title: Altered spinal cord activity during sexual stimulation in women with SCI: a pilot fMRI study.
abstract: BACKGROUND
  The objective of this study was to assess the feasibility of the use of functional magnetic resonance imaging (fMRI) to evaluate the spinal activation during sexual response of the thoracic, lumbar and sacral spinal cord.
  
  
  METHODS
  This is a laboratory-based pilot study in human females at a University-based medical center in the United States. In three healthy spinal cord injury (SCI) females, spinal cord activations during sexual audiovisual stimulation (alone), genital self-stimulation (alone) and simultaneous audiovisual and genital self-stimulation (combined) were assessed and then compared with each subjects' remaining sensory and motor function.
  
  
  RESULTS
  Spinal fMRI responses of the intermediolateral columns were found during audiovisual stimulation in both subjects with incomplete injuries, but they were not observed in the subject with a complete injury. Moreover, sacral responses to combined stimulation differed greatly between the subjects with complete and incomplete injuries.
  
  
  CONCLUSIONS
  These results not only provide the firstin vivodocumentation of spinal fMRI responses associated with sexual arousal in women with SCIs, but also suggest that spinal cord fMRI is capable of distinguishing between injury subtypes. Therefore, although there are certain limitations associated with fMRI during sexual stimulation (for example, movement artifacts, an artificially controlled environment and so), these findings demonstrate the potential utility of incorporating spinal cord fMRI in future research to evaluate the impact of specific patterns of SCI on sexual responses and/or the effects of treatment.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA; Rehabilitative Medicine, Birmingham VA Medical Center, Birmingham, AL, USA; Department of Physical Medicine and Rehabilitation, Harvard School of Medicine, Boston, MA, USA.
authors.forename: Marcalee
authors.initials: M
authors.lastname: Alexander
authors.affiliation: Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada; Department of Molecular Medicine and Robarts Research Institute, Western University, London, ON, Canada.
authors.forename: Natalie
authors.initials: N
authors.lastname: Kozyrev
authors.affiliation: Department of Radiology, University of Manitoba, Winnipeg, MB, Canada; Neuroscience Research Program and Division of Diagnostic Imaging, Kleysen Institute for Advanced Medicine, Health Sciences Centre, Winnipeg, MB, Canada; Department of Psychological and Brain Sciences, Johns Hopkins University, Baltimore, MD, USA.
authors.forename: Chase R
authors.initials: CR
authors.lastname: Figley
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham , Birmingham, AL, USA.
authors.forename: J Scott
authors.initials: JS
authors.lastname: Richards
keywords: Autonomic nervous system; Spinal cord