Effects of SCI on Female Sexual Response

描述（由申请人提供）：该项目的长期目标是：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)确定女性性反应中涉及的特定神经通路；3)开发和评价新的女性神经源性性功能障碍的评估和治疗方法。在这个项目中，我们计划以我们在SCI女性患者中的发现为基础，研究多发性硬化症（MS）继发SCD女性患者的性反应。我们将研究多发性硬化症女性的性唤起和性高潮，看看是否可以根据SCD的范围和位置记录与sci女性相似的影响。我们将通过研究大鼠的尿道反射模型、脊柱性反射和阴道变化，为我们的人类发现提供解剖学上的证实。为了确定交感神经、副交感神经和躯体神经系统在调节生殖器兴奋和性高潮中的作用，我们将研究双侧腹下神经、盆腔神经和阴部神经被切断的完整大鼠。外周和大脑刺激将被执行，以模仿外周和心因性刺激。我们还将测试交感神经系统（SNS）的药理操作对SCD女性性唤起的影响，并将测试两种治疗方案，旨在再训练神经源性FSD女性反射性高潮。我们的中心假设是：1)在女性中，SNS调节心因性生殖器血管充血2)在女性中，性高潮反射需要完整的骶脊髓存在3)在女性中，模式发生器负责性高潮反射4)在SCIID女性中，保留了对生殖器的交感神经支配。5)对于脊髓性神经性性功能障碍的女性，使用阴蒂真空泵和振动刺激可以提高性高潮能力。这项拨款代表了一个由物理学家和一位基础科学家领导的长期研究小组之间的新合作努力，他们都具有研究神经病变后女性性反应的丰富经验。这些研究将提供关于SCD对女性性反应的预期影响的信息，以及在大鼠中对研究结果的解剖学证实，并测试三种神经源性性功能障碍的治疗方案。

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.