The neurologic control of arousal and orgasm with specific attention to spinal cord lesions: Integrating preclinical and clinical sciences

Alexander, Marcalee; Marson, Lesley

doi:10.1016/j.autneu.2017.01.005

Cited by 20 publications

(13 citation statements)

References 118 publications

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“…Increased sympathetic activity due to arousal may also result in a positive feedback loop, which would increase the effective duration of stimulation. While a mechanism for sexual arousal involving sympathetic and parasympathetic feedback has been proposed, the dynamics are not well‐understood . Our observed blood flow responses are much longer in duration than rat coitus.…”

Section: Discussionmentioning

confidence: 68%

Time-Frequency Analysis of Increases in Vaginal Blood Perfusion Elicited by Long-Duration Pudendal Neuromodulation in Anesthetized Rats

Rice

Zimmerman

Ross

et al. 2017

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 68%

Time-Frequency Analysis of Increases in Vaginal Blood Perfusion Elicited by Long-Duration Pudendal Neuromodulation in Anesthetized Rats

Rice

Zimmerman

Ross

et al. 2017

Neuromodulation: Technology at the Neural Interface

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“…Ejaculation was a pleasurable physiological behavior, which usually occurred in conjunction with orgasm and was closely related to the subjective pleasurable feelings during sexual intercourse (Alwaal et al ., ; Puppo & Puppo, ). Peripheral nerves including the pelvic plexus and somatic, sacral parasympathetic, thoracolumbar sympathetic nerves of spinal cord system all involved in ejaculation (Chéhensse et al ., ; Alexander & Marson, ; El‐Hamd et al ., ). Previous studies had found that the brain also had central roles in modulating the process of ejaculation, including excitatory and inhibitory effect on ejaculation (Zhang et al ., ; Yang et al ., ).…”

Section: Introductionmentioning

confidence: 99%

Graph analysis of DTI‐based connectome: decreased local efficiency of subcortical regions in PE patients with high sympathetic activity

Chen

Xiao-hong

et al. 2019

Andrology

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Introduction Hyperactivity of the sympathetic nervous system was considered as one of the factors involved in the pathological mechanisms of premature ejaculation (PE). Sympathetic skin response of the penis (PSSR) was used to evaluate the activity of sympathetic innervations in the penis, which was controlled by the central nervous system (brain). Shorter PSSR was found in PE patients; however, little was known regarding the central neural mechanisms of PE patients with high sympathetic activity. Methods PSSR of PE patients was evaluated, and diffusion tensor images of participants were collected. Graph theoretical analysis was employed to examine the differences of the topological properties of structural brain connectome between PE patients with high sympathetic activity and healthy controls (HCs). Moreover, the relationships between topological characteristics and clinical features in PE patients were also explored. Results Decreased local efficacy was found in the left amygdala, right pallidum and thalamus in the white matter brain networks of PE when compared with HC (survived false discovery rate (FDR) correction). In addition, PE patients showed decreased global efficacy in the left amygdala and right rolandic operculum, supramarginal gyrus, heschl gyrus, inferior temporal gyrus, pallidum and thalamus; however, these results did not survive FDR correction. Finally, the local efficacy of right thalamus had a positive correlation with the premature ejaculation diagnostic tool (PEDT) scores, while the local efficacy of left amygdala was negatively associated with the state score of the state‐trait anxiety inventory (STAI) and penile shaft sensory threshold. Conclusion The results highlighted the abnormal topological properties of structural brain connectome in PE with high sympathetic activity. We also suggested that the clinical features of PE were related to the abnormality of several brain regions involved in the central control of ejaculation and emotion. This study provided new insights into the central neural mechanisms of PE, which might offer biological markers for understanding the physiopathology of PE.

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“…This is unfortunate, because as more reports are published with regards to improving sexual responsiveness, 9 it is important to have a standardized reporting system and in published research studies, there are often wide variations in the information provided to the readers. 10 More importantly, it is useful to have a standard system to address and track improvement or decline in the sexual function of persons with SCI or SCD. Improvements need to be documented with addition of pro-sexual medications while negative side effects of other medications used to treat other organ system issues related to SCI should also be documented.…”

Section: Discussionmentioning

confidence: 99%

International spinal cord injury male sexual function and female sexual and reproductive function basic data sets—version 2.0

Alexander

New

Biering‐Sørensen

et al. 2017

Spinal Cord Ser Cases

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published research, suggestions from concerned individuals and on line work group consensus. The revised data sets were then posted on the International Spinal Cord Society (ISCoS) and American Spinal Injury Association (ASIA) websites for 2 months for review. Subsequently, the data sets were approved by the ISCoS Scientific and Executive Committees and ASIA board of directors. RESULTS: The data sets were modified to a self-report format. They were reviewed for appropriateness for the pediatric age group and adapted to include a new variable to address the issue of sexual orientation. A clarification of the difference between the data sets and the autonomic standards was also developed. CONCLUSION: Sexuality is a continuously evolving topic. Modifications were needed to address this topic in a comprehensive fashion. It is recommended that Version 2.0 of these data sets are used for ongoing documentation of sexual status in the medical record and for documentation of sexual concerns during on-going research.Spinal Cord Series and Cases (2017) 3, 17050; doi:10.1038/scsandc.2017.50; published online 10 August 2017 INTRODUCTIONSexuality is an important issue for persons with spinal cord injuries (SCIs) and non-traumatic spinal cord dysfunction (SCD). 1 However, persons with SCI or SCD are often dissatisfied about the education and the treatment they receive regarding sexual concerns, 2 and this lack of care may lead to a decrease in patient's participation in sexual activity and sexual satisfaction. Thus, it is important for clinicians to take sexual concerns into account and address them as they work to engage in patientcentered care.The International SCI Basic Data Sets for Male Sexual Function and Female Sexual and Reproductive Function were developed in 2011 3,4 as part of the overall International Data Sets project. Their purpose was to help provide a standardized platform that clinicians could use in the medical record to follow patient's sexual concerns. They included separate documentation of the concepts of psychogenic and reflex sexual arousal in both males and females along with the need for separate documentation of the retention of orgasmic capacity in both sexes and of ejaculation in males. Another purpose of the data sets was so researchers could use a basic data set to describe sexual concerns, thus promoting comparison of study results.Based upon recent analyses and data set updates 5,6 it was determined that updates to the International SCI Basic Data Sets for Male Sexual Function and Female Sexual and Reproductive Function are necessary. Subsequent to the development of Version 1.0, a validation study was performed that identified the need for a self-report format. 5 In addition, the need to acknowledge sexual orientation and the issues of children were raised. In light of these concerns, it was determined that a revision of the basic data sets was necessary. The purpose of this article is to describe the developments of the International SCI Male Sexual Function Basic Data Set Version 2.0 and the...

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The neurologic control of arousal and orgasm with specific attention to spinal cord lesions: Integrating preclinical and clinical sciences

Cited by 20 publications

References 118 publications

Time-Frequency Analysis of Increases in Vaginal Blood Perfusion Elicited by Long-Duration Pudendal Neuromodulation in Anesthetized Rats

Time-Frequency Analysis of Increases in Vaginal Blood Perfusion Elicited by Long-Duration Pudendal Neuromodulation in Anesthetized Rats

Graph analysis of DTI‐based connectome: decreased local efficiency of subcortical regions in PE patients with high sympathetic activity

International spinal cord injury male sexual function and female sexual and reproductive function basic data sets—version 2.0

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