Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation.
Abnormal Thalamic Metabolism in Patients With Lifelong Premature Ejaculation.
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DOI：
10.1016/j.jsxm.2020.11.014
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发表时间：
2020-12
期刊：
影响因子：
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通讯作者：
Jiadong Xia;Fei Chen;Qi-Jie Zhang;Ya-min Wang;Yutian Dai;N. Song;Zeng-jun Wang;Bing Zhang;Jie Yang
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文献类型：
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作者：
Jiadong Xia;Fei Chen;Qi-Jie Zhang;Ya-min Wang;Yutian Dai;N. Song;Zeng-jun Wang;Bing Zhang;Jie Yang
研究背景虽然最近的一些神经影像学研究表明终身早泄（LPE）患者的大脑结构或功能异常，丘脑功能异常是否以及如何参与LPE患者性行为信息的处理尚不清楚，目的本研究旨在评估LPE患者丘脑代谢和结构完整性的变化。采用3.0T磁共振成像系统，包括质子磁共振波谱（1H-MRS）、弥散张量成像和容积分析，检测20例LPE患者和15例健康对照者丘脑代谢和结构的差异。用LCModel软件计算N-乙酰天冬氨酸、胆碱、肌酸（Cr）和谷氨酸/谷氨酰胺（Glu）的峰面积。1H-MRS研究显示LPE患者丘脑Glu浓度和Glu/Cr比值均显著高于健康对照组（P<0.01）。此外，本发明还提供了一种方法，阴道射精潜伏时间评分和中国早泄性功能指数-5评分均与Glu浓度和Glu/Cr比值呈负相关。临床意义丘脑谷氨酸能活性变化可能是评价LPE患者感觉传导效率的潜在指标。本研究首次发现LPE患者存在丘脑代谢异常，有助于更好地了解LPE的病因。局限性包括一个横截面的研究设计，小样本，没有检查其他脑areas. CONCLUSION我们的研究结果表明，丘脑的谷氨酸能活动的增加与LPE，这表明，增加谷氨酸神经传递在丘脑可能有助于早泄的发展。
BackgroundAlthough some recent neuroimaging studies have indicated the abnormal brain structure or function in patients with lifelong premature ejaculation (LPE), whether and how the abnormal thalamic function participates in processing sexual behavioral information are still unclear in patients with LPE.AimThe aim of this study was to assess the changes in the thalamus metabolism and structural integrity in patients with LPE.MethodsWe performed a multimodal magnetic resonance approach in a 3.0 T system, including proton magnetic resonance spectroscopy (1H-MRS), diffusion tensor imaging, and volumetric analysis to detect the differences in thalamic metabolism and structure between 20 patients with LPE and 15 healthy controls.OutcomesWe analyzed and correlated the clinical symptoms of the subjects with significant1H-MRS-based features. Peak areas of N-acetylaspartate, choline, creatine (Cr), and glutamate/glutamine (Glu) were calculated with the LCModel software.RESULTSDiffusion tensor imaging and volumetric analysis of thalami showed no differences between the 2 groups. On the contrary,1H-MRS study disclosed that both Glu concentrations and Glu/Cr ratio values in the thalami of patients with LPE were remarkably increased when compared with healthy controls (P< .01 for both variables). In addition, both the intravaginal ejaculatory latency time score and Chinese Index of Sexual Function for Premature Ejaculation–5 score were negatively related to increased Glu concentrations and Glu/Cr ratio values.Clinical ImplicationsGlutamatergic activity changes of thalamus may be an underlying indicator for evaluating sensory conduction efficiency in patients with LPE.Strengths & LimitationsThe present study first found the abnormal thalamic metabolism in patients with LPE and contributed to a better understanding of the LPE etiology. Limitations include a cross-sectional study design with small samples and no examination of other brain areas.CONCLUSIONOur findings show that the increase in glutamatergic activity of thalamus is related to LPE, suggesting that the increased Glu neurotransmission in the thalamus may contribute to the development of premature ejaculation.