Gao Ming, Feng Nana, Wu Jiayu, Sun Jianhua, Zhang Lei, Guo Xinlong, Yuan Jianlin, Guo Jun, Liu Peng
Assisted Reproduction Center, Northwest Women and Children Hospital Affiliated to Xi'an JiaoTong University, Xi'an, China.
Department of Andrology, XiYuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
J Magn Reson Imaging. 2020 Sep;52(3):778-784. doi: 10.1002/jmri.27099. Epub 2020 Feb 18.
As one of the most prevalent sexual dysfunctions in men, lifelong premature ejaculation (PE) often leads to patient distress. The hypothalamus is implicated in the ejaculatory control of healthy males. However, we do not know whether the hypothalamus-related intrinsic connectivity is altered in lifelong PE patients.
To investigate abnormal intrinsic connectivity of the hypothalamus in lifelong PE patients compared with healthy controls (HCs).
Prospective pilot study using cross-sectional data of patients and HCs.
Forty-seven lifelong PE patients and 30 HCs were included in this study.
FIELD STRENGTH/SEQUENCE: 3.0T MRI scanner for T -weighted imaging using spoiled gradient recalled echo sequence and functional imaging using a single-shot gradient recalled echo sequence.
Preprocessing of MRI data and hypothalamus-seeded functional connectivity (FC) computation were performed using DPABI4.1.
The two-sample t-test within SPM12 was adopted to examine possible alterations of intrinsic connectivity of hypothalamus in lifelong PE patients compared with HCs including anxiety and depression scores as covariates (false discovery rate-corrected, P < 0.05). The correlation analysis was then used to assess possible associations between the imaging findings and clinical features in the patient group (Bonferroni-corrected, P < 0.05).
Compared with HCs, lifelong PE patients had decreased hypothalamus-seeded FC in the left orbitofrontal cortex, bilateral insula, superior temporal cortex, superior temporal pole, middle temporal cortex, left fusiform, right parahippocampal gyrus, and right cerebellum. The intravaginal ejaculatory latency time positively correlated with the mean z-score from the hypothalamus-insula (r = 0.45) and hypothalamus-cerebellum (r = 0.48) intrinsic connectivity, separately.
We have shown that hypothalamus-seeded FC alterations and the correlations between the aforementioned abnormal FC alterations and intravaginal ejaculatory latency time. The current findings may promote the understanding of the hypothalamus-related neural mechanisms involved in the abnormal ejaculatory information processing in lifelong PE patients.
1 TECHNICAL EFFICACY STAGE: 3 J. Magn. Reson. Imaging 2020;52:778-784.
终身早泄（PE）作为男性中最常见的性功能障碍之一，常导致患者痛苦。下丘脑参与健康男性的射精控制。然而，我们尚不清楚终身PE患者下丘脑相关的内在连接是否发生改变。
探讨终身PE患者与健康对照（HCs）相比下丘脑的异常内在连接。
使用患者和HCs横断面数据的前瞻性试点研究。
本研究纳入了47例终身PE患者和30例HCs。
场强/序列：使用扰相梯度回波序列进行T加权成像以及使用单次激发梯度回波序列进行功能成像的3.0T MRI扫描仪。
使用DPABI4.1对MRI数据进行预处理并计算以下丘脑为种子点的功能连接（FC）。
采用SPM12中的两样本t检验，以检查终身PE患者与HCs相比下丘脑内在连接的可能改变，将焦虑和抑郁评分作为协变量（错误发现率校正，P < 0.05）。然后进行相关性分析，以评估患者组中影像学表现与临床特征之间的可能关联（Bonferroni校正；P < 0.05）。
与HCs相比，终身PE患者在下述脑区以下丘脑为种子点的FC降低，这些脑区包括左侧眶额皮质、双侧岛叶、颞上叶皮质、颞上极、颞中皮质、左侧梭状回、右侧海马旁回和右侧小脑。阴道内射精潜伏期分别与下丘脑-岛叶（r = 0.45）和下丘脑-小脑（r = 0.48）内在连接的平均z分数呈正相关。
我们已经表明了以下丘脑为种子点的FC改变以及上述异常FC改变与阴道内射精潜伏期之间的相关性。目前的研究结果可能有助于增进对终身PE患者射精信息处理异常中下丘脑相关神经机制的理解。
1 技术效能阶段：3 《磁共振成像杂志》2020年；52:778 - 784。
