Variation in Brain Subcortical Network Topology Between Men With and Without PE: A Diffusion Tensor Imaging Study.
INTRODUCTION
Premature ejaculation (PE) is a highly prevalent male sexual dysfunction. Previous studies have found abnormal activity in the sympathetic nervous system and penile sensory pathway of PE. Few studies have investigated the neural mechanisms underlying PE.


AIM
The aim of this study was to examine whether the altered cortico-subcortical network topological properties of the brain white matter structural network could be used to differentiate patients with PE from healthy control (HC) subjects.


METHODS
Diffusion tensor images data were collected from 32 patients with PE and 35 HC participants. Then, brain white matter structural networks were reconstructed from image acquisition.


MAIN OUTCOME MEASURE
Furthermore, nodal measures were calculated and hub regions were identified using the graph-theoretical methods.


RESULTS
For cortical brain regions, increased strength, global efficiency, and decreased shortest path length were found in the right superior frontal gyrus (medial), and superior frontal gyrus (medial orbital) were found in patients with PE. In addition, patients with PE also showed decreased strength in the right rolandic operculum and decreased shortest path length, and increased global efficiency in the right inferior frontal gyrus (triangular part). For subcortical brain structures, patients with PE were associated with decreased shortest path length and increased global efficiency in the left insula and right caudate nucleus. Finally, the results showed that 9 PE-specific hub regions were identified in patients compared with HCs, including 7 cortical regions and 2 subcortical regions.


CLINICAL IMPLICATIONS
Our results provide new understanding about the pathology of PE and enhances the understanding of PE pathology.


STRENGTH & LIMITATIONS
Our results offer biological markers for understanding the physiopathology of PE. However, our study is a cross-sectional design, longitudinal design studies need to explore the causal relationships between aberrant topological characteristics and PE.


CONCLUSION
Our results provide new insights into the neural mechanism of PE involving cortico-subcortical network changes, which could serve as a potential biomarker to differentiate individuals with PE from HCs. Chen J, Yang J, Huang X, et al. Variation in Brain Subcortical Network Topology Between Men With and Without PE: A Diffusion Tensor Imaging Study. J Sex Med 2020;17:48-59.
['Chen|Jianhuai|J|', 'Yang|Jie|J|', 'Huang|Xinfei|X|', 'Lu|Chao|C|', 'Liu|Shaowei|S|', 'Dai|Yutian|Y|', 'Yao|Zhijian|Z|', 'Chen|Yun|Y|', 'Yu|Min|M|']
D000328:Adult D001921:Brain D003430:Cross-Sectional Studies D056324:Diffusion Tensor Imaging D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D061686:Premature Ejaculation D066127:White Matter D055815:Young Adult
Diffusion Tensor Imaging Premature Ejaculation Cortico-Subcortical Network Graph Theoretical Analysis