Brain processing of visual sexual stimuli in men with hypoactive sexual desire disorder

• Published in: Psychiatry research Vol. 124; no. 2; pp. 67 - 86
• Main Authors: Stoléru, Serge, Redouté, Jérôme, Costes, Nicolas, Lavenne, Frank, Bars, Didier Le, Dechaud, Henri, Forest, Maguelone G., Pugeat, Michel, Cinotti, Luc, Pujol, Jean-François
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 30.10.2003; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Biological and medical sciences; Brain - blood supply; Brain - diagnostic imaging; Cingulate gyrus; Emotions - physiology; Erotica; Frontal Lobe - blood supply; Frontal Lobe - diagnostic imaging; Gyrus Cinguli - blood supply; Gyrus Cinguli - diagnostic imaging; Humans; Image Processing, Computer-Assisted; Imaging, Three-Dimensional; Inhibition; Male; Medical sciences; Middle Aged; Motivation; Neural Inhibition - physiology; Parietal lobe; Parietal Lobe - blood supply; Parietal Lobe - diagnostic imaging; Pattern Recognition, Visual - physiology; Prefrontal cortex; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Reference Values; Regional Blood Flow - physiology; Sexual behavior disorders. Psychogenic sexual dysfunctions; Sexual Dysfunctions, Psychological - diagnostic imaging; Sexual Dysfunctions, Psychological - physiopathology; Sexuality; Somatosensory Cortex - blood supply; Somatosensory Cortex - diagnostic imaging; Tomography, Emission-Computed; Parietal lobe; Prefrontal cortex; Inhibition; Motivation; Cingulate gyrus; Sexuality; Human; Orbitofrontal cortex; Desire; Central nervous system; Male; Encephalon; Somatosensory cortex; Visual stimulus; Sexual behavior disorder; Cingulate cortex
• ISSN: 0925-4927; 0165-1781; 1872-7506
• DOI: 10.1016/S0925-4927(03)00068-4

Although hypoactive sexual desire disorder (HSDD) is a common condition and has long been hypothesized to result from malfunctions of the cerebral control mechanisms that adjust the level of sexual motivation, very little is known about the pathophysiology of this disorder. The primary objective was to identify in patients with HSDD brain regions where functional perturbations disrupt the regulation of sexual motivation. We used positron emission tomography to compare seven male patients with HSDD with eight healthy men on their regional cerebral blood flow responses to visual sexual stimuli (VSS) of graded intensity. Statistical Parametric Mapping was used to locate brain regions that demonstrated a differential activation (or deactivation) across the groups. Whereas in control subjects the medial orbitofrontal cortex showed a deactivation in response to VSS, in HSDD patients there was an abnormally maintained activity of this region, which has been implicated in the inhibitory control of motivated behavior. By contrast, the reverse pattern—activation in control subjects, deactivation or unchanged activity in patients—was found in the secondary somatosensory cortex and inferior parietal lobules, regions mediating emotional and motor imagery processes, as well as in those areas of the anterior cingulate gyrus and of the frontal lobes that are involved in premotor processes.