功能核磁共振成像法评价妇女局部应用前列腺素E_1乳膏的脑局部反应

Functional magnetic resonance imaging method in evaluating women’s local cerebral response for local application of Prostaglandin E_1 cream

目的:通过功能性核磁共振扫描(fMRI)评价在视觉刺激条件下在阴蒂和G点涂抹前列腺素E1乳膏后的脑激活状态。方法:健康妇女及性唤起障碍妇女各5名,进行随机、双盲、安慰剂交叉对照研究。每一位受试者随机应用前列腺素E1乳膏或安慰剂乳膏,两次访视间隔7天的清洗期。通过fMRI评价脑区域的激活状态。结果:在健康组中,药物强于安慰剂的区域为左侧额上回、右侧前额叶,但是在双侧顶叶位置较弱;在患者组中药物组的激活状态在右侧顶叶较安慰剂减弱。前列腺素E1在健康组左侧前语言区、右侧岛叶、左后扣带回和右侧顶叶的激活状态高于患者;在左侧梭状回、右侧前额叶、左侧额上回患者的激活效应高于健康组。结论:前列腺素E1乳膏的作用是性刺激依赖的。右侧前额叶、左侧额上回是与药物效应有关的激活脑区,患者和健康人之间的脑部不同激活模式可能与病因有关。

Objectives： To explore the cerebral activation patterns by using functional magnetic resonance imaging （fMRI） during visual sexual stimulation after application of alprostadil cream to the clitoris and G - spot. Methods： This study was de-signed with a random group separation, double - blind and cross - over mechanism and a placebo - controlled comparison. A total of 5 healthy and 5 FSAD women randomly applied the alprostadil or the placebo cream in a 7 - day wash off period. Record the fMRI data to document the local cerebral response after the erotic visual stimulation. Result： Among healthy women, the activa- tion effects of the alprostadil cream were stronger than placebo in the left superior frontal gyms and the right anterior frontal lobe, but weaker in the bilateral parietal lobe. For the FSAD patients, the activation effect of the alprostadil cream was weaker in the right parietal lobe. Alprostadil cream administration caused stronger activation in the right prefrontal lobe, left gyms fusiformis and left superior frontal gyrus for the FSAD women, whereas caused weaker activation in the left broca＇ s area, fight insula, left posterior cingulate gyrus and right parietal lobe. Conclusion： The arousal effect of the alprostadil cream was sexual stimulation dependent. The left superior frontal gyrus and right anterior frontal lobe were the activation areas associated with the alprostadil cream topical administration.