Dynamic Changes of Intrinsic Brain Activity and Neurotransmitter Defect Profile in Patients with Lifelong Premature Ejaculation

Abstract

Abstract Lifelong premature ejaculation (LPE) is a vexing male sexual disorder potentially linked to brain dysfunctions, although the precise mechanisms remain unclear. Data of resting state functional magnetic resonance imaging was acquired from 46 LPE patients and 35 male healthy controls. We firstly investigated altered temporal variability of spontaneous brain activity fluctuations of LPE patients using sliding-window approach. Secondly, the correlation analysis was performed between brain areas with abnormal brain dynamics and clinical characteristics. Finally, the relationship between brain dynamic abnormalities and the impairments of specific neurotransmitter systems in LPE patients was assessed using JuSpace. Dynamic analysis revealed that LPE patients had decreased dynamic regional homogeneity (dReHo) in the precentral gyrus, supplementary motor area (SMA), frontal gyrus, rolandic operculum and increased dReHo in the lingual gyrus (LING), precuneus, calcarine cortex, fusiform gyrus. While analysis also revealed that LPE patients had decreased dynamic amplitude of low-frequency fluctuations (dALFF) in the LING gyrus, occipital cortex, and increased dALFF in the cuneus, postcentral gyrus. Correlation analysis exhibited the mean dReHo of left SMA was positive associated with the ejaculation latency time (IELT) scores. Moreover, aberrant brain dynamic was significantly associated with the spatial distribution of serotonin and endogenous opioid peptide pathways. Our study indicates LPE patients brain dynamic abnormality involved in multiple brain networks, and suggests that the LPE pathophysiology may be involved in neurotransmitter system imbalances. We hope our findings may offer fresh insights into the mechanisms of LPE and potential avenues for treatment in future.