Schwarz Johanna, Gertzen Marcus, Rabenstein Andrea, Straßburger Moritz, Horstmann Alana, Pogarell Oliver, Rüther Tobias, Karch Susanne
Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Germany.
Department of Psychiatry, Psychotherapy, and Psychosomatics, Medical Faculty, University of Augsburg, Augsburg, Germany.
Eur Arch Psychiatry Clin Neurosci. 2025 Feb;275(1):227-240. doi: 10.1007/s00406-024-01856-2. Epub 2024 Jul 6.
Chemsex describes the use of specific substances (methamphetamine, GHB/GBL, mephedrone, ketamine) which initiate or enhance sexual experiences and is mainly prevalent among men who have sex with men. Many Chemsex users experience somatic complications (for example sexually transmitted diseases) and sometimes adverse sociological, psychological, and neurological symptoms, such as depression, impulse control disorders or hypersexuality. Changes in impulsivity and deficits in executive functions have demonstrated to be associated with addiction and impulse control disorders as well as frontal brain dysfunction and behavioral control deficits. This study aims to explore the effects of neurophysiological correlates of inhibition and decision making in Chemsex users with an EEG paradigm using event-related potentials (N2, P3). 15 Chemsex users and 14 matched control subjects, all of them men who have sex with man, participated in an auditory Go/NoGo/Voluntary Selection EEG paradigm. In addition, clinical data (e.g. regarding depression), demographic information as well as measures of well-being and sexual behavior were collected. The results demonstrated that clinical symptoms, hypersexuality, and sexual risk behavior were more pronounced in Chemsex users compared to non-users. P3 amplitudes did not differ significantly between groups. However, the Chemsex users showed decreased electrophysiological N2 responses in fronto-central brain regions during decision-making, indicating compromised executive function and inhibitory control. The observed impairments may lead to increased risk behavior regarding drug abuse and hypersexuality. Understanding the neurobiological mechanisms can contribute to targeted interventions in order to mitigate the negative consequences of engaging in Chemsex and improve general well-being.
化学性行为描述的是使用特定物质（甲基苯丙胺、γ-羟基丁酸/γ-丁内酯、甲麻黄碱、氯胺酮）来引发或增强性体验，这种行为主要在男同性恋者中盛行。许多化学性行为使用者会出现躯体并发症（例如性传播疾病），有时还会出现不良的社会学、心理学和神经学症状，如抑郁、冲动控制障碍或性欲亢进。冲动性的改变和执行功能缺陷已被证明与成瘾、冲动控制障碍以及额叶脑功能障碍和行为控制缺陷有关。本研究旨在使用事件相关电位（N2、P3）的脑电图范式，探讨化学性行为使用者中抑制和决策的神经生理相关性的影响。15名化学性行为使用者和14名匹配的对照受试者，均为男同性恋者，参与了听觉Go/NoGo/自愿选择脑电图范式。此外，还收集了临床数据（例如关于抑郁的）、人口统计学信息以及幸福感和性行为的测量数据。结果表明，与非使用者相比，化学性行为使用者的临床症状、性欲亢进和性风险行为更为明显。两组之间的P3波幅没有显著差异。然而，化学性行为使用者在决策过程中额中央脑区的电生理N2反应降低，表明执行功能和抑制控制受损。观察到的损伤可能导致药物滥用和性欲亢进方面的风险行为增加。了解神经生物学机制有助于进行有针对性的干预，以减轻从事化学性行为的负面后果并改善总体幸福感。
