Faculty of Medicine, Department of Nuclear Medicine, University of Cologne, Cologne, Germany.
Faculty of Medicine, Department of Neurology, University of Cologne, Cologne, Germany.
Exp Brain Res. 2022 Aug;240(7-8):2097-2107. doi: 10.1007/s00221-022-06397-5. Epub 2022 Jun 28.
Hypersexuality in medicated patients with PD is caused by an increased influence of motivational drive areas and a decreased influence of inhibitory control areas due to dopaminergic medication. In this pilot study, we test a newly developed paradigm investigating the influence of dopaminergic medication on brain activation elicited by sexual pictures with and without inhibitory contextual framing. Twenty PD patients with and without hypersexuality were examined with fMRI either OFF or ON standardized dopaminergic medication. The paradigm consisted of a priming phase where either a neutral context or an inhibitory context was presented. This priming phase was either followed by a sexual or a neutral target. Sexual, compared to neutral pictures resulted in a BOLD activation of various brain regions implicated in sexual processing. Hypersexual PD patients showed increased activity compared to PD controls in these regions. There was no relevant effect of medication between the two groups. The inhibitory context elicited less activation in inhibition-related areas in hypersexual PD, but had no influence on the perception of sexual cues. The paradigm partially worked: reactivity of motivational brain areas to sexual cues was increased in hypersexual PD and inhibitory contextual framing lead to decreased activation of inhibitory control areas in PD. We could not find a medication effect and the length of the inhibitory stimulus was not optimal to suppress reactivity to sexual cues. Our data provide new insights into the mechanisms of hypersexuality and warrant a replication with a greater cohort and an optimized stimulus length in the future.
药物治疗的帕金森病患者的性欲亢进是由于多巴胺能药物增加了动机驱动区域的影响，降低了抑制控制区域的影响。在这项初步研究中，我们测试了一种新开发的范式，该范式研究了多巴胺能药物对带有和不带有抑制性语境框架的性图片引起的大脑激活的影响。我们对 20 名伴有或不伴有性欲亢进的帕金森病患者进行了 fMRI 检查，这些患者要么处于停药状态，要么处于标准化多巴胺能药物治疗状态。该范式包括一个启动阶段，在此阶段呈现中性或抑制性语境。该启动阶段之后要么是性目标，要么是中性目标。与中性图片相比，性图片会导致涉及性处理的各种大脑区域的 BOLD 激活。与帕金森病对照组相比，性欲亢进的帕金森病患者在这些区域的活性增加。两组之间没有药物的相关影响。在性欲亢进的帕金森病患者中，抑制性语境在与抑制相关的区域引起的激活较少，但对性线索的感知没有影响。该范式部分有效：性欲亢进的帕金森病患者对性线索的动机大脑区域的反应性增加，而抑制性语境框架导致帕金森病患者抑制控制区域的激活减少。我们没有发现药物的作用，而且抑制性刺激的长度不足以抑制对性线索的反应。我们的数据为性欲亢进的机制提供了新的见解，并需要在未来使用更大的队列和优化的刺激长度进行复制。
