The Role of Oxytocin in Polycystic Ovary Syndrome: A Systematic Review.

Polycystic Ovary Syndrome (PCOS) is the most common endocrine disorder that affects women of reproductive age, representing the primary cause of anovulatory infertility. The nonapeptide oxytocin (OT) plays an important role in cognitive, emotional, and reproductive functions in human beings. Oxytocin receptors are expressed in several body parts, including the ovaries. Despite this, the possible role played by oxytocin in symptoms of PCOS is not clear. The present systematic review aimed at understanding the presence of possible oxytocin level alterations in PCOS, the connection between alterations of OT levels and the symptoms of PCOS, and the effect of oxytocin administration in PCOS. After a systematic search in the principal databases, eight studies, five human and three animal, were included. Four human studies and one animal study highlighted the role played by oxytocin in fertility issues related to PCOS. Three human and two animal studies investigated the role of body weight and OT levels. Studies that analyzed oxytocin basal levels in women agreed that PCOS is associated with a reduction in the serum level of oxytocin. Two human studies and one animal study agreed about lower levels of oxytocin, confirming a possible implication of the dysfunction of OT in the pathogenesis of PCOS.

The Impact of Psychosis on Sexual Functioning: A Systematic Review.

BACKGROUND: Sexual dysfunction among psychotic patients is highly prevalent. However, most research has focused on antipsychotic side effects on sexual functioning. AIM: To provide evidence by means of a systematic review of the literature about the impact of psychosis on sexual functioning among unmedicated patients. METHODS: Systematic search of MEDLINE (PubMed), Scopus, and Google Scholar for studies that reported sexual functioning among psychotic patients, who were drug-naïve or drug-free for at least 3 weeks before the study. Studies were published in English language between January 1994 and October 2019. We used the approach recommended by PRISMA, and the selection process was carried out by 2 reviewers. OUTCOMES: The outcome measures were sexual function and sexual dysfunctions. RESULTS: A total of 734 articles were obtained, 658 were obtained after duplicates were removed, 612 were excluded after reading the title and abstract, and 46 were included for a complete review of the articles. 5 papers were finally included. A total of 770 cases were included in the systematic review. The prevalence of sexual dysfunction in psychosis varied from 16.8% to 70% and in ultra-high state was 50%. It is noteworthy that those ultra-high-risk (prodromal) patients who develop psychosis had higher rates of sexual impairment. Therefore, we found higher rates of sexual dysfunction among untreated patients, both psychotic and ultra-high risk patients, than healthy controls. CLINICAL IMPLICATIONS: The assessment of sexual behavior should be a part of routine psychiatric examination not only in psychotic but also in ultra-high-risk patients. STRENGTHS & LIMITATIONS: This is the first systematic review about the impact of psychosis on sexual functioning among unmedicated patients. However, scarce and heterogeneous studies were identified. CONCLUSIONS: Impaired sexual functioning is common in the onset of psychosis (or during ultra-high-risk state) and prior to the beginning of treatment. This suggests that psychotic symptoms and sexual dysfunction may have common etiological pathways at the psychosocial and neurobiological levels. Vargas-Cáceres S, Cera N, Nobre P, et al. The Impact of Psychosis on Sexual Functioning: A Systematic Review. J Sex Med 2021;18:457-466.

Late-Life Depression: Modifications of Brain Resting State Activity.

