Variation in Brain Subcortical Network Topology Between Men with and Without PE: A Diffusion Tensor Imaging Study

Abstract

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.

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

“…Compared with HC, nsPE patients showed less aberrant brain regions than sPE patients, which were located in DMN (the left median cingulate and paracingulate gyri and right superior frontal gyrus, orbital part) and AN (the left superior parietal gyrus). Decreased shortest path length was found in the superior frontal gyrus (medial orbital) of PE in our diffusion tensor imaging (DTI) study 36 . In addition, previous fMRI study shows that decreased intrinsic activity was found in the orbitofrontal cortex of PE patients 43 .…”

“…The precuneus has been identified as hub regions in the brain of ED and PE patients, which were essential for the information integration of the brain 36‐38 . The superior temporal gyrus and supramarginal gyrus were two components of AUD, 39,40 and the superior temporal gyrus was one of the hubs in the brain network of PE patients 36 . Increased activities of the supramarginal gyrus and precuneus were observed in PE patients 26,30 .…”

“…It had been reported that the precuneus was the hub of the DMN, which was active during resting state and was important for the episodic memory, self‐awareness, and self reflection 34,35 . The precuneus has been identified as hub regions in the brain of ED and PE patients, which were essential for the information integration of the brain 36‐38 . The superior temporal gyrus and supramarginal gyrus were two components of AUD, 39,40 and the superior temporal gyrus was one of the hubs in the brain network of PE patients 36 .…”

“…34,35 The precuneus has been identified as hub regions in the brain of ED and PE patients, which were essential for the information integration of the brain. [36][37][38] The superior temporal gyrus and supramarginal gyrus were two components of AUD, 39,40 and the F I G U R E 3 Brain regions showing significant ReHo differences between nsPE and HC. The color bar indicated the t values of the t test.…”

Impaired frontal‐parietal control network in chronic prostatitis/chronic pelvic pain syndrome revealed by graph theoretical analysis: A DTI study

“…Anatomical images were performed with T1 weighted 3D sagittal acquisition (repetition time (TR), 1900 ms; echo time (TE), 2.48 ms; slice thickness, 1 mm; matrix size, 256 × 256; field of view (FOV), 250mm 2 × 250mm 2 ; flip angle (FA), 9°; slice thickness, 1 mm) [22] . The whole-brain diffusion MRI sequence using diffusion tensor spin echo planar imaging was acquired (TR, 6600 ms; TE, 93 ms, matrix size,128 × 128; FOV, 240mm 2 × 240mm 2 ; thickness, 3 mm; number of slices, 45).…”