The spinal pattern generator for ejaculation

Carro‐Juárez, Miguel; Rodrı́guez–Manzo, Gabriela

doi:10.1016/j.brainresrev.2007.12.002

Cited by 79 publications

(67 citation statements)

References 99 publications

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“…28 More recently a 'spinal pattern generator' model was developed and extensively tested to literature findings. 29 Spinal pattern generators are known to be responsible for several protective reflexes like swallowing and coughing and match perfectly with the rhythmic contraction during ejaculation. 30 In conclusion, ejaculation has two components, a somatic and an autonomic, which are for the purpose of this article defined as 'somatic ejaculation' and 'autonomic ejaculation'.…”

Section: Ejaculationmentioning

confidence: 95%

“…30 In conclusion, ejaculation has two components, a somatic and an autonomic, which are for the purpose of this article defined as 'somatic ejaculation' and 'autonomic ejaculation'. 29 Nocturnal ejaculation stands for what could also be called 'psychogenic ejaculation'. At last we are recognizing vibratory ejaculation and electroejaculation both with their specific indications.…”

Section: Ejaculationmentioning

confidence: 99%

“…41 The spinal reflex ejaculation generator centre has been localized in the thoracolumbar region and contains lumbar spinothalamic cells (LST cells). 29,30 These lumbar spinothalamic cells activate (increased c-Fos activity) during ejaculation and are direct projections of cells in the paragigantocellular nucleus in the thalamus. A complete lesion of these lumbar spinothalamic cells leads to anejaculation in rats but does not decrease or abolish mounting or intromission.…”

Section: Ejaculationmentioning

confidence: 99%

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Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

et al. 2010

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Study design: Review article. Objectives: The neuroanatomy and physiology of psychogenic erection, cholinergic versus adrenergic innervation of emission and the predictability of outcome of vibration and electroejaculation require a review and synthesis. Setting: University Hospital Belgium. Methods: We reviewed the literature with PubMed 1973PubMed -2008. Results: Erection, emission and ejaculation are separate phenomena and have different innervations. It is important to realize, which are the afferents and efferents and where the motor neuron of the end organ is located. When interpreting a specific lesion it is important to understand if postsynaptic fibres are intact or not. Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. For vibratory-evoked ejaculation, the reflex arch must be complete; for electroejaculation, the postsynaptic neurons (paravertebral ganglia) must be intact. Conclusion: Afferents of erection, emission and ejaculation are the pudendal nerve and descending pathways from the brain. Erection is cholinergic and NO-mediated. Emission starts cholinergically (as a secretion) and ends sympathetically (as a contraction). Ejaculation is mainly adrenergic and somatic. In neurogenic disease, a good knowledge of neuroanatomy and physiology makes understanding of sexual dysfunction possible and predictable. The minimal requirement for the success of penile vibration is a preserved reflex arch and the minimal requirement for the success of electroejaculation is the existence of intact post-ganglionic fibres.

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Section: Ejaculationmentioning

confidence: 95%

Section: Ejaculationmentioning

confidence: 99%

Section: Ejaculationmentioning

confidence: 99%

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Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

et al. 2010

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“…ICC revealed that these GRP neurons in the upper lumbar spinal cord projected their axons to the lower lumbar and upper sacral spinal cord, presenting a sexually dimorphic pattern of fibers innervating autonomic centers that regulate male sexual reflexes 11 . These fibers were much more prominent in male rats than in females in the sacral parasympathetic nucleus (SPN) (n = 5, F 2,12 = 42.2, P < 0.001) and the dorsal gray commissure (DGC) surrounding the central canal (F 2,12 = 53.9, P < 0.001) (Fig.…”

mentioning

confidence: 99%

Sexually dimorphic gastrin releasing peptide system in the spinal cord controls male reproductive functions

