUD were associated with PEDT scores and PSSR latencies in the patient group. Conclusion Our results suggested that PE patients had abnormal ReHo values in DMN, AUD, and AN. Patients with sPE were characterized by increased neuronal activity in AUD and decreased activity in DMN. This highlighted the significances of DMN, AUD, and AN in the pathophysiology of PE and also provided potential neuroimaging biomarkers for distinguishing sPE from nsPE and HC.

Potential biomarkers for distinguishing primary from acquired premature ejaculation: A diffusion tensor imaging based network study

“…Until now, only a few studies have explored the topological characteristics of the brain network in male sexual dysfunction using the method of graph theory ( Chen et al, 2018a , b , 2020c , 2021 ). With respect to PE, our previous studies found disrupted topological architectures in the white matter brain network of patients with primary PE and patients with depression ( Chen et al, 2020c , 2021 ), as well as functional abnormalities in those with high sympathetic activity ( Chen et al, 2020b ). In addition, brain functional biomarkers were identified for distinguish patients with PE from those with anejaculation by the method of resting-state functional magnetic resonance imaging (MRI) ( Chen et al, 2020e ).…”

Altered Regional Homogeneity in Patients With Diabetic Erectile Dysfunction: A Resting-State fMRI Study

“…All participants were instructed to relax, think of nothing in particular, stay awake with eyes closed, move as little as possible during the scan. Sagittal 3D T1-weighted images were acquired with the following parameters: repetition time (TR) =1900ms; echo time (TE)=2.48ms; flip angle (FA)=9°; field of view (FOV)=250mm×250mm; matrix size=256×256; slice thickness=1mm; number of slices=176 (42,43). Rs-MRI BOLD images were acquired with the following parameters: TR/ TE =3000/40ms; FA=90°; FOV=240mm×240mm; matrix size=64×64; slice thickness=4mm; number of slices=32; number of volumes=133 (42,43).…”

“…Sagittal 3D T1-weighted images were acquired with the following parameters: repetition time (TR) =1900ms; echo time (TE)=2.48ms; flip angle (FA)=9°; field of view (FOV)=250mm×250mm; matrix size=256×256; slice thickness=1mm; number of slices=176 (42,43). Rs-MRI BOLD images were acquired with the following parameters: TR/ TE =3000/40ms; FA=90°; FOV=240mm×240mm; matrix size=64×64; slice thickness=4mm; number of slices=32; number of volumes=133 (42,43). All subjects had no obvious structural damages examined by two radiologists based on conventional MRI images.…”

“…(44). The steps of MRI data preprocessing were described in our previous studies (42,43). The first 6 volumes of functional time points were discarded for magnetization stabilization and adaptation of participants.…”

Multivariate Pattern Analysis of Lifelong Premature Ejaculation Based on Multiple Kernel Support Vector Machine

“…A recent study found that altered amplitude of low-frequency fluctuations (ALFF) of the frontal cortex, the parietal cortex, and the putamen might help distinguish premature ejaculation from anejaculation ( 5 ). Another study investigated the neural basis of patients with PE based on the measure of regional homogeneity (ReHo) ( 6 ). Patients with lifelong PE showed abnormal degree centrality (DC) value in the medial prefrontal cortex, the precuneus, the primary somatosensory cortex, and the orbitofrontal cortex ( 7 ).…”