Department of Urology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Radiology, The Yancheng School of Clinical Medicine of Nanjing Medical University, Yancheng, Jiangsu, China.
J Sex Med. 2021 Feb;18(2):275-283. doi: 10.1016/j.jsxm.2020.11.014. Epub 2020 Dec 24.
Although some recent neuroimaging studies have indicated the abnormal brain structure or function in patients with lifelong premature ejaculation (LPE), whether and how the abnormal thalamic function participates in processing sexual behavioral information are still unclear in patients with LPE.
The aim of this study was to assess the changes in the thalamus metabolism and structural integrity in patients with LPE.
We performed a multimodal magnetic resonance approach in a 3.0 T system, including proton magnetic resonance spectroscopy (H-MRS), diffusion tensor imaging, and volumetric analysis to detect the differences in thalamic metabolism and structure between 20 patients with LPE and 15 healthy controls.
We analyzed and correlated the clinical symptoms of the subjects with significant H-MRS-based features. Peak areas of N-acetylaspartate, choline, creatine (Cr), and glutamate/glutamine (Glu) were calculated with the LCModel software.
Diffusion tensor imaging and volumetric analysis of thalami showed no differences between the 2 groups. On the contrary, H-MRS study disclosed that both Glu concentrations and Glu/Cr ratio values in the thalami of patients with LPE were remarkably increased when compared with healthy controls (P < .01 for both variables). In addition, both the intravaginal ejaculatory latency time score and Chinese Index of Sexual Function for Premature Ejaculation-5 score were negatively related to increased Glu concentrations and Glu/Cr ratio values.
Glutamatergic activity changes of thalamus may be an underlying indicator for evaluating sensory conduction efficiency in patients with LPE.
STRENGTHS & LIMITATIONS: The present study first found the abnormal thalamic metabolism in patients with LPE and contributed to a better understanding of the LPE etiology. Limitations include a cross-sectional study design with small samples and no examination of other brain areas.
Our findings show that the increase in glutamatergic activity of thalamus is related to LPE, suggesting that the increased Glu neurotransmission in the thalamus may contribute to the development of premature ejaculation. Xia J-D, Chen F, Zhang Q-J, et al. Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation. J Sex Med 2021;18:275-283.
尽管一些最近的神经影像学研究表明，终身性早泄（LPE）患者存在异常的大脑结构或功能，但 LPE 患者的异常丘脑功能如何参与处理性行为信息仍不清楚。
本研究旨在评估 LPE 患者丘脑代谢和结构完整性的变化。
我们在 3.0T 系统中采用了多模态磁共振方法，包括质子磁共振波谱（H-MRS）、弥散张量成像和容积分析，以检测 20 例 LPE 患者和 15 例健康对照者之间丘脑代谢和结构的差异。
我们分析并将受试者的临床症状与基于 H-MRS 的显著特征相关联。使用 LCModel 软件计算 N-乙酰天冬氨酸、胆碱、肌酸（Cr）和谷氨酸/谷氨酰胺（Glu）的峰面积。
丘脑的弥散张量成像和容积分析显示两组之间没有差异。相反，H-MRS 研究显示，与健康对照组相比，LPE 患者丘脑的 Glu 浓度和 Glu/Cr 比值显著升高（两个变量的 P 值均<.01）。此外，阴道内射精潜伏期评分和中国早泄指数-5 评分均与 Glu 浓度和 Glu/Cr 比值的增加呈负相关。
丘脑谷氨酸能活动的变化可能是评估 LPE 患者感觉传导效率的潜在指标。
本研究首次发现 LPE 患者丘脑代谢异常，并有助于更好地了解 LPE 的病因。局限性包括样本量小且未检查其他脑区的横断面研究设计。
我们的研究结果表明，丘脑谷氨酸能活性的增加与 LPE 有关，提示丘脑内 Glu 神经传递的增加可能导致早泄的发生。
