[Neuropsychiatry of sexual desire]. / Neuropsychiatrie du désir sexuel.

Inspired by the basic concepts of neuroscience, neuropsychiatry is a discipline at the interface between psychiatry, psychology, neurology and neuropathology. Interestingly, neuropsychiatry can also include specialized disciplines, such as developmental psychology, endocrinology and sexology. In this article, we describe the neuropsychiatric approach and present how it may be related to social neuroscience, and apply to sexual medicine by describing its importance for sexual dysfunctions and sexual desire.

[Hypoactive sexual desire disorder in men: clinical approach in sexual medicine]. / Désir sexuel hypoactif chez l'homme: prise en charge en médecine sexuelle.

Hypoactive sexual desire disorder in men: clinical approach in sexual medicine Hypoactive sexual desire disorder (HSDD) has a high prevalence in the population, representing an important cause of consultations in sexual medicine. Although HSDD affects women mostly, it also affects men. HSDD in men can be due to different factors. A precise medical evaluation of these factors is needed to start an efficient therapy. Along these lines, HSDD evaluation must follow a precise schema that integrates psychological factors and also endocrinological, toxic and psychiatric factors. A specific formation in sexual medicine is recommended for an optimal evaluation of HSDD. The present article describes the milestones of the adequate evaluation of HSDD to help the physicians in their daily clinical practice.

[Temporal evolution of passionate brain states in long-term couple relationships]. / Evolution temporelle de l'état passionnel dans la relation de couple.

A growing body of evidence proposes that passion is a function of change in intimacy between spouses. In mathematical terms, passion is a function of the first derivative of intimacy over time. High passion occurs when intimacy is felt to be rising. Low passion occurs when intimacy is stable (either high or low). In the present article, we review the experimental evidences that attribute changes in passion in couple-longitudinal patterns as a function of a triadic model between passion, intimacy and personality traits. In light of this, future studies in couple therapy and human sexuality would need to take account of the consequences of both standard approaches in sexology and this triadic model in the understanding and treatment of decreases in frequency of sexual relationships in long-term relationships.

[A socio-cognitive approach of human sexual desire]. / Approche sociocognitive du désir sexuel.

The ability to direct motivational feelings towards another person, and develop an intimate partner-relationship is important for social interaction, notably for sexual desire (SD). The recent discovery of a brain network for SD recruiting higher-order cognitive brain areas (angular gyrus), in addition to emotional limbic brain regions, suggests that SD is sustained by cognitive mechanisms, rather than by instinct only. Critically recent studies in social cognitive neuroscience support the interaction between SD and a self expansion model. The findings we report here are important theoretically and practically.

[Male sexual function after stroke]. / Fonction sexuelte masculine après accident vasculaire cérébral.

Stroke represents the third leading cause of death, ranking behind heart disease and cancer and it is the major cause of worldwide long-term disability after the age of 65. Stroke has an important psychological and emotional impact on the patient and his environment. Some trials show the substantial lowering of libido, of the frequency of sexual intercourse, the presence of erectile dysfunction and reduced sexual satisfaction. After stroke it is important to evaluate the relational and sexual aspects of the patient and his sexual partner. A specialized consultation should be proposed when necessary to optimise the patient's post-stroke rehabilitation.

[The neurophysiology of the female orgasm]. / Le cerveau au coeur du plaisir féminin.

The way women experience orgasm during passionate sexual activity has been of interest throughout the ages. The astonishing advances of functional imaging techniques recently allowed unravelling the neuroanatomy of female orgasm within a distributed corticosubcortical neural network. In the present article, we review the clinical and experimental evidence that attributes orgasm not only a peripheral but also a central origin. We thus outline the importance of integrating orgasm as a complex process involving the entire woman, mind and body. In light of this, future studies in female sexuality would need to take account of the consequences of both standard approaches in sexology and functional imaging results in the understanding of the human sexual function and in the treatment of sexual dysfunctions.

