Effects of SCI on Female Sexual Response

描述（由申请人提供）：本项目的长期目标是：1）了解不同程度和水平的SCI和功能障碍（SCI/D）对女性性反应的影响; 2）确定参与女性性反应的特定神经元通路; 3）开发和评估女性神经源性功能障碍的新评估和治疗方法。 在这个项目中，我们计划建立在我们的研究结果，在女性SCI研究人类女性SCD继发于多发性硬化症（MS）的性反应。 我们将研究MS女性的性唤起和性高潮，看看是否可以根据SCD的程度和位置记录与SCI女性相似的效果。我们将通过研究大鼠的尿道生殖器（UG）反射模型、脊髓性反射和阴道变化，为我们的人类研究结果提供解剖学证实。 我们将研究大鼠是完整的，双侧腹下，骨盆和阴部神经切断，以确定交感神经，副交感神经和躯体神经系统在调节生殖器的觉醒和性高潮的贡献。将进行外周和大脑刺激，以模拟外周和心因性刺激。我们还将测试交感神经系统（SNS）的药理学操作对SCD女性性唤起的影响，并将测试两种治疗方案，旨在重新训练神经源性FSD女性的反射性高潮。我们的主要假设是：1）在女性中，SNS调节心因性生殖器血管充血2）在女性中，高潮反射需要存在完整的骶骨脊髓3）在女性中，模式发生器负责高潮反射4）在患有SCIID和保留交感神经支配生殖器的女性中，药理交感神经操纵将改变生殖器的反应性和5）在患有神经性性功能障碍的女性中，使用阴蒂真空泵和振动刺激可以提高性高潮能力。 这项资助代表了一个由理疗师和基础科学家领导的长期研究团队之间的新的合作努力，他们都具有研究神经病变后女性性反应的丰富经验。 这些研究将提供SCD对雌性性反应的预期影响的信息，沿着大鼠中发现的解剖学确认，并测试神经源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.