Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.
Women's Hospital of Nanjing Medical University, Nanjing Maternity and Child Health Care Hospital, Nanjing, China.
Andrology. 2021 Jan;9(1):277-287. doi: 10.1111/andr.12914. Epub 2020 Nov 11.
Hyperactivity of the sympathetic nervous system is considered as an important component involved in the pathological mechanisms of premature ejaculation (PE). However, the neural mechanisms of PE with high sympathetic activity are still not well understood.
The activity of the sympathetic innervations in the penis was evaluated by the sympathetic skin response of the penis (PSSR) with an electromyograph and evoked potential equipment. Resting-state functional magnetic resonance imaging (fMRI) data were acquired from 18 PE patients with high sympathetic activity (sPE), 17 PE patients with normal sympathetic activity (nsPE), and 24 healthy controls (HC). We investigated the neural basis of sPE based on the measure of regional homogeneity (ReHo). Moreover, the correlations between brain regions with altered ReHo and PEDT scores and PSSR latencies in the patient group were explored.
Altered ReHo values among three groups were found in the temporal, cingulated, and parietal cortex in the default mode network (DMN), as well as the temporal cortex in the auditory network (AUD). Compared with HC, Patients with sPE had increased ReHo values of brain regions in DMN, AUD, and decreased ReHo values of brain regions in DMN. In addition, increased ReHo values were found in DMN of patients with nsPE, while decreased ReHo values were found in DMN and the attention network (AN). Moreover, sPE patients had increased ReHo values in AUD and decreased ReHo values in DMN when compared with nsPE patients. Finally, altered ReHo values of brain regions in DMN and AUD were associated with PEDT scores and PSSR latencies in the patient group.
Our results suggested that PE patients had abnormal ReHo values in DMN, AUD, and AN. Patients with sPE were characterized by increased neuronal activity in AUD and decreased activity in DMN. This highlighted the significances of DMN, AUD, and AN in the pathophysiology of PE and also provided potential neuroimaging biomarkers for distinguishing sPE from nsPE and HC.
交感神经系统的过度活跃被认为是早泄（PE）病理机制的一个重要组成部分。然而，高交感活性的 PE 的神经机制仍未被很好地理解。
使用肌电图和诱发电位设备评估阴茎交感神经支配的活动，通过阴茎交感皮肤反应（PSSR）进行评估。从 18 名高交感活性的 PE 患者（sPE）、17 名交感活性正常的 PE 患者（nsPE）和 24 名健康对照者（HC）中采集静息态功能磁共振成像（fMRI）数据。我们基于局部一致性（ReHo）测量，研究 sPE 的神经基础。此外，还探讨了患者组中改变的 ReHo 值与 PEDT 评分和 PSSR 潜伏期之间的相关性。
在默认模式网络（DMN）的颞叶、扣带和顶叶皮质以及听觉网络（AUD）的颞叶皮质中，三组之间存在改变的 ReHo 值。与 HC 相比，sPE 患者的 DMN、AUD 中的脑区 ReHo 值增加，DMN 中的脑区 ReHo 值降低。此外，nsPE 患者的 DMN 中发现了 ReHo 值增加，DMN 和注意网络（AN）中发现了 ReHo 值降低。此外，与 nsPE 患者相比，sPE 患者的 AUD 中 ReHo 值增加，DMN 中 ReHo 值降低。最后，DMN 和 AUD 中脑区的改变的 ReHo 值与患者组的 PEDT 评分和 PSSR 潜伏期相关。
我们的结果表明，PE 患者的 DMN、AUD 和 AN 中存在异常的 ReHo 值。sPE 患者的特征是 AUD 中的神经元活动增加，DMN 中的活动减少。这强调了 DMN、AUD 和 AN 在 PE 病理生理学中的重要性，并为区分 sPE 与 nsPE 和 HC 提供了潜在的神经影像学生物标志物。