Late-life depression (LLD) is a common emotional and mental disability in the elderly population characterized by the presence of depressed mood, the loss of interest or pleasure in daily activities, and other depression symptoms. It has a serious effect on the quality of life of elderly individuals and increases their risk of developing physical and mental diseases. It is an important area of research, given the growing elderly population. Brain functional connectivity modifications represent one of the neurobiological biomarker for LLD even if to date remains poorly understood. In our study, we enrolled 10 elderly patients with depressive symptoms compared to 11 age-matched healthy controls. All participants were evaluated by means of neuropsychological tests and underwent the same functional magnetic resonance imaging (fMRI) protocol to evaluate modifications of brain resting state functional connectivity. Between-group differences were observed for the Geriatric Depression Scale and Hamilton Depression Rating Scale, with higher scores for patients with LLD. Voxel-wise, 1-way analysis of variance revealed between-group differences in left frontoparietal network (lFPN) and sensory motor network (SMN): Increased intrinsic connectivity in the LLD group was observed in the left dorsolateral prefrontal cortex and in the left superior parietal lobule of the lFPN and increased intrinsic connectivity in the LLD group was observed in the bilateral primary somatosensory cortex of the SMN. Our findings support the use of resting state fMRI as a potential biomarker for LLD; even if to confirm the relationship between brain changes and the pathophysiology of LLD, longitudinal neuroimaging studies are required.

Olfaction and Anxiety Are Differently Associated in Men and Women in Cognitive Physiological and Pathological Aging.

BACKGROUND: Olfaction impairment in aging is associated with increased anxiety. We explored this association in cognitively healthy controls (HCs), Mild Cognitive Impairment (MCI) and Parkinson's disease (PD) patients. Both olfaction and anxiety have sex differences, therefore we also investigated these variances. OBJECTIVES: Investigate the association of olfaction with anxiety in three distinct clinical categories of aging, exploring the potential role of sex. METHODS: 117 subjects (29 HCs, 43 MCI, and 45 PD patients) were assessed for olfaction and anxiety. We used regression models to determine whether B-SIT predicted anxiety and whether sex impacted that relationship. RESULTS: Lower olfaction was related to greater anxiety traits in all groups (HCs: p = 0.015; MCI: p = 0.001 and PD: p = 0.038), significantly differed by sex. In fact, in HCs, for every unit increase in B-SIT, anxiety traits decreased by 7.63 in men (p = 0.009) and 1.5 in women (p = 0.225). In MCI patients for every unit increase in B-SIT, anxiety traits decreased by 1.19 in men (p = 0.048) and 3.03 in women (p = 0.0036). Finally, in PD patients for every unit increase in B-SIT, anxiety traits decreased by 1.73 in men (p = 0.004) and 0.41 in women (p = 0.3632). DISCUSSION: Olfaction and anxiety are correlated in all three distinct diagnostic categories, but differently in men and women.

The role of left superior parietal lobe in male sexual behavior: dynamics of distinct components revealed by FMRI.

INTRODUCTION: Despite the interest for the brain correlates of male sexual arousal, few studies investigated neural mechanisms underlying psychogenic erectile dysfunction (ED). Although these studies showed several brain regions active in ED patients during visual erotic stimulation, the dynamics of inhibition of sexual response is still unclear. AIM: This study investigated the dynamics of brain regions involved in the psychogenic ED. METHODS: Functional magnetic resonance imaging (fMRI) and simultaneous penile tumescence (PT) were used to study brain activity evoked in 17 outpatients with psychogenic ED and 19 healthy controls during visual erotic stimulation. Patterns of brain activation related to different phases of sexual response in the two groups were compared. MAIN OUTCOME MEASURES: Simultaneous recording of blood oxygen level-dependent fMRI responses and PT during visual erotic stimulation. RESULTS: During visual erotic stimuli, a larger activation was observed for the patient group in the left superior parietal lobe, ventromedial prefrontal cortex, and posterior cingulate cortex, whereas the control group showed larger activation in the right middle insula and dorsal anterior cingulate cortex and hippocampus. Moreover, the left superior parietal lobe showed a larger activation in patients than controls especially during the later stage of sexual response. CONCLUSION: Our results suggest that, among regions more active in patient group, the left superior parietal lobe plays a crucial role in inhibition of sexual response. Previous studies showed that left superior parietal lobe is involved in monitoring of internal body representation. The larger activation of this region in patients during later stages of sexual response suggests a high monitoring of the internal body representation, possibly affecting the behavioral response. These findings provide insight on brain mechanisms involved in psychogenic ED.

