Abstract

BackgroundSexual dysfunction, namely, erectile dysfunction (ED) and premature ejaculation (PE), has been found to be associated with abnormal structural connectivity in the brain. Previous studies have mainly focused on a single disorder, however, convergent and divergent structural connectivity patterns of the brain network between ED and PE remain poorly understood.MethodsT1-weighted structural data and diffusion tensor imaging data of 28 patients with psychological ED, 28 patients with lifelong PE (LPE), and 28 healthy controls (HCs) were obtained to map the white matter (WM) brain networks. Then, the graph-theoretical method was applied to investigate the differences of network properties (small-world measures) of the WM network between patients with ED and LPE. Furthermore, nodal segregative and integrative parameters (nodal clustering coefficient and characteristic path length) were also explored between these patients.ResultsSmall-world architecture of the brain networks were identified for both psychological ED and LPE groups. However, patients with ED exhibited increased average characteristic path length of the brain network when compared with patients with LPE and HCs. No significant difference was found in the average characteristic path length between patients with LPE and HCs. Moreover, increased nodal characteristic path length was found in the right middle frontal gyrus (orbital part) of patients with ED and LPE when compared with HCs. In addition, patients with ED had increased nodal characteristic path length in the right middle frontal gyrus (orbital part) when compared with patients with LPE.ConclusionTogether, our results demonstrated that decreased integration of the right middle frontal gyrus (orbital part) might be a convergent neuropathological basis for both psychological ED and LPE. In addition, patients with ED also exhibited decreased integration in the whole WM brain network, which was not found in patients with LPE. Therefore, altered integration of the whole brain network might be the divergent structural connectivity patterns for psychological ED and LPE.

Highlights

  • Male sexual behavior is divided into five stages: sexual desire, sexual arousal/erection, sexual intercourse, ejaculation, and orgasm [1, 2]

  • We evaluated the architecture of white matter (WM) networks in patients with Erectile dysfunction (ED) and lifelong PE (LPE), which presented similar small-world organization

  • The results of this study demonstrated that the brain WM network of both patients with psychological ED and LPE had small-world organization

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Summary

Introduction

Male sexual behavior is divided into five stages: sexual desire, sexual arousal/erection, sexual intercourse, ejaculation, and orgasm [1, 2]. Previous studies have demonstrated that erection and ejaculation are considered two distinct phases of male sexual behavior, which are controlled by the peripheral and central nervous systems [6,7,8,9]. Erectile dysfunction (ED) and premature ejaculation (PE) are the two most common sexual dysfunctions with many little-known links, which have a negative impact on the physical and psychosocial health and quality of sexual intercourse for both men and their female partners [10, 11]. Erectile dysfunction (ED) and premature ejaculation (PE), has been found to be associated with abnormal structural connectivity in the brain. Previous studies have mainly focused on a single disorder, convergent and divergent structural connectivity patterns of the brain network between ED and PE remain poorly understood

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