Effects of SCI on Female Sexual Response

描述(申请人提供)：这个项目的长期目标是：1)了解不同程度和水平的脊髓损伤和性功能障碍(SCI/D)对女性性反应的影响：2)确定与女性性反应有关的特定神经元通路；以及3)开发和评估女性神经源性性功能障碍的新评估和治疗方法。在这个项目中，我们计划以我们在女性脊髓损伤患者中的发现为基础，研究继发于多发性硬化症(MS)的女性SCD患者的性反应。我们将研究患有多发性硬化症的女性的性唤起和性高潮，看看是否可以根据SCD的范围和位置来记录与SCI女性类似的影响。我们将通过研究大鼠的尿路生殖器(UG)反射模型、脊柱性反射和阴道变化，从解剖学上证实我们的发现。我们将研究双侧腹下、盆腔和阴部神经切断的完整大鼠，以确定交感、副交感和躯体神经系统在调节生殖器唤醒和性高潮中的作用。将进行外周和大脑刺激，以模拟外周和心理起因性刺激。我们还将测试交感神经系统(SNS)的药物操作对SCD女性性唤起的影响，并将测试两种旨在重新训练神经源性FSD女性反射性高潮的治疗方案。我们的中心假设是：1)在女性中，SNS调节心理性生殖器血管充血2)在女性中，高潮反射需要存在完整的骶髓3)在女性中，模式生成器负责高潮反射4)在患有SCIID并保留生殖器交感神经支配的女性中，药物交感神经操作将改变生殖器的反应性，5)在患有神经源性脊柱疾病的女性中，使用阴蒂真空泵和振动刺激将提高性高潮能力。这笔赠款代表了一个由理疗师领导的长期研究团队和一名基础科学家之间的新合作努力，他们都拥有研究神经损伤后女性性反应的丰富经验。这些研究将提供有关SCD对女性性反应的预期影响的信息，以及在大鼠身上对该发现的解剖学证实，并测试神经原性功能障碍的三种治疗方案。

DESCRIPTION (provided by applicant): The long term aims of this project are to: 1) understand the effect of varying degrees and levels of SCI and dysfunction (SCI/D) on female sexual response: 2) identify the specific neuronal pathways involved in female sexual responses; and 3) develop and evaluate new assessment and treatment methods for neurogenic sexual dysfunction in women. In this project, we plan to build upon our findings in women with SCI to study sexual response in human females with SCD secondary to multiple sclerosis (MS). We will study sexual arousal and orgasm in women with MS to see if similar effects as in women with SCIs can be documented based upon the extent and location of their SCD. We will provide anatomical confirmation of our human findings by studying the urethrogenital (UG) reflex model, a spinal sexual reflex and vaginal changes in the rat. We will study rats that are intact, with bilateral hypogastric, pelvic and pudendal nerve cuts in order to determine the contribution of the sympathetic, parasympathetic and somatic nervous system in regulating genital arousal and orgasm. Peripheral and brain stimulation will be performed in order to mimic peripheral and psychogenic sexual stimulation. We will also test the effects of pharmacologic manipulation of the sympathetic nervous system (SNS) on sexual arousal in women with SCD and will test two treatment protocols aimed at retraining reflex orgasm in women with neurogenic FSD. Our central hypotheses are: 1) In females, the SNS regulates psychogenic genital vasocongestion 2) In females the orgasmic reflex requires the presence of an intact sacral spinal cord 3) In females a pattern generator is responsible for the orgasmic reflex 4) In females with SCIID and preserved sympathetic innervation to the genitals, pharmacologic sympathetic manipulation will alter genital responsiveness and 5) In females with neurogenic sexual dysfunction of spinal etiology use of a clitoral vacuum pump and vibratory stimulation will improve orgasmic ability. This grant represents a new collaborative effort between a long-standing research team led by physiatrist and a basic scientist, all with extensive experience studying female sexual response after neurologic lesions. These studies will provide information about the expected impact of SCD on female sexual response along with anatomical confirmation of the findings in the rat and test three treatment protocols for neurogenic sexual dysfunction.