The "Ifs" and "Hows" of the Role of Music on the Implementation of Emotional Regulation Strategies.

Music is believed to aid the implementation of emotion regulation strategies like distraction or reappraisal, but empirical studies have shown null results. However, the moderating role of one's relation with music (musical sophistication) and/or executive functioning skills has not been considered yet. In addition, little is known about how music acts. In the present study, we induced anger in a group of participants characterized by musical sophistication and executive functioning. We asked them to regulate their emotional state and measured regulation efficacy. Participants were split into four groups, defined by regulation strategy (distraction vs. reappraisal) and music (with vs. without). Results indicated music effects in higher, but not in lower musical sophistication participants. In the former, music benefitted from reappraisal but was an impaired distraction. Two different executive functions-working memory and affective flexibility-had opposite effects: higher, but not lower working memory participants benefited from music; lower, but not higher, effective flexibility participants took advantage of music. Reports of subjective experience suggested that music favors more empathic reappraisals, and that these may be more long-lasting. Our findings support the idea that music effects depend on listeners' characteristics, and they raise new hypotheses concerning the specificity of emotional regulation aided by music.

Neural correlates of psychodynamic and non-psychodynamic therapies in different clinical populations through fMRI: A meta-analysis and systematic review.

Background: The COVID-19 pandemic has exacerbated the ongoing crisis in psychiatric and psychological care, contributing to what we have identified as a new psychological and psychiatric pandemic. Psychotherapy is an effective method for easing the psychological suffering experienced also by the various impacts of COVID-19. This treatment can be examined from a neurological perspective, through the application of brain imaging techniques. Specifically, the meta-analysis of imaging studies can aid in expanding researchers' understanding of the many beneficial applications of psychotherapy. Objectives: We examined the functional brain changes accompanying different mental disorders with functional Magnetic Resonance Imaging (fMRI), through a meta-analysis, and systematic review in order to better understand the general neural mechanism involved in psychotherapy and the potential neural difference between psychodynamic and non-psychodynamic approaches. Data sources: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were employed for our systematic review and meta-analysis. We conducted a computer-based literature search, following the Population, Intervention, Comparison and Outcomes (PICO) approach, to retrieve all published articles in English regarding the above-described topics from PubMed (MEDLINE), Scopus, and Web of Science. Study eligibility criteria participants and interventions: We combined terms related to psychotherapy and fMRI: ("psychotherapy" [All Fields] OR "psychotherapy" [MeSH Terms] OR "psychotherapy" [All Fields] OR "psychotherapies" [All Fields] OR "psychotherapy s" [All Fields]) AND ("magnetic resonance imaging" [MeSH Terms]) OR ("magnetic"[All Fields] AND "resonance"[All Fields] AND "imaging"[All Fields]) OR ("magnetic resonance imaging"[All Fields] OR "fmri"[All Fields]). We considered (1) whole brain fMRI studies; (2) studies in which participants have been involved in a clinical trial with psychotherapy sessions, with pre/post fMRI; (3) fMRI results presented in coordinate-based (x, y, and z) in MNI or Talairach space; (4) presence of neuropsychiatric patients. The exclusion criteria were: (1) systematic review or meta-analysis; (2) behavioral study; (3) single-case MRI or fMRI study; and (4) other imaging techniques (i.e., PET, SPECT) or EEG. Results: After duplicates removal and assessment of the content of each published study, we included 38 sources. The map including all studies that assessed longitudinal differences in brain activity showed two homogeneous clusters in the left inferior frontal gyrus, and caudally involving the anterior insular cortex (p < 0.0001, corr.). Similarly, studies that assessed psychotherapy-related longitudinal changes using emotional or cognitive tasks (TASK map) showed a left-sided homogeneity in the anterior insula (p < 0.000) extending to Broca's area of the inferior frontal gyrus (p < 0.0001) and the superior frontal gyrus (p < 0.0001). Studies that applied psychodynamic psychotherapy showed Family-Wise Error (FWE) cluster-corrected (p < 0.05) homogeneity values in the right superior and inferior frontal gyri, with a small cluster in the putamen. No FWE-corrected homogeneity foci were observed for Mindful- based and cognitive behavioral therapy psychotherapy. In both pre- and post-therapy results, studies showed two bilateral clusters in the dorsal anterior insulae (p = 0.00001 and p = 0.00003, respectively) and involvement of the medial superior frontal gyrus (p = 0.0002). Limitations: Subjective experiences, such as an individual's response to therapy, are intrinsically challenging to quantify as objective, factual realities. Brain changes observed both pre- and post-therapy could be related to other factors, not necessary to the specific treatment received. Therapeutic modalities and study designs are generally heterogeneous. Differences exist in sample characteristics, such as the specificity of the disorder and number and duration of sessions. Moreover, the sample size is relatively small, particularly due to the paucity of studies in this field and the little contribution of PDT. Conclusions and implications of key findings: All psychological interventions seem to influence the brain from a functional point of view, showing their efficacy from a neurological perspective. Frontal, prefrontal regions, insular cortex, superior and inferior frontal gyrus, and putamen seem involved in these neural changes, with the psychodynamic more linked to the latter three regions.

