Short- and long-range synergism disorders in lifelong premature ejaculation evaluated using the functional connectivity density and network property

Abstract

This study was aimed to investigate brain function connectivity in premature ejaculation (PE) patients using the functional connectivity density (FCD) and network property of resting-state functional magnetic resonance imaging. Twenty PE patients (mean age: 27.95 ± 4.52 years) and 15 normal controls (mean age: 27.87 ± 3.78 years) with no self-reported history of neurologic or psychiatric disease were enrolled in this study. International Index of Erectile Function-5 and Chinese Index of Sexual Function for Premature Ejaculation-5 questionnaires and self-reported intravaginal ejaculatory latency time (IELT) were obtained from each participant for symptom assessment. Two-sample t-tests (intergroup comparison) were applied in the short-range FCD (SFCD) analysis, long-range FCD (LFCD) analysis, region of interest–based analysis, and network topological organization analysis. Pearson correlation analysis was performed to correlate IELT with FCD or the network property. The patients with PE showed significantly decreased SFCD in the bilateral middle temporal gyrus, left orbitofrontal cortex, nucleus accumbens, fusiform, caudate, and thalamus (p < 0.05, AlphaSim-corrected). Notably, all these aforementioned brain areas are located in the dopamine pathway. In contrast, increased LFCD was observed in the left insula, Heschl's gyrus, putamen, bilateral precuneus, supplementary motor area, middle cingulate cortex, and anterior cingulate cortex in PE patients (p < 0.05, AlphaSim-corrected). In addition, the network topological analysis found reinforced network connectivity between several nodes. The degree of hub nodes increased in the patients with PE. IELT was positively correlated with SFCD and negatively correlated with LFCD or the degree of hub nodes (p < 0.05, Pearson correlation). In summary, our results are important for understanding the brain network in PE patients. The present findings indicate that PE patients have a significant synergism disorder across the region of dopamine pathway, which implied neuronal pathological changes might be related with the change of dopamine. The FCD and network property can serve as new disease severity biomarkers and therapeutic targets in PE.

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

“…In addition, PE patients had a significantly decreased functional connectivity in the left thalamus and caudate involving the serotonergic pathways (Zhang et al ., ; Yang et al ., ; Xu et al ., ). Several neuroimaging studies had identified a complex set of brain regions involved in the processing of sexual behavior, such as the amygdala, pallidum, thalamus and caudate nucleus (Zhang et al ., ; Chen et al ., ,b; Guo et al ., ; Lu et al ., ; Yang et al ., ; Xu et al ., ). These brain structures occupied a pivotal position in the brain network, as they were regions involved in the control of sexual response.…”

“…Brain structures including medial pre‐optic area (MPOA) of the hypothalamus regulated ejaculation and played a pivotal role in the control of ejaculation (Nutsch et al ., ; Will et al ., , ). Brain imaging studies in humans had found that a larger network of the brain or cerebral circuits and various neurotransmitters and receptor subtypes involved in the regulation and control of ejaculation (Guo et al ., ; Lu et al ., ; Xu et al ., ).…”

“…In recent years, male sexual disorders had become a topic of interest in many animal and clinical studies, especially premature ejaculation (PE). Non‐invasive brain imaging methods, like functional or structural magnetic resonance imaging (MRI), were used to explore the brain functional and structural changes of PE (Guo et al ., ; Lu et al ., ; Xu et al ., ). Altered neural activation was found in the insula, temporal cortex and supplementary motor area in the brain of PE during viewing visual erotic stimulation (Zhang et al ., ; Lu et al ., ; Yang et al ., ).…”

“…Non‐invasive brain imaging methods, like functional or structural magnetic resonance imaging (MRI), were used to explore the brain functional and structural changes of PE (Guo et al ., ; Lu et al ., ; Xu et al ., ). Altered neural activation was found in the insula, temporal cortex and supplementary motor area in the brain of PE during viewing visual erotic stimulation (Zhang et al ., ; Lu et al ., ; Yang et al ., ). Weaker functional connectivity was found in the left prefrontal lobe of PE, which suggested that the rapid ejaculation of PE patients was related with the reduced central control network in the brain (Zhang et al ., ; Yang et al ., ; Xu et al ., ).…”

Brain Cortical Complexity and Subcortical Morphometrics in Lifelong Premature Ejaculation

“…Additionally, the thalamus makes connections between the subcortical regions (e.g., connections to the hippocampus via the mammillothalamic tract) and the cerebral cortex (e.g., connections to the hippocampus via the thalamocortical radiations; Carlesimo et al, 2011). Our previous short functional connectivity density (SFCD) results showed that the thalamus had a decreased SFCD in PE patients compared to NCs (Lu et al, 2018). This may indicate that the functional change may have been caused by expanding structural changes in the thalamus.…”