Erectile dysfunction: to prescribe or not to prescribe?

Even with the help of modern pharmacology, treatment of erectile dysfunction often remains complex, and requires taking into account the social, psychological, and behavioral dimensions of the disorder. This brief report presents a case study highlighting this complexity.

The neural basis of love as a subliminal prime: an event-related functional magnetic resonance imaging study.

Throughout the ages, love has been defined as a motivated and goal-directed mechanism with explicit and implicit mechanisms. Recent evidence demonstrated that the explicit representation of love recruits subcorticocortical pathways mediating reward, emotion, and motivation systems. However, the neural basis of the implicit (unconscious) representation of love remains unknown. To assess this question, we combined event-related functional magnetic resonance imaging (fMRI) with a behavioral subliminal priming paradigm embedded in a lexical decision task. In this task, the name of either a beloved partner, a neutral friend, or a passionate hobby was subliminally presented before a target stimulus (word, nonword, or blank), and participants were required to decide if the target was a word or not. Behavioral results showed that subliminal presentation of either a beloved's name (love prime) or a passion descriptor (passion prime) enhanced reaction times in a similar fashion. Subliminal presentation of a friend's name (friend prime) did not show any beneficial effects. Functional results showed that subliminal priming with a beloved's name (as opposed to either a friend's name or a passion descriptor) specifically recruited brain areas involved in abstract representations of others and the self, in addition to motivation circuits shared with other sources of passion. More precisely, love primes recruited the fusiform and angular gyri. Our findings suggest that love, as a subliminal prime, involves a specific neural network that surpasses a dopaminergic-motivation system.

Double dissociation between representational personal and extrapersonal neglect.

BACKGROUND: Although perceptual and representational neglect are frequently associated, the demonstration of a double dissociation between both neglect forms suggests that both rely on different central mechanisms. In addition, perceptual neglect can be selectively observed within personal space or extrapersonal space. However, it is not known whether the latter dissociation also exists in representational neglect. METHODS: The authors investigated this question in two brain-damaged patients with anatomically different lesions sites, using neuropsychological tests specifically designed to assess perceptual and representational neglect in both personal and extrapersonal space. RESULTS: Patients presented a double dissociation with respect to personal and extrapersonal space in representational neglect. CONCLUSIONS: These data suggest that the cerebral networks that process mental space representation use similar principles of space compartmentalization as those used by cerebral networks processing perceived space.

Speech arrest with stimulation may not reliably predict language deficit after epilepsy surgery.

The authors present a patient in whom electrical cortical stimulation of the posterior temporal cortex induced speech arrest, comprehension deficits, and other language-related impairments. This area was ultimately resected because of persistence of a severe seizure disorder. No postoperative aphasia was observed despite the cortical stimulation results, and the patient is since seizure free. These findings question the well-established principle that corticography directly reflects local cortical functions in all patients.

Pure representational neglect after right thalamic lesion.

After a right thalamic stroke, an 86-year-old man presented an acute pure left representational neglect in the absence of any perceptual neglect. On spatial mental imagery tasks, the patient systematically omitted items located on his left side, but only when a vantage point was given. This suggests that (1) pure representational neglect is not just a residual finding after recovery from global (perceptual and representational) neglect; (2) space representation can be coded by two independent processes: in viewer-centered or world-based (allocentric) coordinates; and (3) the right thalamus serves as a relay in the processing of spatial visual imagery.

Pure imagery hemi-neglect of far space.

Patients with hemispatial neglect restricted to near (within reaching distance) or to far space (beyond reaching distance) have been described. This constitutes a double-dissociation considered by current neurocognitive thinking as compelling evidence for separate networks. However, a similar double-dissociation exists with respect to perceived as opposed to imagined space. If the organization of represented space was similar to that of perceived space, it should contain a far/near dissociation as well. This paper describes a patient with pure representational neglect restricted to far space.