PHYSIOLOGIC EFFECTS OF SCI ON FEMALE SEXUAL RESPONSE

该项目代表了第一个也是唯一的实验室对照研究， 脊髓损伤（SCI）妇女的生理性功能， 将提供有关SCI和女性性行为的知识基础 反应 四个长期目标包括：（1）了解影响 不同程度和水平的SCI对女性性反应的影响;（2） 确定参与性反应的特定神经元通路， （3）开发新的治疗方法，以改善 SCI女性的性满意度;（4）通过增加 对性活动的满意度，增加性生活的频率 性交，从而增加SCI妇女的生育能力。 30名受伤程度在T6或以上的女性SCI患者， 影响骶骨脊髓的运动神经元功能障碍将包括 实验对象。 10名年龄种族 和社会经济地位将组成对照组。 全面 神经学、神经生理学和性心理学评估，以确定 将对所有受试者进行发病前和SCI后的功能测试。 受试者将根据感知能力的存在进行分组 针刺感在T11 - L2皮节，并将经历三个 实验方案：（1）手动刺激-以确定生理 对孤立反射性生殖器刺激的性反应;（2）性高潮- 决定伴随性高潮的自主神经和生殖器反应 包括性活动中自主神经反射障碍的发生率 （3）视力和体力 刺激-以确定生理性反应，以孤立的 心因性刺激和心因性与反射性复合刺激 刺激. 此外，高血压治疗方案将评估 2%硝酸甘油软膏改善皮肤病的效果 脊髓损伤妇女与性刺激相关的反射障碍反应。 结果将有助于确定神经系统程度和 脊柱损伤伴心理和生理性反应的模式 包括保护特定类型的润滑。 结果将 用于开发性功能障碍性SCI的治疗方法 妇女和划定，必要的神经通路， 反射和心因性阴道反应。

This project represents the first and only laboratory controlled study of physiological sexual functioning in spinal cord injured (SCI) women and will provide a foundation of knowledge about SCI and female sexual response. The four long-term aims include: (1) to understand the effects of varying degrees and levels of SCI on female sexual response; (2) to identify the specific neuronal pathways involved in sexual response in able-bodied females; (3) to develop new treatment methods to improve sexual satisfaction in SCI females; and (4) through increased satisfaction with sexual activity, to increase the frequency of sexual intercourse thereby increasing the childbearing capacity of SCI women. Thirty SCI females with injuries at or above the level of T6 with upper motor neuron dysfunction affecting the sacral spinal cord will comprise the experimental subjects. Ten able-bodied females matched on age, race and socioeconomic status will comprise the control group. Comprehensive neurologic, neurophysiologic and psychosexual evaluations to determine pre-morbid and post-SCI functioning will be performed on all subjects. Subjects will be grouped based on the presence of the ability to perceive pin prick sensation in the T11 - L2 dermatomes and will undergo three experimental protocols: (1) Manual Stimulation - to determine physiologic sexual responses to isolated reflex genital stimulation; (2) Orgasm - to determine the autonomic and genital responses accompanying orgasm including the incidence of autonomic dysreflexia during sexual activity in women with injures above the level of T6; and (3) Visual and Manual Stimulation - to determine the physiologic sexual responses to isolated psychogenic stimulation and combined psychogenic and reflexogenic stimulation. In addition, a hypertensive treatment protocol will assess the efficacy of nitroglycerin 2 % ointment in the amelioration of the dysreflexic response associated with sexual stimulation in SCI women. Results will help determine the association between neurologic degree and pattern of spinal injury with psychological and physical sexual responses including preservation of specific types of lubrication. Results will be useful in developing treatment methods for sexually dysfunctional SCI women and for delineation, of the neurologic pathways necessary for reflex and psychogenic vaginal responses.