Human metabolic emissions of carbon dioxide and methane and their implications for carbon emissions.

Carbon dioxide (CO2) and methane (CH4) are important greenhouse gases in the atmosphere and have large impacts on Earth's radiative forcing and climate. Their natural and anthropogenic emissions have often been in focus, while the role of human metabolic emissions has received less attention. In this study, exhaled, dermal and whole-body CO2 and CH4 emission rates from a total of 20 volunteers were quantified under various controlled environmental conditions in a climate chamber. The whole-body CO2 emissions increased with temperature. Individual differences were the most important factor for the whole-body CH4 emissions. Dermal emissions of CO2 and CH4 only contributed ~3.5% and ~5.5% to the whole-body emissions, respectively. Breath measurements conducted on 24 volunteers in a companion study identified one third of the volunteers as CH4 producers (exhaled CH4 exceeded 1 ppm above ambient level). The exhaled CH4 emission rate of these CH4 producers (4.03 ± 0.71 mg/h/person, mean ± one standard deviation) was ten times higher than that of the rest of the volunteers (non-CH4 producers; 0.41 ± 0.45 mg/h/person). With increasing global population and the expected large reduction in global anthropogenic carbon emissions in the next decades, metabolic emissions of CH4 (although not CO2) from humans may play an increasing role in regional and global carbon budgets.

Specific factors and methodological decisions influencing brain responses to sexual stimuli in women.

Most of the neuroimaging studies on sexual behavior have been conducted with male participants, leading to men-based models of sexual arousal. Here, possible factors and methodological decisions that might influence brain responses to sexual stimuli, specifically for the inclusion of women, will be reviewed. Based on this review, we suggest that future studies consider the following factors: menstrual phase, hormonal contraception use, history of sexual or psychiatric disorders or diseases, and medication use. Moreover, when researching sexual arousal, we suggest future studies assess sexual orientation and preferences, that women should select visual sexual stimuli, and a longer duration than commonly used. This review is thought to represent a useful guideline for future research in sexual arousal, which hopefully will lead to a higher inclusion of women and therefore more accurate neurobiological models of sexual arousal.

How Relevant is the Systemic Oxytocin Concentration for Human Sexual Behavior? A Systematic Review.

