PHYSIOLOGIC EFFECTS OF SCI ON FEMALE SEXUAL RESPONSE

该项目是第一个也是唯一一个实验室对照研究 脊髓损伤(SCI)妇女的生理性性功能和 将提供有关脊髓损伤和女性性行为的知识基础 回应。四个长期目标包括：(1)了解影响 不同程度和水平的脊髓损伤对女性性反应的影响； 确定与性反应有关的特定神经元通路 健全女性；(3)开发新的治疗方法，以改善 脊髓损伤女性的性满意度；以及(4)通过增加 对性行为的满意度，以增加性行为的频率 性交，从而提高脊髓损伤妇女的生育能力。 30例女性脊髓损伤，损伤程度在T6或以上，并有上 影响骶髓的运动神经元功能障碍将包括 实验对象。十名身体健全的女性在年龄、种族上相匹配 而社会经济地位将构成控制组。全面 神经学、神经生理学和性心理评估以确定 将对所有受试者进行发病前和脊髓损伤后的功能检查。 受试者将根据感知能力的存在进行分组 T11-L2皮肤体有针刺感，将经历三次 实验方案：(1)人工刺激--测定生理学 对孤立反射生殖器刺激的性反应；(2)性高潮--至 确定伴随性高潮的自主神经和生殖器反应 包括性行为期间自主神经反射障碍的发生率 损伤水平高于T6的女性；和(3)视觉和手动 刺激--确定对隔离的生理性反应 心因性刺激与心因性与反身性结合 刺激。此外，高血压治疗方案将评估 2%硝酸甘油软膏改善牙周炎的疗效观察 脊髓损伤女性与性刺激相关的反射障碍反应。 结果将有助于确定神经学程度和 伴有心理和生理性反应的脊柱损伤类型 包括保存特定类型的润滑。结果将是 有助于开发性功能障碍脊髓损伤的治疗方法 妇女和描绘，所需的神经学途径 反射和心理性阴道反应。

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.