Effects of sertraline on brain current source of the high beta frequency band: analysis of electroencephalography during audiovisual erotic stimulation in males with premature ejaculation

Abstract

To identify the effects of sertraline, a selective serotonin reuptake inhibitor, for the treatment of premature ejaculation (PE), changes in brain current-source density (CSD) of the high beta frequency band (22-30 Hz) induced by sertraline administration were investigated during audiovisual erotic stimulation. Eleven patients with PE (36.9 ± 7.8 yrs) and 11 male volunteers (24.2 ± 1.9 years) were enrolled. Scalp electroencephalography (EEG) was conducted twice: once before sertraline administration and then again 4 h after the administration of 50 mg sertraline. Statistical nonparametric maps were obtained using the EEG segments to detect the current-density differences in the high beta frequency bands (beta-3, 22-30 Hz) between the EEGs before and after sertraline administration in the patient group and between the patient group and controls after the administration of sertraline during the erotic video sessions. Comparing between before and after sertraline administration in the patients with PE, the CSD of the high beta frequency band at 4 h after sertraline administration increased significantly in both superior frontal gyri and the right medial frontal gyrus (Po0.01). The CSD of the beta-3 band of the patients with PE were less activated significantly in the middle and superior temporal gyrus, lingual and fusiform gyrus, inferior occipital gyrus and cuneus of the right cerebral hemisphere compared with the normal volunteers 4 h after sertraline administration (Po0.01). In conclusion, sertraline administration increased the CSD in both the superior frontal and right middle temporal gyrus in patients with PE. The results suggest that the increased neural activity in these particular cerebral regions after sertraline administration may be associated with inhibitory effects on ejaculation in patients with PE.

Alterations in cortical thickness in nonmedicated premature ejaculation patients: A morphometric MRI study

“…And the effect could be related to the activation of higher‐order areas including OFC . We detected cortical thickening in the left lingual gyrus which is also spatially consistent with previous EEG study …”

“…Its activation is also related to general emotional arousal and to a specific role in mediating the erectile response . Kwon et al proved that the brain current source density of the high beta frequency of both superior frontal gyri and the right medial frontal cortex could be increased after sertraline treatment for PE …”

“…A previous study used functional MRI to prove that the inferior frontal cortex, insula cortex, inferior temporal lobe were activated during ejaculation when viewing an erotic film . With the electroencephalography (EEG) result, decreased neural activity in middle and superior temporal gyrus, inferior occipital gyrus has been detected in patients with PE . The cortical thickness is assumed to reflect the arrangement and density of neuronal and glial cells and is reported to be evidence for neuronal function, including memory and attention .…”

“…8 With the electroencephalography (EEG) result, decreased neural activity in middle and superior temporal gyrus, inferior occipital gyrus has been detected in patients with PE. 9 The cortical thickness is assumed to reflect the arrangement and density of neuronal and glial cells and is reported to be evidence for neuronal function, including memory and attention. 10,11 Therefore, structural changes of brain were widely used for studying of neuronal functional changes.…”

Current pharmacological agents for the treatment of premature ejaculation

“…Sitalopram, fluoksetin, fluvaksamin, paroksetin, sertralin ve yeni bir ilaç olan dapoxetine olmak üzere altı farklı etken tedavide kullanılmaktadır [5]. İlaç-ların etkinliği birkaç gün içerisinde başlamaktadır, dapoxetin farkılı olarak ilk kullanımda ve saatler içerisinde etki edebilmektedir [13]. İlaçların dü-zenli günlük kullanıldığında daha başarılı sonuçlar elde edildiği gösterilmiştir [14].…”