Biological Sciences Division, Department of Psychiatry and Behavioral Neuroscience, Center for Cognitive and Social Neuroscience, The University of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Sex Med Rev. 2017 Oct;5(4):434-444. doi: 10.1016/j.sxmr.2017.07.006. Epub 2017 Aug 31.
Recent advances in neuroimaging offer an unprecedented window into the female sexual brain. The small samples and poor statistical power of individual functional magnetic resonance imaging studies have limited what can be gleaned about the systematic brain network that is involved in female sexual desire and female sexual dysfunction (eg, hypoactive sexual desire disorder [HSDD]).
To quantitatively determine the brain network involved in HSDD.
Systematic retrospective review and statistical meta-analysis of pertinent neuroimaging literature.
Review of published literature on functional magnetic resonance imaging studies illustrating brain regions associated with female sexual desire and female HSDD.
HSDD is associated with a specific fronto-limbic-parietal dysfunction characterized by (i) lower blood oxygen level-dependent responses in the sexual desire brain network and (ii) higher blood oxygen level-dependent responses in the self-referential brain network.
The meta-analytic results are in line with a top-down neurofunctional model of HSDD in which inspecting, monitoring, and evaluating oneself (rather than sensory experience) before or during sexual activities interfere with sexual desire. These results raise new questions regarding the necessity and sufficiency of dysfunctional activation in the sexual desire and self-referential brain networks, whose answers bear on the development and evaluation of personalized treatments for HSDD. Cacioppo S. Neuroimaging of Female Sexual Desire and Hypoactive Sexual Desire Disorder. Sex Med Rev 2017;5:434-444.
神经影像学的最新进展为研究女性的性脑提供了前所未有的窗口。由于个体功能磁共振成像研究的样本量小、统计能力差,因此对于涉及女性性欲和女性性功能障碍(如,性欲低下障碍[HSDD])的系统性大脑网络,目前所能了解到的信息非常有限。
定量确定与 HSDD 相关的大脑网络。
对相关神经影像学文献进行系统回顾和统计元分析。
回顾与女性性欲和女性 HSDD 相关的功能磁共振成像研究的已发表文献。
HSDD 与特定的额-边缘-顶叶功能障碍有关,其特征为:(i)性欲大脑网络的血氧水平依赖反应降低;(ii)自我参照大脑网络的血氧水平依赖反应升高。
元分析结果与 HSDD 的自上而下的神经功能模型一致,即性行为之前或期间对自身进行检查、监控和评估(而不是感觉体验)会干扰性欲。这些结果提出了有关性欲和自我参照大脑网络中功能障碍激活的必要性和充分性的新问题,其答案关系到 HSDD 的个性化治疗的发展和评估。Cacioppo S. 女性性欲和性欲低下障碍的神经影像学。性医学评论 2017;5:434-444.