Temel Y, Visser-Vandewalle V, Ackermans L, Beuls E A M
Department of Neurosurgery, University Hospital Maastricht, Maastricht, The Netherlands.
Int J Impot Res. 2004 Dec;16(6):505-11. doi: 10.1038/sj.ijir.3901233.
Penile erection is a complex neurovascular event. The neuronal system involved is often divided into a spinal (generator) and supraspinal (controller) network. Little is known about the supraspinal control. The recent finding of changes in penile erection following deep brain stimulation of the thalamus in two patients has raised the question as to what extent the thalamus is involved in erectile function. The thalamus has generally been regarded as a group of relay nuclei that served as a 'gate' for sexual information from the spinal cord towards higher centres. Recent evidence, however, suggests a more integrated regulatory function. Our review of the literature from 1960 until 2003 revealed 13 reports describing original data (preclinical and clinical). Various thalamic regions, varying from the midline thalamus to the posterior thalamus, have been reported to be activated during erection. The majority of the reports, however, showed that mainly the mediodorsal (MD) nucleus and the centromedian-parafascicular nucleus (Cm-Pf complex) are involved in penile erection. MD is the second largest nuclear aggregation located within the medial part of the thalamus. Anatomically, the MD is closely related to the Cm-Pf complex. The Cm-Pf complex is one of the most important relay stations in which the anterolateral spinothalamic pathway is further processed. This pathway is thought to transmit peripheral sexual sensations. On the whole, the present data on the role of the thalamus in erection are far from complete and future experiments are required to delineate its involvement.
阴茎勃起是一个复杂的神经血管事件。所涉及的神经系统通常分为脊髓（发生器）和脊髓上（控制器）网络。人们对脊髓上控制了解甚少。最近在两名患者中发现，丘脑深部脑刺激后阴茎勃起发生变化，这引发了一个问题，即丘脑在勃起功能中究竟参与到何种程度。丘脑通常被视为一组中继核，作为性信息从脊髓传向更高中枢的“大门”。然而，最近的证据表明其具有更综合的调节功能。我们对1960年至2003年的文献进行回顾，发现有13篇报告描述了原始数据（临床前和临床数据）。据报道，从丘脑中线到丘脑后部的各个丘脑区域在勃起过程中都会被激活。然而，大多数报告表明，主要是背内侧（MD）核和中央中-束旁核（Cm-Pf复合体）参与阴茎勃起。MD是位于丘脑内侧部分的第二大核团聚集区。从解剖学上讲，MD与Cm-Pf复合体密切相关。Cm-Pf复合体是最重要的中继站之一，脊髓丘脑前束在其中进一步得到处理。该通路被认为传递外周性感觉。总体而言，目前关于丘脑在勃起中作用的数据远不完整，需要未来的实验来阐明其参与情况。