INTRODUCTION: Despite its role in social cognition and affiliative behavior, less is known about the role played by oxytocin in human sexual behavior. AIM: In the present systematic review, we aimed to find the levels of oxytocin related to human sexual arousal and orgasm. METHODS: We conducted the study according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We performed a systematic search in the principal databases for studies that reported collection of salivary or plasmatic samples, with dosage of oxytocin in relation to sexual activity during induction of sexual arousal and orgasm. RESULTS: 414 articles were obtained. After duplicates removal and the application of pre exclusion criteria, 16 articles were considered eligible and 13 articles were included with a Cohen's k of 0.827. Most of the studies used sexual self-stimulation and collected plasmatic or salivary samples to measure oxytocin. The sexual arousal and orgasm were assessed based on subjective reports. MAIN OUTCOME MEASURE: The primary outcomes were the oxytocin levels collected during the induction of sexual arousal and orgasm. CONCLUSIONS: Several studies collected only subjective reports about the sexual arousal and the orgasm. Most of the studies found higher levels of oxytocin during the orgasm or ejaculation. Given the sexual arousal evoked by self-stimulation in which sexual fantasies play an important role, it should be possible to postulate for a role of the oxytocin in sexual desire. In particular, we hypothesize a complex role of the oxytocin in the modulation of sexual fantasies and thoughts that are relevant in the sexual desire and help to trigger genital and sexual arousal. Cera N, Vargas-Cáceres S, Oliveira C, et al. How Relevant is the Systemic Oxytocin Concentration for Human Sexual Behavior? A Systematic Review. Sex Med 2021;9:100370.

The role of anterior and posterior insula in male genital response and in visual attention: an exploratory multimodal fMRI study.

Several studies highlighted the role of insula on several functions and in sexual behavior. This exploratory study examines the relationships among genital responses, brain responses, and eye movements, to disentangle the role played by the anterior and posterior insula during different stages of male sexual response and during visual attention to sexual stimuli. In 19 healthy men, fMRI, eye movement, and penile tumescence data were collected during a visual sexual stimulation task. After a whole-brain analysis comparing neutral and sexual clips and confirming a role for the bilateral insulae, we selected two bilateral seed regions in anterior and posterior insula for functional connectivity analysis. Single-ROI-GLMs were run for the FC target regions. Single-ROI-GLMs were performed based on areas to which participants fixate: "Faces", "Genitals," and "Background" with the contrast "Genitals > Faces". Single-ROI-GLMs with baseline, onset, and sustained PT response for the sexual clips were performed. We found stronger effects for the posterior than the anterior insula. In the target regions of the posterior insula, we found three different pathways: the first involved in visual attention, onset of erection, and sustained erection; the second involved only in the onset of erection, and the third limited to sustained erection.

Altered Cingulate Cortex Functional Connectivity in Normal Aging and Mild Cognitive Impairment.

PURPOSE: Resting-state functional Magnetic Resonance Imaging studies revealed that the brain is organized into specialized networks constituted by regions that show a coherent fluctuation of spontaneous activity. Among these networks, the cingulate cortex appears to play a crucial role, particularly in the default mode network, the dorsal attention network and the salience network. In the present study, we mapped the functional connectivity (FC) pattern of different regions of the cingulate cortex: the anterior cingulate cortex, midcingulate cortex and posterior cingulate cortex/retro splenial cortex, which have been in turn divided into a total of 9 subregions. We compared FC patterns of the cingulate subregions in a sample of mild cognitive impairment patients and healthy elderly subjects. METHODS: We enrolled 19 healthy elders (age range: 61-72 y.o.) and 16 Mild cognitive impairment patients (age range 64-87 y.o.). All participants had comparable levels of education (8-10 years) and were neurologically examined to exclude visual and motor impairments, major medical conditions, psychiatric or neurological disorders and consumption of psychotropic drugs. The diagnosis of mild cognitive impairment was performed according to Petersen criteria. Subjects were evaluated with Mini-Mental State Examination, Frontal Assessment Battery, and prose memory (Babcock story) tests. In addition, with functional Magnetic Resonance Imaging, we investigated resting-state network activities. RESULTS: Healthy elderly, compared to mild cognitive impairment, showed significant increased level of FC for the ventral part of the anterior cingulate cortex in correspondence to the bilateral caudate and ventromedial prefrontal cortex. Moreover, for the midcingulate cortex the healthy elderly group showed increased levels of FC in the somatomotor region, prefrontal cortex, and superior parietal lobule. Meanwhile, the mild cognitive impairment group showed an increased level of FC for the superior frontal gyrus, frontal eye field and orbitofrontal cortex compared to the healthy elderly group. CONCLUSION: Our findings indicate that cognitive decline observed in mild cognitive impairment patients damages the global FC of the cingulate cortex, supporting the idea that abnormalities in resting-state activities of the cingulate cortex could be a useful additional tool in order to better understand the brain mechanisms of MCI.