et al. 2008

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Neurons in the upper lumbar spinal cord project axons containing gastrin-releasing peptide (GRP) to innervate lower lumbar regions controlling erection and ejaculation. This system is vestigial in female rats and in males with genetic dysfunction of androgen receptors, but in male rats, pharmacological stimulation of spinal GRP receptors restores penile reflexes and ejaculation after castration. GRP offers new avenues for understanding potential therapeutic approaches to masculine reproductive dysfunction.GRP, a member of the bombesin-like peptide family 1 , is distributed widely in the central nervous system and gastrointestinal tract of mammals 2 , 3 . GRP and neuromedin B (NMB), the mammalian counterpart of bombesin, play a role in many physiological processes, including itch 4 , circadian rhythms 5 , food intake 6 and fear memory consolidation 7 , 8 . In mammals, bombesin-like peptides act through a family of at least three G protein-coupled receptors: GRP-preferring receptor (GRP-R), NMB-preferring receptor (NMB-R) and bombesin receptor subtype-3 (BRS-3) 9 .Using immunocytochemistry (ICC) directed at GRP, we found a group of neurons within a region previously dubbed the 'spinal ejaculation generator' because toxins that selectively lesion galanin-containing neurons there virtually eliminate ejaculation in rats 10 . These galaninergic neurons project to the thalamus 10 , but it had been unclear whether there are also direct connections between this center and the lower spinal cord regions that directly trigger ejaculation 11 . The separate, GRP-containing neurons that we found within the center projected axons to more caudal spinal regions and were much more prominent in wild-type (WT) males than in WT females ( Fig. 1a,b; Supplementary Fig. 1 online) (n = 5, F 2,12 = 299.9, P < 0.001). Semiquantitative reverse transcription (RT)-PCR confirmed more pre-pro NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptGrp transcripts in this region of males than of females ( Supplementary Fig. 2 online). To test whether androgen receptors direct sexual dimorphism of these neurons, we examined genetically male (XY) Long-Evans rats carrying the testicular feminization mutation (Tfm) of the androgen receptor gene Ar. These rats develop testes embryologically and secrete testosterone pre-and postnatally but, because their androgen receptor protein is dysfunctional, develop a wholly feminine exterior, including a clitoris rather than a penis. The spinal cord of Tfm rats was hyperfeminine, having even fewer GRP-positive neurons in this region than did WT females (P <0.001) (Fig. 1c,d). In normal males, GRP-expressing neurons also expressed androgen receptor (96.1 ± 1.7%; n = 4 WT males), but not estrogen receptor alpha (ERα) (Fig. 1e-h). Because androgens such as testosterone augment ejaculation in male rats and humans 12 , the presence of androgen receptor in the GRPpositive neurons of the ejaculation center offers a locus for androgenic modulation of ejaculation and other sexual reflexes.ICC r...

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“…In addition, the SEG integrates this outflow with inputs conveying biochemical or mechanical information from the accessory sex organs (Carro-Juarez et al, 2003). In addition, the SEG is under inhibitory and excitatory influence of supraspinal sites (Carro-Juarez & Rodriguez-Manzo, 2008). The efferent limb of the reflex responsible for emission consists of sympathetic efferent fibers (thoracic 10-Lumbar 2, termed a secretory center) that cause sequential contractions of the epididymis, vas deferens, seminal vesicles, and prostate with closure of the bladder neck (Vignozzi et al, 2008).…”

Section: Brain Areas and Spinal Control Centermentioning

confidence: 99%

The characterization, current medications, and promising therapeutics targets for premature ejaculation

Gür

Sikka

2015

Andrology

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SUMMARYPremature ejaculation (PE) is the most prevalent male sexual dysfunction. This is associated with negative personal and interpersonal psychological outcomes. The pharmacologic treatment of PE includes the use of antidepressants, local anesthetic agents, and phosphodiesterase type 5 inhibitors. While numerous treatments can control PE, only antidepressants and topical anesthetic creams and sprays have recently been shown to be more effective. This review focuses on the physiology and pharmacology of ejaculation, the pathophysiology of PE and the most effective pharmacological treatment of PE. Pharmacotherapy of PE with off-label shortacting selective serotonin reuptake inhibitors (SSRIs) is common, effective, and safe. Dapoxetine, a SSRI with a short half-life, has been recently evaluated for the treatment of PE by several countries and results are promising. In clinical practice, follow-up side effects are an important part of the management strategy for PE. The understanding of etiology, pathophysiology, and treatment modalities of PE would be beneficial to clinician in helping patients with this disappointing sexual problem.

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The spinal pattern generator for ejaculation

Cited by 79 publications

References 99 publications

Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

Sexually dimorphic gastrin releasing peptide system in the spinal cord controls male reproductive functions

The characterization, current medications, and promising therapeutics targets for premature ejaculation

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