Neuroanatomic Correlates of Female Sexual Dysfunction in Multiple Sclerosis

Winder, Klemens; Linker, Ralf A.; Seifert, F.; Deutsch, Martina; Engelhorn, Tobias; Dörfler, Arnd; Lee, Dong Hoon; Hösl, Katharina; Hilz, Max J.

doi:10.1002/ana.24746

Cited by 35 publications

(43 citation statements)

References 52 publications

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“…In female and male MS patients, Zivadinov et al [16] and Zorzon et al [17] found associations between SD and pontine lesions. Our group recently showed associations between the site of MS-specific cerebral lesions and female SD [14,15]. We found associations between right occipital lesions and impaired arousal and between left insular lesions and decreased lubrication [14].…”

Section: Discussionsupporting

confidence: 53%

“…Our group recently showed associations between the site of MS-specific cerebral lesions and female SD [14,15]. We found associations between right occipital lesions and impaired arousal and between left insular lesions and decreased lubrication [14]. In another study, we found that MS lesions in left temporal periventricular and right visual association areas compromise orgasmic function [15].…”

Section: Discussionmentioning

confidence: 49%

“…Our group recently demonstrated associations between the site of MS-specific cerebral lesions and specific disorders of female sexual function, such as arousal, lubrication or orgasmic dysfunction [14,15]. Based on our previous studies [14,15,28], we hypothesize that primary SD [18] due to central MS lesions is a major contributing factor of depression in female MS patients.…”

mentioning

confidence: 82%

“…Several studies show that SD in MS patients is often associated with MS lesions in cerebral or spinal cord areas contributing to central pathways of sexual function [11,[14][15][16][17]27]. Our group recently demonstrated associations between the site of MS-specific cerebral lesions and specific disorders of female sexual function, such as arousal, lubrication or orgasmic dysfunction [14,15].…”

mentioning

confidence: 88%

“…Again, SD may be multifactorial. In addition to MSrelated cerebral or spinal lesions [11,[14][15][16][17], psychological or social problems [18], physical complications of MS, such as bladder and bowel dysfunction [19,20] or spasticity, may give rise to SD [21,22].…”

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confidence: 99%

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Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

et al. 2018

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Background: In women with multiple sclerosis (MS), depression and sexual dysfunction (SD) are common. Whether SD promotes depression or vice versa remains unclear despite therapeutic relevance. Therefore, we aimed to assess whether SD more likely triggers depression or vice versa. Methods: In 83 female MS patients and 21 age-matched healthy women, we assessed depression, using the Beck Depression Inventory-V (BDI-V), and SD using the Female Sexual Function Index (FSFI). We diagnosed depression with BDI-V-scores >35 and SD with FSFI scores < 26.55. We divided patients into groups with and without SD, with and without depression. Between groups, we compared prevalence of SD and depression (Fisher’s-exact-test), age, MS-duration, MS-severity, BDI-V-, and FSFI scores (Mann-Whitney U-test; significance: p < 0.05). Results: A total of 37/83 MS patients and 1/21 controls had SD; 28/83 patients and 3/21 controls had depression; 51.4% patients with SD but only 19.6% without SD had depression (p = 0.003). SD was present in 67.9% depressed and 32.7% non-depressed patients. BDI-V-scores were higher in patients with SD than in patients without SD. FSFI scores were lower in depressed than non-depressed patients. Conclusion: In conclusion, SD was more common than depression. SD afflicted 67.9% depressed MS patients and was also more common in non-depressed MS patients than controls. SD may occur independently from depression while increased depressiveness seems linked to coexistent SD.

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confidence: 53%

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confidence: 49%

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confidence: 82%

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confidence: 88%

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confidence: 99%

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Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

et al. 2018

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Pathophysiology and Medical Management of Female Orgasm Disorder

Goldstein¹,

Komisaruk²

2018

Textbook of Female Sexual Function and Dysfunction

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Cerebral lesion correlates of sympathetic cardiovascular activation in multiple sclerosis

Winder

Linker

Seifert

et al. 2019

Human Brain Mapping

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Cardiovascular autonomic dysfunction is common in multiple sclerosis (MS) and contributes significantly to disability. We hypothesized that cerebral MS‐lesions in specific areas of the central autonomic network might account for imbalance of the sympathetic and parasympathetic cardiovascular modulation. Therefore, we used voxel‐based lesion symptom mapping (VLSM) to determine associations between cardiovascular autonomic dysfunction and cerebral MS‐related lesion sites. In 74 MS‐patients (mean age 37.0 ± 10.5 years), we recorded electrocardiographic RR‐intervals and systolic and diastolic blood pressure. Using trigonometric regressive spectral analysis, we assessed low (0.04–0.15 Hz) and high (0.15–0.5 Hz) frequency RR‐interval‐and blood pressure‐oscillations and determined parasympathetically mediated RR‐interval–high‐frequency modulation, mainly sympathetically mediated RR‐interval–low‐frequency modulation, sympathetically mediated blood pressure‐low‐frequency modulation, and the ratios of sympathetic and parasympathetic RR‐interval‐modulation as an index of sympathetic‐parasympathetic balance. Cerebral MS‐lesions were analyzed on imaging scans. We performed a VLSM‐analysis correlating parameters of autonomic dysfunction with cerebral MS‐lesion sites. The VLSM‐analysis showed associations between increased RR‐interval low‐frequency/high‐frequency ratios and lesions most prominently in the left insular, hippocampal, and right frontal inferior opercular region, and a smaller lesion cluster in the right middle cerebellar peduncle. Increased blood pressure‐low‐frequency powers were associated with lesions primarily in the right posterior parietal white matter and again left insular region. Our data indicate associations between a shift of cardiovascular sympathetic‐parasympathetic balance toward increased sympathetic modulation and left insular and hippocampal lesions, areas of the central autonomic network. The VLSM‐analysis further distinguished between right inferior fronto‐opercular lesions disinhibiting cardiac sympathetic activation and right posterior parietal lesions increasing sympathetic blood pressure modulation.

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Neuroanatomic Correlates of Female Sexual Dysfunction in Multiple Sclerosis

Cited by 35 publications

References 52 publications

Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

Sexual Dysfunction Seems to Trigger Depression in Female Multiple Sclerosis Patients

Pathophysiology and Medical Management of Female Orgasm Disorder

Cerebral lesion correlates of sympathetic cardiovascular activation in multiple sclerosis

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