Department of Neurology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Department of Neuroradiology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
Ann Neurol. 2016 Oct;80(4):490-8. doi: 10.1002/ana.24746. Epub 2016 Aug 19.
This study intended to determine associations between alterations of female sexual arousal as well as vaginal lubrication and the site of cerebral multiple sclerosis (MS) lesions.
In 44 women with MS (mean age: 36.5 ± 9.9 years), we assessed their medical history and evaluated sexual function using the Female Sexual Function Index scores for arousal and vaginal lubrication. We determined potential confounding factors of sexual dysfunction: age; disease duration; physical disability; depression; bladder or urinary dysfunction; and total volume of cerebral lesions. Arousal and lubrication scores were correlated with one another and with potential confounding factors. Cerebral MS lesions were recorded on imaging scans. A voxel-based lesion symptom mapping (VLSM) analysis adjusted for confounding variables was performed correlating cerebral sites of MS lesions with arousal and lubrication scores.
Decreased arousal scores correlated with decreased lubrication scores; decreased lubrication scores were associated with bladder or urinary symptoms. Arousal and lubrication scores were not associated with any other variables. Multivariate VLSM analysis, including arousal and lubrication scores as covariables of interest, showed right occipital lesions associated with impaired arousal and left insular lesions associated with decreased lubrication. Impaired lubrication remained associated with left insular lesions after adjustment for bladder or urinary dysfunction.
Our data indicate that impaired female sexual arousal is associated with MS lesions in the occipital region, integrating visual information and modulating attention toward visual input. Impaired lubrication correlated with lesions in the left insular region, contributing to mapping and generating visceral arousal states. Ann Neurol 2016;80:490-498.
本研究旨在确定女性性唤起和阴道润滑功能的改变与脑部多发性硬化（MS）病变部位之间的关系。
我们对 44 名 MS 女性患者（平均年龄：36.5±9.9 岁）进行了评估，记录了她们的病史，采用女性性健康指数（FSFI）评估性唤起和阴道润滑功能。我们确定了性功能障碍的潜在混杂因素：年龄、疾病持续时间、身体残疾、抑郁、膀胱或尿功能障碍以及脑部病变总容积。对性唤起和润滑评分与其他潜在混杂因素之间进行了相关性分析。记录脑部 MS 病变的影像学扫描。对校正了混杂变量的基于体素的病变症状映射（VLSM）分析进行了相关性分析，将脑部 MS 病变部位与性唤起和润滑评分进行了关联。
性唤起评分降低与润滑评分降低相关，润滑评分降低与膀胱或尿症状相关。性唤起和润滑评分与其他变量均无相关性。包括性唤起和润滑评分作为感兴趣的协变量的多元 VLSM 分析显示，右侧枕叶病变与性唤起受损相关，左侧岛叶病变与润滑减少相关。在调整了膀胱或尿功能障碍后，润滑功能障碍仍与左侧岛叶病变相关。
我们的数据表明，女性性唤起受损与 MS 病变的枕叶部位有关，这一部位整合了视觉信息并调节了对视觉输入的注意力。润滑功能障碍与左侧岛叶病变相关，有助于映射和产生内脏唤醒状态。神经病学年鉴 2016；80：490-498。
