Department of Behavioral Science-Unit 1330, The University of Texas MD Anderson Cancer Center, P.O. Box 301439, Houston, TX, 77230-1439, USA,
Brain Imaging Behav. 2013 Dec;7(4):533-42. doi: 10.1007/s11682-013-9252-1.
Many breast cancer survivors report a loss of sexual desire and arousability, consonant with the new DSM-V category of female sexual interest/arousal disorder. The cause of decreased sexual desire and pleasure after treatment for cancer is unknown. One possibility is that cancer, or treatment for cancer, damages brain circuits that are involved in reward-seeking. To test the hypothesis that brain reward systems are involved in decreased sexual desire in breast cancer survivors, we used functional magnetic resonance imaging (fMRI) to compare brain responses to erotica and other emotional stimuli in two groups of women previously treated for breast cancer with chemotherapy: those who were distressed about a perceived loss of sexual desire and those who may have had low desire, but were not distressed about it. Women distressed about their desire had reduced brain responses to erotica in the anterior cingulate and dorsolateral prefrontal cortex, which are part of the brain reward system. This study is the first to demonstrate, in cancer survivors, that problems with sexual desire/arousability are associated with blunted brain responses to erotica in reward systems. Future research is necessary to determine whether brain responses differ as a result of chemotherapy, hormone therapy, and menopausal status. This may contribute to the development of new, evidence-based interventions for one of the most prevalent and enduring side effects of cancer treatment.
许多乳腺癌幸存者报告性欲和唤起能力下降，符合新的 DSM-V 女性性兴趣/唤起障碍类别。癌症治疗后性欲和性快感下降的原因尚不清楚。一种可能性是癌症或癌症治疗损伤了参与寻求奖励的大脑回路。为了测试大脑奖励系统参与乳腺癌幸存者性欲下降的假设，我们使用功能磁共振成像 (fMRI) 比较了两组先前接受过化疗的乳腺癌女性对色情和其他情绪刺激的大脑反应：那些对感知到的性欲丧失感到困扰的女性，以及那些可能性欲较低但对此并不困扰的女性。对自己的欲望感到困扰的女性在前扣带回和背外侧前额叶皮层对色情内容的大脑反应减弱，而这些区域是大脑奖励系统的一部分。这项研究首次证明，在癌症幸存者中，性欲/唤起能力的问题与奖励系统中对色情内容的反应迟钝有关。需要进一步研究以确定大脑反应是否因化疗、激素治疗和绝经状态而有所不同。这可能有助于为癌症治疗最常见和持久的副作用之一开发新的、基于证据的干预措施。
