Giuliano F, Allard J
Groupe de Recherche en Urologie, UPRES, Medical University of Paris South, France.
Int J Impot Res. 2001 Aug;13 Suppl 3:S18-28. doi: 10.1038/sj.ijir.3900719.
The use of the D1/D2 dopamine receptor agonist apomorphine SL for the treatment of erectile dysfunction provides a strong support in favour of a participation of the dopaminergic system in the control of sexual function. However, the exact involvement of dopamine in sexual motivation and in the control of genital arousal in humans is unknown. In contrast, experimental data suggest an implication of dopamine at all these stages of the copulatory behaviour in rodents. The release of dopamine at the level of the nucleus accumbens, which is innervated by the mesolimbic dopaminergic pathway originating in the ventral tegmental area, is positively implicated in the pre-copulatory or appetitive phase in male rats. There is also a permissive role in the copulatory or consumatory phase for dopamine released at the level of the median pre-optic area, which receives projection from the dopaminergic incertohypothalamic pathway within the hypothalamus. It is noteworthy that these participations of the dopaminergic system are not specific to sexual behaviour but rather reflect the more general involvement of dopamine in the regulation of cognitive, integrative and reward processes. Due to its role in the control of locomotor activity, the integrity of the nigrostriatal dopaminergic pathway is also essential for the display of copulatory behaviour. Somehow more specific to sexual function, it is likely that dopamine can trigger penile erection by acting on oxytocinergic neurons located in the paraventricular nucleus of the hypothalamus, and perhaps on the pro-erectile sacral parasympathetic nucleus within the spinal cord. The counterpart of such regulation of the genital arousal by dopamine has not yet been established in females. In conclusion, the central dopaminergic system is a key element of the control of sexual function.
使用D1/D2多巴胺受体激动剂阿扑吗啡舌下含片治疗勃起功能障碍，有力地支持了多巴胺能系统参与性功能控制的观点。然而，多巴胺在人类性动机和生殖器唤起控制中的确切作用尚不清楚。相比之下，实验数据表明多巴胺在啮齿动物交配行为的所有这些阶段都有涉及。伏隔核水平的多巴胺释放与雄性大鼠交配前或求偶阶段呈正相关，伏隔核由起源于腹侧被盖区的中脑边缘多巴胺能通路支配。视前正中区水平释放的多巴胺在交配或 consummatory 阶段也起允许作用，视前正中区接受来自下丘脑内多巴胺能不确定下丘脑通路的投射。值得注意的是，多巴胺能系统的这些参与并非性行为所特有，而是反映了多巴胺在认知、整合和奖赏过程调节中更普遍的作用。由于其在控制运动活动中的作用，黑质纹状体多巴胺能通路的完整性对于交配行为的表现也至关重要。在性功能方面可能更具特异性的是，多巴胺可能通过作用于位于下丘脑室旁核的催产素能神经元，或许还作用于脊髓内的促勃起骶副交感核来触发阴茎勃起。多巴胺对生殖器唤起的这种调节在女性中的对应情况尚未确定。总之，中枢多巴胺能系统是性功能控制的关键要素。