Modifications in resting state functional anticorrelation between default mode network and dorsal attention network: comparison among young adults, healthy elders and mild cognitive impairment patients.

Resting state brain activity incorporates different components, including the Default Mode Network and the Dorsal Attention Network, also known as task-negative network and task-positive network respectively. These two networks typically show an anticorrelated activity during both spontaneous oscillations and task execution. However modifications of this anticorrelated activity pattern with age and pathology are still unclear. The present study aimed to investigate differences in resting state Default Mode Network-Dorsal Attention Network functional anticorrelation among young adults, healthy elders and Mild Cognitive Impairment patients. We retrospectively enrolled in this study 27 healthy young adults (age range: 25-35 y.o.; mean age: 28,5), 26 healthy elders (age range: 61-72 y.o.; mean age: 65,1) and 17 MCI patients (age range 64-87 y.o.; mean age: 73,6). Mild Cognitive Impairment patients were selected following Petersen criteria. All participants underwent neuropsychological evaluation and resting state functional Magnetic Resonance Imaging. Spontaneous anticorrelated activity between Default Mode Network and Dorsal Attention Network was observed in each group. This anticorrelation was significantly decreased with age in most Default Mode Network-Dorsal Attention Network connections (p < 0.001, False Discovery Rate corrected). Moreover, the anticorrelation between the posterior cingulate cortex node of the Default Mode Network and the right inferior parietal sulcus node of the Dorsal Attention Network was significantly decreased when comparing Mild Cognitive Impairment with normal elders (p < 0.001, False Discovery Rate corrected). The functional connectivity changes in patients were not related to significant differences in grey matter content. Our results suggest that a reduced anticorrelated activity between Default Mode Network and Dorsal Attention Network is part of the normal aging process and that Mild Cognitive Impairment status is associated with more evident inter-networks functional connectivity changes.

A review of infrared thermography as applied to human sexual psychophysiology.

Infrared thermography (IRT) is a non-contact technique that permits mapping and analysis of the temperature of the body's skin surface. This method has been applied to sexual psychophysiology since the 1980s and its use has been expanding ever since, mainly because it provides several advantages over existing genital response measures. This article presents a review of experimental studies employing IRT to investigate human sexual arousal, with the aim of summarizing the available procedures and evidence so far and to identify important caveats in the literature. The studies reviewed support the feasibility and validity of IRT as a real-time physiological measure of sexual arousal but varied substantially regarding methodology and procedures. The results of this review underscore the value and validity of IRT in sexual psychophysiology and point at the critical need for the standardization of IRT protocols to accommodate the specific needs of applying this methodology to sexual physiology.

Infective complications after retrograde intrarenal surgery: a new standardized classification system.

