The behavioral component of sexual inhibition and its relation with testosterone levels: An fMRI study in transgender and cisgender individuals.

Many transgender individuals report having difficulties with initiating and seeking sexual contacts. Relatively to cisgender individuals, transgender individuals are more likely to avoid sexual activity, indicating that the groups might differ in the neural underpinnings of the behavioral component of sexual inhibition. In this fMRI study, transgender (n = 33) and cisgender (n = 34) participants performed an Approach Avoidance Task (AAT) assessing sexual inhibition. We found that over the entire sample, the task elicited brain activation commonly associated with general and sexual inhibition, for instance in the bilateral insula, right inferior parietal lobule, and right inferior and middle frontal gyri. Upon investigating group differences between transgender and cisgender participants, we mainly found similarities in neural activation during the task. However, there were group differences in regions involved in decision making processes (left middle temporal gyrus) and sexual response inhibition (right anterior cingulate cortex and left inferior parietal lobule). In order to investigate whether these group differences were modulated by testosterone levels, we performed ROI-analyses assessing the relationship between testosterone and neural activation during the AAT (controlling for sex assigned at birth), but no correlations were found. On the whole brain level, however, we found that testosterone correlated positively with cerebral activation in the right claustrum (a region associated with sexual arousal) during the approach of sexual stimuli in the transgender group. Overall, these findings indicate that transgender and cisgender individuals mostly show similarities in their neural response to a sexual Approach-Avoidance task, and that testosterone levels are unlikely to play an important role.

Seeing in the dark: Phosphene thresholds with eyes open versus closed in the absence of visual inputs.

BACKGROUND: Voluntarily opening or closing our eyes results in fundamentally different input patterns and expectancies. Yet it remains unclear how our brains and visual systems adapt to these ocular states. OBJECTIVE/HYPOTHESIS: We here used transcranial magnetic stimulation (TMS) to probe the excitability of the human visual system with eyes open or closed, in the complete absence of visual inputs. METHODS: Combining Bayesian staircase procedures with computer control of TMS pulse intensity allowed interleaved determination of phosphene thresholds (PT) in both conditions. We measured parieto-occipital EEG baseline activity in several stages to track oscillatory power in the alpha (8-12 Hz) frequency-band, which has previously been shown to be inversely related to phosphene perception. RESULTS: Since closing the eyes generally increases alpha power, one might have expected a decrease in excitability (higher PT). While we confirmed a rise in alpha power with eyes closed, visual excitability was actually increased (PT was lower) with eyes closed. CONCLUSIONS: This suggests that, aside from oscillatory alpha power, additional neuronal mechanisms influence the excitability of early visual cortex. One of these may involve a more internally oriented mode of brain operation, engaged by closing the eyes. In this state, visual cortex may be more susceptible to top-down inputs, to facilitate for example multisensory integration or imagery/working memory, although alternative explanations remain possible.