Sexual dysfunction in multiple sclerosis: a MRI, neurophysiological and urodynamic study.
We studied 31 patients with relapsing-remitting (RR) multiple sclerosis (MS) in which we performed an urodynamic study, the pudendal cortical evoked potentials, the tibial cortical evoked potentials and the cranial and cervical spinal cord magnetic resonance imaging (MRI). We calculated the T(1) and T(2) lesion load (LL) and brain parenchymal fraction (BPF) of whole brain, frontal lobes, pons and cervical spinal cord. We also estimated the cross-sectional area at C(2) level. Spearman's rank correlation analysis showed a relationship between symptoms of sexual dysfunction and age (r=0.73, p<0.0001), cognitive performances (r=-0.63, p<0.0001), level of independence (r=-0.63, p<0.0001), disability (r=0.56, p<0.001), symptoms of anxiety (r=0.55, p<0.001) and depression (r=0.50, p<0.005), disease duration (r=0.42, p<0.02) and parenchymal atrophy in the pons (r=-0.38, p=0.031). Sexual dysfunction was not correlated with any other MRI measure, urodynamic patterns or cortical evoked potentials. In multiple regression analysis, sexual dysfunction was predicted only by T(1) lesion load of the pons. In conclusion, we confirmed previous correlations of sexual dysfunction with various clinical variables and demonstrated an association between sexual dysfunction and destructive lesions in the pons, as detected by MRI, in patients with relapsing-remitting multiple sclerosis.
Department of Clinical Medicine and Neurology, University of Trieste, Cattinara Hospital, Strada di Fiume, 447-34149 Trieste, Italy.
Robert
R
Zivadinov
Marino
M
Zorzon
Laura
L
Locatelli
Barbara
B
Stival
Fabrizio
F
Monti
Davide
D
Nasuelli
Maria Antonietta
MA
Tommasi
Alessio
A
Bratina
Giuseppe
G
Cazzato
D000328:Adult; D001921:Brain / Q000473:pathology; D004185:Disability Evaluation; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008609:Mental Status Schedule / Q000706:statistics & numerical data; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000150:complications*; D009482:Neurophysiology; D009483:Neuropsychological Tests; D012735:Sexual Dysfunction, Physiological / Q000209:etiology*; D013116:Spinal Cord / Q000473:pathology; D001745:Urinary Bladder Diseases; D014563:Urodynamics / Q000502:physiology*