title: Human spinal ejaculation generator.
abstract: OBJECTIVE
  A spinal ejaculation generator (SEG) has been identified in the rat with lumbar galaninergic interneurons playing a pivotal role (Science 2002;297:1566-1569). The aim was to evidence a SEG in humans.
  
  
  METHODS
  Spatial distribution of galaninergic neurons was studied in postmortem spinal cord segments of 6 men and compared with that of 6 women for evidencing sexual dimorphism. Based on the identified segmental distribution of galaninergic neurons, the ability for penile vibratory stimulation (PVS) to elicit ejaculation when the concerned spinal segments were injured was studied in 384 patients with clinically complete spinal cord injury (SCI) and consequent anejaculation. Such patients represent a unique model to investigate the role of defined spinal segments in the control of ejaculation.
  
  
  RESULTS
  Galaninergic neurons were mostly located between L2 and L5 segments in medial lamina VII, with a maximal density within L4. Three-dimensional 3D reconstruction showed that these neurons were grouped into single columns bilaterally to the central canal. In addition, galaninergic neuron density was found higher in L3 and L4 segments in men as compared to women supporting sexual dimorphism. In the patients' cohort, injury of L3-L5 segments was the sole independent predictor for failure of PVS to induce ejaculation. Although evidence from clinical observations was indirect, there is close correspondence to neuroanatomical data.
  
  
  CONCLUSIONS
  Organization and sexual dimorphism of human spinal galaninergic neurons were similar to the rat's SEG. Neurohistological data, together with clinical results, corroborate the existence of an SEG in humans in L3-L5 segments. Such a generator could be targeted to treat neurogenic and non-neurogenic ejaculatory disorders. ANN NEUROL 2017;81:35-45.
authors.affiliation: Université de Versailles St-Quentin en Yvelines, Inserm UMR 1179, Montigny-le-Bretonneux, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Chéhensse
authors.affiliation: Université de Versailles St-Quentin en Yvelines, Inserm UMR 1179, Montigny-le-Bretonneux, France.
authors.forename: Patricia
authors.initials: P
authors.lastname: Facchinetti
authors.affiliation: Université de Versailles St-Quentin en Yvelines, EA 4047, Montigny-le-Bretonneux, France.|INSERM CIC 1429 and Public Health department, Raymond Poincaré Hospital, AP-HP, Garches, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Bahrami
authors.affiliation: INRA-AgroParisTech, Institut Jean-Pierre Bourgin, UMR 1318, ERL CNRS 3559, Saclay Plant Sciences, Versailles, France.|Sorbonne Universités, UPMC Paris 6, UFR927, Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Andrey
authors.affiliation: Urodynamics and sexology laboratory, Bouffard Vercelli Centre, Cerbère, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Soler
authors.affiliation: Institut Pasteur, Human Histopathology and Animal Models, Paris, France.|Service de Neuropathologie, Sainte Anne Hospital, AP-HP, Paris, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Chrétien
authors.affiliation: Université de Versailles St-Quentin en Yvelines, Inserm UMR 1179, Montigny-le-Bretonneux, France.
authors.forename: Jacques
authors.initials: J
authors.lastname: Bernabé
authors.affiliation: Université de Versailles St-Quentin en Yvelines, Inserm UMR 1179, Montigny-le-Bretonneux, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Clément
authors.affiliation: Université de Versailles St-Quentin en Yvelines, Inserm UMR 1179, Montigny-le-Bretonneux, France.|Neuro-Uro-Andrology, Physical Medicine and Rehabilitation department, Raymond Poincaré Hospital, AP-HP, Garches, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Denys
authors.affiliation: Université de Versailles St-Quentin en Yvelines, Inserm UMR 1179, Montigny-le-Bretonneux, France.|Neuro-Uro-Andrology, Physical Medicine and Rehabilitation department, Raymond Poincaré Hospital, AP-HP, Garches, France.
authors.forename: François
authors.initials: F
authors.lastname: Giuliano
mesh_terms: D000369:Aged, 80 and over; D004542:Ejaculation / Q000502:physiology*; D005260:Female; D019004:Galanin / Q000378:metabolism / Q000502:physiology*; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D009474:Neurons / Q000378:metabolism / Q000502:physiology; D012727:Sex Characteristics; D013116:Spinal Cord / Q000033:anatomy & histology / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000628:therapy*; D014732:Vibration / Q000627:therapeutic use*
chemical_list: D019004:Galanin