Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the Vagus nerves
Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the Vagus nerves
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DOI：
10.1016/j.brainres.2004.07.029
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发表时间：
2004-10-22
期刊：
影响因子：
2.9
通讯作者：
Mosier, K
中科院分区：
文献类型：
--
作者：
Komisaruk, BR;Whipple, B;Mosier, K
在T10或以上诊断为完全性脊髓损伤（SCI）的女性报告阴道-颈部知觉意识。为了测试是否迷走神经，绕过脊髓，提供传入通路的这种反应，我们假设，延髓的孤束核（NTS）区域，迷走神经的项目，被激活的阴道颈部自我刺激（CSS）在这样的妇女，可视化功能磁共振成像（fMRI）。局部血氧水平依赖（BOLD）信号强度在CSS和其他运动和感觉程序，使用统计参数映射（SPM）分析与头部运动伪影校正成像。物理治疗检查和MRI确定了脊髓损伤的位置和程度。为了划分NTS，味觉刺激和手部运动分别被用来激活NTS的上级区域和NTS的下部区域相邻的楔状核。4名脊髓中断或“完全”损伤（ASIA标准）的女性和1名严重但“不完全”SCI的女性，均在T10或以上，在CSS期间显示NTS下部区域激活。在CSS期间，每个女性都表现出镇痛，在手指处测量，证实了先前的发现。三个女人在CSS期间经历了性高潮。在高潮期间表现出激活的大脑区域包括下丘脑室旁核、内侧杏仁核、前扣带回、额叶、顶叶和岛叶皮质以及小脑。我们的结论是迷走神经提供了一个脊髓旁路途径阴道颈敏感性的妇女完全脊髓损伤以上的水平进入脊髓的已知genitospinal神经。(C)2004 Elsevier B. V.保留所有权利。
Women diagnosed with complete spinal cord injury (SCI) at T10 or above report vaginal-cervical perceptual awareness. To test whether the Vagus nerves, which bypass the spinal cord, provide the afferent pathway for this response, we hypothesized that the Nucleus Tractus Solitarii (NTS) region of the medulla oblongata, to which the Vagus nerves project, is activated by vaginal-cervical self-stimulation (CSS) in such women, as visualized by functional magnetic resonance imaging (fMRI). Regional blood oxygen level-dependent (BOLD) signal intensity was imaged during CSS and other motor and sensory procedures, using statistical parametric mapping (SPM) analysis with head motion artifact correction. Physiatric examination and MRI established the location and extent of spinal cord injury. In order to demarcate the NTS, a gustatory stimulus and hand movement were used to activate the superior region of the NTS and the Nucleus Cuneatus adjacent to the inferior region of the NTS, respectively. Each of four women with interruption, or "complete" injury, of the spinal cord (ASIA criteria), and one woman with significant, but "incomplete" SCI, all at or above T10, showed activation of the inferior region of the NTS during CSS. Each woman showed analgesia, measured at the fingers, during CSS, confirming previous findings. Three women experienced orgasm during the CSS. The brain regions that showed activation during the orgasms included hypothalamic paraventricular nucleus, medial amygdala, anterior cingulate, frontal, parietal, and insular cortices, and cerebellum. We conclude that the Vagus nerves provide a spinal cord-bypass pathway for vaginal-cervical sensibility in women with complete spinal cord injury above the level of entry into spinal cord of the known genitospinal nerves. (C) 2004 Elsevier B.V. All rights reserved.