White matter microstructural changes in psychogenic erectile dysfunction patients

Abstract

SUMMARYBrain dysfunction in erectile dysfunction (ED) has been identified by multiple neuroimaging studies. A recent MRI study indicated grey matter alterations in ED patients. This study aims to investigate the microstructural changes of cerebral white matter (WM) in psychological ED patients and their possible correlations with clinical variables. Twenty-seven psychological ED patients and 27 healthy subjects (HS) were included and underwent a magnetic resonance (MR) diffusion tensor imaging (DTI) scan. The tract-based spatial statistics were employed to identify the WM structure alterations in psychological ED patients. The multiple DTI-derived indices′ [fractional anisotropy (FA), axial diffusivity (AD) and mean diffusivity (MD)] correlations with the symptoms and their durations, respectively, were analysed. The IIEF-5, quality of erection questionnaire (QEQ) and the self-esteem and relationship (SEAR) questionnaire were used to assess the symptoms of psychological ED patients. Compared with HS, the psychological ED patients showed increased FA values, reduced MD values and reduced AD values in multiple WM tracts including the corpus callosum (genu, body and splenium), corticospinal tract, internal capsule, corona radiata, external capsule and superior longitudinal fasciculus (p < 0.05, threshold-free cluster enhancement corrected). Both of the IIEF scores and QEQ scores of ED patients showed a significantly negative correlation with the average FA values, and positive correlation with average AD values and MD values in the splenium of the corpus callosum (p < 0.05). The results provided preliminary evidence of WM microstructural changes in patients with psychological ED. The morphological alterations in the splenium of the corpus callosum were related to the symptom severity.

Structural insights into aberrant cortical morphometry and network organization in psychogenic erectile dysfunction

“…Moreover, it has been found that negative CTh correlations are not mediated by direct fiber connections [Gong et al, 2012]. Therefore, the negative correlations observed in this work might concur with the observation of impaired WM fiber connectivities in pED [Zhang et al, 2014].…”

“…The neurobehavioral components of male SA are conceived as closely interrelated and coordinated [Stoleru et al, ]. The reported WM microstructural alterations in pED [Zhang et al, ] might indicate neuroanatomical connectivity abnormalities. Therefore, we predict that the pathology of pED may be also correlated with abnormal cortical structural network architecture.…”

Dopamine D2 receptors in the basolateral amygdala modulate erectile function in a rat model of nonorganic erectile dysfunction

“…Decreased connectivity was observed in the posterior cingulate cortex, inferior parietal lobes and medial prefrontal cortex of the nED patients compared to the connectivity in the healthy controls, whereas decreased and increased connectivity was observed in the anterior cingulate cortex and the right insula, respectively. Zhang et al reported microstructural differences in white matter between healthy controls and nED patients (Zhang et al, ). Grey matter atrophy of the bilateral nucleus accumbens and left hypothalamus has also been reported in nED patients (Cera et al, ).…”

The central mechanism of tadalafil vs Chaihu-Shugan-San capsule for psychogenic erectile dysfunction: a magnetic resonance imaging study protocol of a randomized placebo-controlled trial

“…There are many studies on the brain MRI of psychogenic ED [7,[19][20][21][22][23][24][25][26][27][28][29][30][31]. Despite significant progress, the mechanism aiming at CNS targets treated by tadalafil is still unknown.…”

“…Normal erectile function is a result of the harmonious regulation and control of the central nervous system (CNS), which includes the supraspinal centres, the spinal cord and peripheral nerves. In the last two decades, exploring the role of CNS in sexual arousal by functional and structural neuroimaging studies, the magnetic resonance imaging (MRI) [20] such as diffusion tensor imaging (DTI) [21,[23][24][25], functional MRI (fMRI) and resting-state fMRI attracted many researchers [23][24][25]. Since 2002, compared with healthy subjects (HS), much researchers have found that psychologic ED patients showed significant changes in cerebral functions.…”