Abstract
Lifelong premature ejaculation (LPE) is a common male sexual dysfunction. Lack of active control for rapid ejaculation brought great distress to sexual harmony and even fertility. Previous neurophysiology studies revealed an ejaculation-related control mechanism in the brain. However, it remains unclear whether this inhibitory network is altered in LPE patients. The present study investigated the central inhibitory network function of LPE patients by using stop signal task (SST)-related functional magnetic resonance imaging (fMRI) and resting-state functional connectivity (FC) analysis. The results showed no difference in task-related behavioral performance or neural activation during response inhibition between LPE patients and controls. However, LPE patients showed a significantly different correlation pattern between the stop signal reaction time (SSRT) and left inferior frontal gyrus (IFG) activation during successful inhibition, in which a typical negative correlation between SSRT and the activation was completely disappeared in patients. In addition, using the left IFG as a seed, patients showed weaker FC between the seed and two areas (left dentate nucleus (DN) and right frontal pole) compared with controls. These data suggest that LPE patients have an abnormal brain control network, which may contribute to the reduced central control of rapid ejaculation. This study provides new insights into the neural mechanism of LPE involving the central inhibitory network, which may offer an underlying intervention target for future treatment.
Highlights
Lifelong premature ejaculation (LPE) is a common male sexual dysfunction, with a prevalence of 3% in the Chinese population (Althof et al, 2014)
Our findings provide a new understanding of the neural mechanism of LPE from an inhibition control perspective
By using the stop signal task (SST), a classic inhibition control task, we found that the correlation of neural activation during inhibition with stop signal reaction time (SSRT) was completely different in control and LPE groups
Summary
Lifelong premature ejaculation (LPE) is a common male sexual dysfunction, with a prevalence of 3% in the Chinese population (Althof et al, 2014). In the latest edition of the Diagnostic and Statistical Manual of Mental disorders (DSM-5TM), PE is defined as ‘‘a persistent or recurrent pattern of ejaculation occurring during partnered sexual activity within approximately 1 min following vaginal penetration and before the individual wishes it’’, the LPE is specified as ‘‘the disturbance has been present since the individual became sexually active’’ (American Psychiatric Association, 2013). According to this definition, congenital disability of the inhibitory control of rapid ejaculation (
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