Feng Nana, Gao Ming, Wu Jiayu, Yang Guang, Piao Ruiqing, Liu Peng
Life Science Research Center, School of Life Science and Technology, Xidian University, Xi'an, China.
Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, China.
Quant Imaging Med Surg. 2021 Jul;11(7):3234-3243. doi: 10.21037/qims-20-1103.
Lifelong premature ejaculation (PE) is one common male sexual dysfunction and is implicated in widespread structural and functional abnormalities of bilateral hemispheres. However, whether the inter-hemisphere functional connectivity (FC) of lifelong PE patients was altered still remain unclear.
Thirty-four lifelong PE patients and 30 healthy controls (HCs) were enrolled in this study and all underwent T1-weighted and resting-state functional MRI (fMRI) scan. The voxel-mirrored homotopic connectivity (VMHC) measure and independent sample -test were applied to examine the alterations of VMHC values in the patients relative to HCs with the significant threshold at P<0.05, false discovery rates corrected. Correlation analysis was adopted to calculate the relationships between the imaging results and clinical characteristics of patients (P<0.05, Bonferroni corrected). Receiver operating characteristic (ROC) curve analysis was performed to investigate the possible biomarkers for distinguishing the patients from the HCs using the VMHC values of inter-group differences.
The results revealed that compared with HCs, lifelong PE patients had higher VMHC values in the precentral gyrus (PG), primary somatosensory cortex (S1), supplementary motor area (SMA), precuneus, middle temporal cortex (MTC), superior temporal pole (STP), thalamus, caudate and middle cingulate cortex (MCC). Correlation analysis showed that the mean VMHC values in the S1 negatively correlated with intravaginal ejaculation latency time (IELT) in the patient group. Furthermore, the caudate revealed the well classification power from the ROC analysis.
The present study showed the abnormal inter-hemisphere interaction and integration of information involved in ejaculation inhibitory control, sensorimotor mediation and self-reference processing including the thalamus, caudate, MCC, widespread parietal cortex and temporal cortex in lifelong PE patients compared with HCs. Correlation analysis and ROC analysis revealed the importance of S1 and caudate in lifelong PE. Notably, the ROC result of caudate might show the core roles of caudate played in the pathophysiology of lifelong PE.
终生早泄（PE）是一种常见的男性性功能障碍，与双侧半球广泛的结构和功能异常有关。然而，终生PE患者的半球间功能连接（FC）是否改变仍不清楚。
本研究纳入了34例终生PE患者和30名健康对照者（HCs），所有受试者均接受了T1加权和静息态功能磁共振成像（fMRI）扫描。采用体素镜像同伦连接（VMHC）测量和独立样本检验，以P<0.05为显著阈值（经错误发现率校正），检查患者相对于HCs的VMHC值的变化。采用相关分析计算成像结果与患者临床特征之间的关系（P<0.05，经Bonferroni校正）。进行受试者工作特征（ROC）曲线分析，以研究使用组间差异的VMHC值区分患者与HCs的可能生物标志物。
结果显示，与HCs相比，终生PE患者在中央前回（PG）、初级躯体感觉皮层（S1）、辅助运动区（SMA）楔前叶、颞中皮层（MTC）、颞上极（STP）、丘脑、尾状核和扣带中部皮层（MCC）的VMHC值更高。相关分析表明，患者组S中的平均VMHC值与阴道内射精潜伏期（IELT）呈负相关。此外，尾状核在ROC分析中显示出良好的分类能力。
本研究表明，与HCs相比，终生PE患者在射精抑制控制、感觉运动调节和自我参照处理（包括丘脑、尾状核、MCC、广泛的顶叶皮层和颞叶皮层）中涉及的半球间信息交互和整合异常。相关分析和ROC分析揭示了S1和尾状核在终生PE中的重要性。值得注意的是，尾状核的ROC结果可能显示了尾状核在终生PE病理生理学中所起的核心作用。
