1Department of Psychiatry, Social Psychiatry and Psychotherapy, Division of Clinical Psychology and Sexual Medicine, Hannover Medical School, Hannover, Germany.
2Center for Systems Neuroscience, Hanover, Germany.
J Behav Addict. 2023 Oct 24;12(4):1032-1045. doi: 10.1556/2006.2023.00056. Print 2023 Dec 22.
Compulsive Sexual Behavior Disorder (CSBD) is a new category in ICD-11. Research examining underlying brain mechanisms is sparse. Research into neurobiological differences can be helpful in advancing the possibilities of new diagnostic approaches and therapeutic methods. The present study aimed to examine brain matter volume and resting state functional connectivity (rs-FC) in CSBD.
Structural and rs-FC magnetic resonance imaging and data from questionnaires were collected in 30 men with CSBD and 32 age- and education-matched controls. Whole brain voxel based morphometry (VBM) and seed based rs-FC in a-priori defined seeds were analyzed.
Structural analyses showed that men with CSBD had significantly increased gray matter volume in the right cerebellum, middle occipital and superior frontal lobe. No differences in rs-FC could be detected when using these brain structures as seed regions in rs-FC. In contrast, literature based rs-FC analysis revealed decreased rs-FC between the right orbital middle frontal cortex (mOFC) and the right gyrus rectus, as well as between left pallidum and right post/precentral gyrus in men with CSBD. In the left amygdala we observed increased rs-FC with precuneus in this group. In addition, most of these measures correlated with symptom severity.
Structural findings may underscore the idea that the cerebellum plays an important role in sexual arousal and CSBD. Perhaps, a simultaneous activation of the left amygdala and the precuneus reflects a constant sexual occupation of men with CSBD. Furthermore, lower connectivity between mOFC and gyrus rectus in CSBD may support the assumption that sexual stimuli are evaluated more positively because inhibition is decreased.
强迫性性行为障碍（CSBD）是 ICD-11 中的一个新类别。研究检查潜在的大脑机制的研究很少。对神经生物学差异的研究有助于推进新的诊断方法和治疗方法的可能性。本研究旨在检查 CSBD 中的脑物质体积和静息状态功能连接（rs-FC）。
在 30 名 CSBD 男性和 32 名年龄和教育程度匹配的对照中收集了结构和 rs-FC 磁共振成像和问卷调查数据。对全脑体素形态计量学（VBM）和预先定义种子的基于种子的 rs-FC 进行了分析。
结构分析表明，CSBD 男性的右侧小脑、中枕叶和额上回的灰质体积明显增加。当使用这些大脑结构作为 rs-FC 的种子区域时，无法检测到 rs-FC 的差异。相比之下，基于文献的 rs-FC 分析显示，CSBD 男性的右侧眶额中回（mOFC）和右侧直回以及左侧苍白球和右侧额/中央前回之间的 rs-FC 降低。在左侧杏仁核中，我们观察到该组与楔前叶的 rs-FC 增加。此外，这些测量值中的大多数与症状严重程度相关。
结构发现可能强调小脑在性唤起和 CSBD 中起着重要作用的观点。也许，左杏仁核和楔前叶的同时激活反映了 CSBD 男性不断的性占据。此外，CSBD 中 mOFC 和直回之间的连接降低可能支持这样的假设，即由于抑制降低，性刺激被评估得更积极。
