Abnormal Functional Connectivity Between the Left Medial Superior Frontal Gyrus and Amygdala Underlying Abnormal Emotion and Premature Ejaculation: A Resting State fMRI Study.

Yan Xu,Xinfei Huang,Jianhuai Chen,Jianguo Xue,Qing Wang,Tao Liu,Jie Yang,Yun Chen,Xing Zhang,Ziliang Xiang,Zhaoxu Yang

doi:10.3389/fnins.2021.704920

Abstract

IntroductionPremature ejaculation (PE) is a common sexual dysfunction and is found to be associated with abnormal emotion. The amygdala plays an important role in the processing of emotion. The process of ejaculation is found to be mediated by the frontal-limbic neural circuits. However, the correlations between PE and emotion are still unclear.MethodsResting-state functional magnetic resonance imaging (rs-fMRI) data were acquired in 27 PE patients with stable emotion (SPE), 27 PE patients with abnormal emotion (NPE), and 30 healthy controls (HC). We used rs-fMRI to explore the underlying neural mechanisms in SPE, NPE, and HC by measuring the functional connectivity (FC). Differences of FC values among the three groups were compared when choosing bilateral amygdala as the regions of interest (ROIs). We also explored the correlations between the brain regions showing altered FC values and scores of the premature ejaculation diagnostic tool (PEDT)/Eysenck Personality Inventory about neuroticism (EPQ-N) in the PE group.ResultsWhen the left amygdala was chosen as the ROI, the SPE group exhibited an increased FC between the left medial superior frontal gyrus (SFGmed) and amygdala compared with the NPE or HC group. When the right amygdala was chosen as the ROI, the NPE group exhibited a decreased FC between the left SFGmed and right amygdala compared with the HC group. In addition, FC values of the left SFGmed had positive correlations with PEDT and negative correlations with EPQ-N scores in the PE group. Moreover, FC values of the left superior temporal gyrus had positive correlations with EPQ-N scores in the PE group.ConclusionThe increased FC values between the left SFGmed and amygdala could reflect a compensatory cortical control mechanism with the effect of stabilized emotion in the limbic regions of PE patients. Abnormal FC between these brain regions could play a critical role in the physiopathology of PE and could help us in dividing PE into more subtypes.

Highlights

Premature ejaculation (PE) is a common sexual dysfunction and is found to be associated with abnormal emotion
Both the NPE and SPE groups had higher scores of premature ejaculation diagnostic tool (PEDT) than the SPE vs. NPE Left amygdala as regions of interest (ROIs) Compared with the NPE group, the SPE group exhibited increased functional connectivity (FC) values between the left amygdala and SFGmed (Table 2 and Figure 3)
Right amygdala as ROI There were no significant differences in the FC values of the right amygdala between the SPE and NPE groups (Table 2)

Summary

Introduction

Premature ejaculation (PE) is a common sexual dysfunction and is found to be associated with abnormal emotion. The amygdala plays an important role in the processing of emotion. The process of ejaculation is found to be mediated by the frontallimbic neural circuits. The correlations between PE and emotion are still unclear. Premature ejaculation (PE) is a common sexual dysfunction with 3% prevalence in Chinese population (Althof S. et al, 2014). Previous studies showed that the etiology of PE usually included anxiety, penile hypersensitivity, and especially 5-hydroxytryptamine (5HT) receptor dysfunction (Donatucci, 2006; Rowland et al, 2010; El-Hamd et al, 2019).

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Discussion

Conclusion