Brain processing of visual sexual stimuli in men with hypoactive sexual desire disorder.
Although hypoactive sexual desire disorder (HSDD) is a common condition and has long been hypothesized to result from malfunctions of the cerebral control mechanisms that adjust the level of sexual motivation, very little is known about the pathophysiology of this disorder. The primary objective was to identify in patients with HSDD brain regions where functional perturbations disrupt the regulation of sexual motivation. We used positron emission tomography to compare seven male patients with HSDD with eight healthy men on their regional cerebral blood flow responses to visual sexual stimuli (VSS) of graded intensity. Statistical Parametric Mapping was used to locate brain regions that demonstrated a differential activation (or deactivation) across the groups. Whereas in control subjects the medial orbitofrontal cortex showed a deactivation in response to VSS, in HSDD patients there was an abnormally maintained activity of this region, which has been implicated in the inhibitory control of motivated behavior. By contrast, the reverse pattern-activation in control subjects, deactivation or unchanged activity in patients-was found in the secondary somatosensory cortex and inferior parietal lobules, regions mediating emotional and motor imagery processes, as well as in those areas of the anterior cingulate gyrus and of the frontal lobes that are involved in premotor processes.
Stoléru
Serge
S
Inserm, Unité 483, Université Pierre et Marie Curie, Boite 23, 9 quai Saint-Bernard, 75252 Paris Cedex 05, France. serge.stoleru@snv.jussieu.fr
Redouté
Jérôme
J
Costes
Nicolas
N
Lavenne
Frank
F
Bars
Didier Le
DL
Dechaud
Henri
H
Forest
Maguelone G
MG
Pugeat
Michel
M
Cinotti
Luc
L
Pujol
Jean François
JF
D000328:Adult; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D004644:Emotions / Q000502:physiology; D004882:Erotica; D005625:Frontal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D006179:Gyrus Cinguli / Q000098:blood supply / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009433:Neural Inhibition / Q000502:physiology; D010296:Parietal Lobe / Q000098:blood supply / Q000000981:diagnostic imaging; D010364:Pattern Recognition, Visual / Q000502:physiology*; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D020018:Sexual Dysfunctions, Psychological / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013003:Somatosensory Cortex / Q000098:blood supply / Q000000981:diagnostic imaging; D014055:Tomography, Emission-Computed