Brain Cortical Complexity and Subcortical Morphometrics in Lifelong Premature Ejaculation.

Jiaming Lu,Qian Chen,Shangwen Yang,Wen Zhang,Junxia Wang,Bing Zhang,Lihua Yuan,Sichu Wu,Zhao Qing,Xin Zhang,Zhishun Wang,Jiaxuan Jin,Ming Li,Yutian Dai

doi:10.3389/fnhum.2020.00283

Abstract

Premature ejaculation (PE) is the most common male sexual dysfunction. The brain disturbances that cause this disorder remain poorly understood. This study aimed to investigate how the morphology of cortical and subcortical brain structures differed in PE, how these morphologic differences were associated with severity measures of PE, such as intravaginal ejaculatory latency time (IELT), and how these cortical and subcortical structures were causally connected through mediation analysis. Anatomical MRI scans were acquired from 39 male participants, 23 with PE (28.78 ± 4.32 years), and 16 without PE (27.88 ± 3.65 years). We used a subcortical analysis package within FSL to perform subcortical shape segmentation and statistical analysis. The PE group was compared with the normal control (NC) group in the shapes of 15 subcortical structures with general linear models [p < 0.05, family-wise error (FWE)-corrected]. We analyzed the cortical complexity revealed by the gyrification index using the Computational Anatomy Toolbox (CAT12). Vertex-wise shape analyses revealed outward shape deformations (expansions) in the left hippocampus and bilateral thalamus. Gyrification index analyses revealed that the right orbital frontal cortex and the right nucleus accumbens had greater complexity in PE patients. The shape deformations were positively correlated with the IELTs in the NC group, while this relationship was interrupted in the PE group. PE is associated with outward deformations of the subcortical surfaces and more complexity of the cortical structures. These morphological differences may be the basis of the brain functional alterations underlying PE.

Highlights

Ejaculation is the final stage of coitus in mammalian males and is mandatory for natural procreation (Clement and Giuliano, 2016)
There were no significant differences in age, education level, or marital status
This study examined the subcortical and cortical brain structure of participants who presented with premature ejaculation (PE)

Summary

Introduction

Ejaculation is the final stage of coitus in mammalian males and is mandatory for natural procreation (Clement and Giuliano, 2016). Affecting approximately 21% to 30% of the population, premature ejaculation (PE) is one of the most common sexual dysfunctions (Laumann et al, 2005; Gur and Sikka, 2015; Saitz and Serefoglu, 2015), reducing the quality of sexual life of the individuals and their partners (Porst et al, 2007). Morphometrics Change in PE Patient (ISSM) definition, PE can be classified as either lifelong PE or acquired PE (Serefoglu et al, 2014a). Ejaculation that always or nearly occurs before or within approximately 1 min of vaginal penetration from the first sexual experience is defined as lifelong PE, and a clinically significant decrease in latency time, often no longer than approximately 3 min, is defined as acquired PE. Many psychiatric disorders, such as anorgasmia and low libido, as well as depression and anxiety, are comorbidities significantly associated with PE (Waldinger et al, 2009)

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