Apomorphine-induced brain modulation during sexual stimulation: a new look at central phenomena related to erectile dysfunction

Abstract

It is well recognized that sexual stimulation leading to penile erection is controlled by different areas in the brain. Animal erection studies have shown that apomorphine (a D24D1 dopamine receptors nonselective agonist) seems to act on neurons located within the paraventricular nucleus and the medial preoptic area of the hypothalamus. Yet, only recently, was a centrally acting agent, apomorphine sublingual, approved for the treatment of erectile dysfunction. The present functional magnetic resonance imaging placebo-controlled study presents the first in vivo demonstration of the apomorphine-induced modulation of cortical and subcortical brain structures in patients with psychogenic erectile dysfunction. Noteworthy, patients in comparison with potent controls, showed an increased activity in frontal limbic areas that was downregulated by apomorphine. This suggests that psychogenic impotence may be associated with previously unrecognized underlying functional abnormalities of the brain.

Inhibitory brainstem reflexes under external emotional-stimuli in bipolar I and II disorders

“…Patients often present their own affective states as mania, depression or mixture of both [18, 48], they also consistently show increased sexual thoughts, desire, and activity [15, 16]. The perception, cognition and behavior under erotic stimulation, might be linked to more excitation of cerebral areas such as the prefrontal, hypothalamus and cingulate cortices [49], which in turn delayed the activation of brainstem inhibitory interneurons, thus delaying the latencies of ES1 and ES2 under erotica. On the other hand, when processing both fear and happiness in patients with BD I, increased activation of the left amygdala/ ventrolateral prefrontal cortex [50], thalamic, pallidal, and caudate/ putamen regions [51] were reported, which again might be the reason for the prolonged ES1 latencies under fear and happiness.…”

Asexuality: Classification and Characterization

“…These include, but are not limited to, sexual psychophysiological responses to sexual stimuli, neurological evidence of differential intensity affective experience (Cuthbert, Schupp, Bradley, Birnbaumer, & Lang, 2000), hormone profiles abnormalities, or generalized, non-sexual motivated behaviors (for discussion, see Bindra, 1959). Indeed, a number of physical factors can affect feelings of sexual desire including menstrual phase (e.g., Hedricks, 1994) physical fatigue due to recent childbirth (Hyde, DeLamater, & Hewitt, 1998) or illness (Meuleman & van Lankveld, 2005), and central dopamanergic dysregulation in women (Bechara, Bertolino, Casabe, & Fredotovich, 2004) and men (Montorsi et al, 2003, as related to erectile functioning).…”

The functional neuroanatomy of male psychosexual and physiosexual arousal: A quantitative meta‐analysis

“…Reports including less than five subjects [e.g., Montorsi et al, 2003b], results of region-of-interest analyses [e.g., Stark et al, 2005], and studies not reporting stereotaxic coordinates [e.g., Montorsi et al, 2003a] were excluded.Only data from healthy men were included, while results from patients and contrasts comparing healthy heterosexual men with another group (e.g., women) were excluded. However, when studies of the latter comprised a group of healthy heterosexual men, their data were included if separately reported or if the authors provided us with the necessary information upon being contacted.…”

“…Reports including less than five subjects [e.g., Montorsi et al, 2003b], results of region-of-interest analyses [e.g., Stark et al, 2005], and studies not reporting stereotaxic coordinates [e.g., Montorsi et al, 2003a] were excluded.…”