Chen Jian-Huai, Huang Xin-Fei, Dai Li-Qin, Liu Tao, Yao Zhi-Jian, Dai Yu-Tian, Chen Yun
Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, 210029, China.
Department of Psychiatry, Nanjing Brain Hospital, Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
Zhonghua Nan Ke Xue. 2019 Jul;25(7):613-618.
To explore the topological properties of the betweenness centrality of the nodes and edges in the brain white matter network of premature ejaculation (PE) patients and analyze the correlation of the importance of the key brain regions and interregional white matter structural connectivity with the ejaculatory function of the patients.Method: We collected the demographic and clinical data, along with the T1 and MR diffusion tensor imaging (MR-DTI) data, on 18 PE patients and 22 normal controls matched in age, sex and education. After preprocessing of the data obtained, we divided the whole brain into 90 symmetrical cortical and subcortical regions (defined as nodes of the brain network) by automated anatomical labeling, examined the structural connectivity between different brain regions by probabilistic white matter fiber tracking (defined as edges of the brain network), and calculated the betweenness centrality of the nodes and edges using the brain connection toolbox. Then, we performed the Mann-Whitney U test on the betweenness centrality of the nodes and edges, subjected the results to false discovery rate (FDR) correction, and assessed the correlation of the attribute values of between-group differences with the ejaculatory function of the patients.
Compared with the normal controls, the PE patients showed a significantly decreased betweenness centrality of the right superior occipital gyrus (SOG) (281.18 ± 255.26 vs 67.78 ± 58.98, Z = －3.49, FDR-corrected P < 0.05), but increased betweenness centrality of the right superior temporal gyrus (STG) (222.91 ± 155.60 vs 557.00 ± 322.65, Z = 3.55, FDR-corrected P < 0.05) and betweeness centrality of the edge between the right rolandic operculum and right insula (4.23 ± 8.39 vs 23.83 ± 23.91, Z = 3.84, FDR-corrected P < 0.05). The betweenness centrality of the right SOG was correlated negatively with the level of difficulty in delaying ejaculation (r = －0.51, P = 0.03) and the probability of ejaculation before expectation (r= －0.61, P = 0.01), while that of the right STG positively with PE-related frustration (r = 0.54, P = 0.02) and the level of concern about PE-related distress of the partner (r = 0.47, P = 0.04).
Abnormalities of structural connections were found in the visual stimulus- and emotion processing-related regions in the right cerebral hemisphere of PE patients, which might be associated with rapid ejaculation or decreased ejaculation control and lead to a series of psychological problems.
探讨早泄（PE）患者脑白质网络中节点和边的中介中心性的拓扑性质，并分析关键脑区重要性及区域间白质结构连通性与患者射精功能的相关性。
收集18例PE患者及22例年龄、性别和教育程度相匹配的正常对照者的人口统计学和临床数据，以及T1和磁共振扩散张量成像（MR-DTI）数据。对获取的数据进行预处理后，通过自动解剖标记将全脑划分为90个对称的皮质和皮质下区域（定义为脑网络的节点），采用概率性白质纤维追踪检查不同脑区之间的结构连通性（定义为脑网络的边），并使用脑连接工具箱计算节点和边的中介中心性。然后，对节点和边的中介中心性进行曼-惠特尼U检验，对结果进行错误发现率（FDR）校正，并评估组间差异属性值与患者射精功能的相关性。
与正常对照相比，PE患者右侧枕上回（SOG）的中介中心性显著降低（281.18±255.26 vs 67.78±58.98，Z =－3.49，FDR校正P<0.05），但右侧颞上回（STG）的中介中心性增加（222.91±155.60 vs 557.00±322.65，Z = 3.55，FDR校正P<0.05），右侧中央前回盖部与右侧岛叶之间边的中介中心性增加（4.23±8.39 vs 23.83±23.91，Z = 3.84，FDR校正P<0.05）。右侧SOG的中介中心性与延迟射精困难程度呈负相关（r =－0.51，P = 0.03）及预期前射精概率呈负相关（r =－0.61，P = 0.01），而右侧STG的中介中心性与PE相关挫折感呈正相关（r = 0.54，P = 0.02）及与伴侣对PE相关困扰的关注程度呈正相关（r = 0.47，P = 0.04）。
PE患者右侧大脑半球与视觉刺激和情绪处理相关区域存在结构连接异常，这可能与快速射精或射精控制能力下降有关，并导致一系列心理问题。
