心因性勃起功能障碍患者大脑局部一致性异常:一项静息态功能磁共振研究

Alterations of regional homogeneity in patients with psychogenic erectile dysfunction:A study by resting-state functional MRI

目的:研究心因性勃起功能障碍(pED)患者大脑局部一致性特征及其与临床特征之间的相关性.方法:招募32例pED患者和28例健康受试者,在使用IIEF-5、自尊和关系(SEAR)问卷客观评价受试者勃起功能和社会心理状态的基础上,使用静息态功能磁共振成像(RS-fMRI)技术和局部一致性(ReHo)分析方法,比较pED患者和健康受试者大脑局部一致性特征差异,并将差异脑区ReHo值与患者临床量表进行相关性分析,探讨pED患者大脑局部一致性特征和病情之间的关系. 结果:相较于健康受试者,pED患者表现出IIEF-5[(13.97±3.60)分vs(22.21 ±0.98)分,P<0.01]和SEAR[(37.58 ±7.96)分vs (61.92±3.73)分,P<0.01]评分显著降低,左侧小脑外侧区域ReHo值升高以及右侧中央前回ReHo值降低的特征,且左侧小脑外侧ReHo值和IIEF-5评分及SEAR评分呈显著负相关(r=-0.51,P<0.01;r=-0.54,P<0.01),右侧中央前回ReHo值和IIEF-5评分及SEAR评分呈显著正相关(r=0.57,P<0.01;r =0.66,P<0.01). 结论:pED患者存在外侧小脑介导的感觉整合处理异常和中央前回参与的运动想象和运动执行功能异常.

Objective:To study the correlation between the brain regional homogeneity(ReHo)features and the clinical characteristics of the patients with psychogenic erectile dysfunction(pED).M ethods:Using IIEF-5 and the Self-Esteem and Relationship(SEAR)questionnaire,we evaluated the erectile function and psychosocial status of 32 pED patients and 28 healthy male subjects.Then,we compared the regional brain activity between the patients and healthy controls hy resting-state functional magnetic resonance imaging(RS-fMRI)and the ReHo method,analyzed the correlation of the ReHo value of the altered brain regions with the results of IIEF-5 and SEAR questionnaire investigation,and explored the relationship between the ReHo features and the symptoms of the pED patients.Results:Compared with the healthy male subjects,the pED patients obtained significantly lower I1EF-5 scores(22.21±0.98 vs 13.97±3.60,P<0.01)and SEAR scores(61.92±3.73 vs 37.58±7.96,P<0.01),a higher ReHo value of the left lateral cerebellum,and a lower ReHo value of the right precentral gyrus.The ReHo value of the left lateral cerebellum was correlated negatively with the IIEF-5 scores(r=-0.51,P<0.01)and SEAR scores(r=-0.54,P<0.01),while that of the right precentral gyrus positively with the IIEF-5 scores(r=0.57,P<0.01)and SEAR scores(r=0.66,P<0.01).Conclusion:Patients with pED had lateral cerebellum-mediated abnormal sensory integration and precentral gyrus-related dysfunction of motor imagery and motor execution.