Park K, Seo J J, Kang H K, Ryu S B, Kim H J, Jeong G W
Department of Urology, Chonnam National University Medical School, Kwangju, Korea.
Int J Impot Res. 2001 Apr;13(2):73-81. doi: 10.1038/sj.ijir.3900649.
It is well known that penile erection is dependent on commands from the central nervous system. However, there has been little research on the central control of penile erection. The aim of this study was to evaluate, for the first time, the cerebral centers of penile erection using BOLD-functional MRI. Functional magnetic resonance imaging (fMRI) on a 1.5T MR scanner was performed in 12 sexually potent male volunteers (mean age: 23) and two hypogonadal impotent patients. In this study, blood oxygenation level dependent (BOLD) technique was utilized to create fMRI reflecting local brain activities. Real-time visual stimulation was performed with an alternatively combined erotic and non-erotic film to identify and quantify the activated brain regions associated with sexual response. Subjective sexual arousal and penile erection responses were assessed using 5-point scales ranging from 1 (no change) to 5 (maximal increase). In normal volunteers, the mean scores on subjective sexual arousal and penile erection by sexual stimulation with erotic film were 3.0 and 3.3 respectively, whereas there were no changes by non-erotic stimulation. During the visual stimulation the occipital cortex was activated by either an erotic or non-erotic film, the erotic film gave 150-200% stronger activation. However, more than seven of the 12 healthy subjects were significantly activated in the areas of inferior frontal lobe, cingulate gyrus, insula gyrus, corpus callosum, thalamus, caudate nucleus, globus pallidus, and inferior temporal lobe by erotic stimulation. In the hypogonadal patients, brain activation in response to the erotic film decreased compared to normal volunteers, however, it was restored by testosterone supplementation. These results are the first demonstration to show the functional neuroanatomy of the brain associated with sexual arousal by visual sexual stimulation using BOLD-based fMRI. Further studies are needed to verify that fMRI provides an important new tool in evaluating the cerebral center of the penile erection.
众所周知，阴茎勃起依赖于中枢神经系统的指令。然而，关于阴茎勃起的中枢控制的研究却很少。本研究的目的是首次使用血氧水平依赖性功能磁共振成像（BOLD-fMRI）评估阴茎勃起的脑中枢。在12名性能力正常的男性志愿者（平均年龄：23岁）和两名性腺功能减退的阳痿患者中，使用1.5T磁共振扫描仪进行了功能磁共振成像（fMRI）。在本研究中，利用血氧水平依赖（BOLD）技术来创建反映局部脑活动的fMRI。使用色情与非色情电影交替组合进行实时视觉刺激，以识别和量化与性反应相关的激活脑区。使用从1（无变化）到5（最大增加）的5分制量表评估主观性唤起和阴茎勃起反应。在正常志愿者中，观看色情电影进行性刺激时，主观性唤起和阴茎勃起的平均得分分别为3.0和3.3，而非色情刺激则无变化。在视觉刺激期间，枕叶皮层在观看色情或非色情电影时均被激活，色情电影引起的激活强度要强150 - 200%。然而，12名健康受试者中有超过7人在额叶下部、扣带回、脑岛、胼胝体、丘脑、尾状核、苍白球和颞下回区域因色情刺激而显著激活。在性腺功能减退的患者中，与正常志愿者相比，对色情电影的脑激活减少，但补充睾酮后恢复。这些结果首次证明了使用基于BOLD的fMRI通过视觉性刺激显示与性唤起相关的脑功能神经解剖学。需要进一步的研究来验证fMRI是否为评估阴茎勃起的脑中枢提供了一种重要的新工具。
