Disrupted topological properties of brain networks in erectile dysfunction patients owing predominantly to psychological factors: a structural and functional neuroimaging study

Abstract

Introduction Human brain was a complex network of interconnected regions. Recent neuroimaging studies had showed that the disruption of brain connectivity was associated with psychological disorders. Abnormal rich club and robustness of brain networks might have a key role in the pathophysiology of psychogenic erectile dysfunction (pED). Methods Both diffusion and functional magnetic resonance imaging were performed in pED patients and healthy controls (HC). Measures of rich club organization and robustness under targeted attack were explored. Results Both pED and HC showed structural and functional rich club organization. However, reduced rich club coefficient was found in pED and different regions in the rich club of structural brain network were less than that of functional brain network. Moreover, decreased connectivity density and strength were only found in feeder connections of functional brain network in pED. In addition, pED showed remarkably reduced resilient to targeted attack and the stability of the functional brain network organization showed more vulnerable to targeted attack in pED. Conclusion Together, our results provided evidence that pED was characterized by a selective disruption of rich club organization and reduced robustness to attack. The abnormal hub regions and connections of functional brain network, less stable organization of structural brain network, and the abnormal psychological factors might lead to the development of erectile dysfunction in pED.

Diffusion tensor imaging: A new valuable method for understanding male sexual functioning

“…In addition, they found that these connections are reduced in patients with iED when compared to controls. The latter finding supports an abnormal process of sexual stimuli that can explain, at least partially, the observed sexual impairment in iED …”

“…The latter finding supports an abnormal process of sexual stimuli that can explain, at least partially, the observed sexual impairment in iED. 5 Ejaculation represents a crucial part of male sexual response cycle, which ends with the resolution phase, and similar to what reported for erection, can be considered a spinal reflex integrated by specific central brain, which includes medial pre-optic area, paraventricular hypothalamic nucleus, and the lateral hypothalamus, identified as the excitatory pathways, whereas ventral medulla has been demonstrated to play an inhibitory influence on ejaculation. 9 Interestingly, in the present issue, the same Chen and co-authors reported data-derived DTI even in subjects with ejaculatory dysfunction.…”

“…4 Using the latter technique in the present issue of Andrology, Chen and co-authors provided important new information on the specific brain neural networks involved in the regulation of erection and ejaculation. [5][6][7] In the first study, by comparing subjects with idiopathic (the term psychogenic, although still largely used, is to be considered obsolete) 8 erectile dysfunction (iED) and healthy controls (HC) they reported that cortex regions, including precuneus, precentral gyrus, middle temporal gyrus, and occipital cortex, are tightly connected with important subcortical areas including caudate nucleus, putamen, insula, and hippocampus. In addition, they found that these connections are reduced in patients with iED when compared to controls.…”

“…Diffusion tensor imaging (DTI) is a particular fMRI technique based on the measurement of water diffusion in the tissue, which allows the determination of brain networks and their topological properties . Using the latter technique in the present issue of Andrology , Chen and co‐authors provided important new information on the specific brain neural networks involved in the regulation of erection and ejaculation . In the first study, by comparing subjects with idiopathic (the term psychogenic, although still largely used, is to be considered obsolete) erectile dysfunction (iED) and healthy controls (HC) they reported that cortex regions, including precuneus, precentral gyrus, middle temporal gyrus, and occipital cortex, are tightly connected with important subcortical areas including caudate nucleus, putamen, insula, and hippocampus.…”

Associations Between Altered Cerebral Activity Patterns and Psychosocial Disorders in Patients With Psychogenic Erectile Dysfunction: A Mediation Analysis of fMRI

“…With the application of neuroimaging technologies, the close correlation between sexuality and the central nervous system (CNS) is becoming clearer (14)(15)(16). Many male sexual dysfunctions, such as ED (17)(18)(19)(20)(21)(22), premature ejaculation (23,24), and anejaculation (25) have been detected to be associated with alterations in the structure and function of the brain. For example, patients with pED demonstrated the atrophied gray matter volume (17,19), altered white matter microstructure (26), aberrant activity patterns (20), and disrupted topological properties (22) in multiple brain regions, such as prefrontal cortex, cingulate cortex, and insular cortex.…”