PURPOSE: Retrograde intrarenal surgery (RIRS) is considered a safe procedure; however, infective complications are potentially serious postoperative complications. The aim of this multicentre study was to evaluate prospectively the prevalence of infective complications after RIRS and identify risk factors. METHODS: Baseline data were collected, and patients were questioned regarding postoperative infective complications following RIRS. The Fisher exact test, Student t test, Mann-Whitney U test, and multivariate regression analysis were used for data analysis. RESULTS: A total of 403 patients from five European centers were included. Antibiotic prophylaxis was administered prior to RIRS in 100 %. Infection complications were recorded in 31 patients (7.7 %), consisting of fever in 18 (4.4 %), SIRS in 7 (1.7), and sepsis in 3 (0.7 %). Three required hospitalization for non-obstructive pyelonephritis (0.7 %). Univariate analysis revealed that coronary heart disease, chronic kidney disease, alteration of lipid metabolism, anticoagulant therapy, past surgery for renal stone, presence of residual fragments were predictors of infective complications. Multivariate analysis did not identify any patient subgroups at a significantly higher risk of infection. The low rate of complications may have limited the conclusions from our study. CONCLUSION: Using a standardized method for the definition and classification of infective complication from a multicentre prospective large database, we find a prevalence of 7.7 % of infective complication among patients undergoing RIRS for renal stone. However, to predict which patients will develop infective complications still remains a clinical challenge.

Modafinil alters intrinsic functional connectivity of the right posterior insula: a pharmacological resting state fMRI study.

BACKGROUND: Modafinil is employed for the treatment of narcolepsy and has also been, off-label, used to treat cognitive dysfunction in neuropsychiatric disorders. In a previous study, we have reported that single dose administration of modafinil in healthy young subjects enhances fluid reasoning and affects resting state activity in the Fronto Parietal Control (FPC) and Dorsal Attention (DAN) networks. No changes were found in the Salience Network (SN), a surprising result as the network is involved in the modulation of emotional and fluid reasoning. The insula is crucial hub of the SN and functionally divided in anterior and posterior subregions. METHODOLOGY: Using a seed-based approach, we have now analyzed effects of modafinil on the functional connectivity (FC) of insular subregions. PRINCIPAL FINDINGS: Analysis of FC with resting state fMRI (rs-FMRI) revealed increased FC between the right posterior insula and the putamen, the superior frontal gyrus and the anterior cingulate cortex in the modafinil-treated group. CONCLUSIONS: Modafinil is considered a putative cognitive enhancer. The rs-fMRI modifications that we have found are consistent with the drug cognitive enhancing properties and indicate subregional targets of action. TRIAL REGISTRATION: ClinicalTrials.gov NCT01684306.

Brain networks during free viewing of complex erotic movie: new insights on psychogenic erectile dysfunction.

Psychogenic erectile dysfunction (ED) is defined as a male sexual dysfunction characterized by a persistent or recurrent inability to attain adequate penile erection due predominantly or exclusively to psychological or interpersonal factors. Previous fMRI studies were based on the common occurrence in the male sexual behaviour represented by the sexual arousal and penile erection related to viewing of erotic movies. However, there is no experimental evidence of altered brain networks in psychogenic ED patients (EDp). Some studies showed that fMRI activity collected during non sexual movie viewing can be analyzed in a reliable manner with independent component analysis (ICA) and that the resulting brain networks are consistent with previous resting state neuroimaging studies. In the present study, we investigated the modification of the brain networks in EDp compared to healthy controls (HC), using whole-brain fMRI during free viewing of an erotic video clip. Sixteen EDp and nineteen HC were recruited after RigiScan evaluation, psychiatric, and general medical evaluations. The performed ICA showed that visual network (VN), default-mode network (DMN), fronto-parietal network (FPN) and salience network (SN) were spatially consistent across EDp and HC. However, between-group differences in functional connectivity were observed in the DMN and in the SN. In the DMN, EDp showed decreased connectivity values in the inferior parietal lobes, posterior cingulate cortex and medial prefrontal cortex, whereas in the SN decreased and increased connectivity was observed in the right insula and in the anterior cingulate cortex respectively. The decreased levels of intrinsic functional connectivity principally involved the subsystem of DMN relevant for the self relevant mental simulation that concerns remembering of past experiences, thinking to the future and conceiving the viewpoint of the other's actions. Moreover, the between group differences in the SN nodes suggested a decreased recognition of autonomical and sexual arousal changes in EDp.