IINKCUKACHA: 'I-Psychogenic ED' ibhekisa kwi-ED evela kwingqondo. Kuhlala kubhekiswa kuyo njenge 'ED yengqondo.' Ngokwahlukileyo, 'i-organic ED' ibhekisa kwi-ED kwinqanaba lobudoda, njengokuguga okudala, okanye iingxaki zemithambo-luvo kunye nentliziyo.
Olu phononongo lufumanise ukuba i-psychogenic ED yayihambelana kakhulu ne-atrophy yento engwevu kwiziko lomvuzo (nucleus accumbens) kunye namaziko ezesondo hypothalamus. Imba engwevu kulapho iiseli zemithambo-luvo zinxibelelana khona. Ngolwazi, jonga uthotho lwam lwevidiyo ezimbini (umda wasekhohlo), othetha nge-dopamine kunye ne-dopamine receptors. Yiloo nto olu phononongo luvavanyiwe.
Ukuba ubundijongile Iphonografi kunye nevidiyo ye-ED Ubonile isilayidi esinotolo olubaleka lusuka kwi-nucleus accumbens luye kwi-hypothalamus, apho kukho amaziko okwakhiwa kwengqondo. I-Dopamine kuzo zombini i-hypothalamus kunye ne-nucleus accumbens yeyona njini iphambili emva kwe-libido kunye nokulungiswa.
Into engwevu engaphantsi ibonisa iiseli zemithambo-luvo ezimbalwa kunye neeseli ezamkela imithambo-luvo. Ngamanye amagama, isifundo sithetha ukuba i-psychogenic ED ayisiyo eyengqondo, kodwa kunokookwasemzimbeni: isibonakaliso esisezantsi se-dopamine kunye ne-dopamine. Ezi zinto zifunyanisiweyo zingqinelana ngokugqibeleleyo ne-hypothesis yam kwi-
Benze novavanyo lwengqondo ngokuthelekisa abantu abane-psychogenic ED kubafana abangenayo i-ED. Bafumene:
- Akukho xhala, njengoko kulinganiswa yi-STAI, okanye ubuntu, njengoko kulinganiswa ngenqanaba le-BIS / BAS, alibonisanga lukhulu phakathi kokungafani kweqela. Umahluko obonakalayo wabonwa kwi-subscale "Ukufuna ulonwabo" kwinqanaba le-BIS / BAS ngenqaku eliphezulu lokulawula kunezigulana "
iziphumo: akukho mahluko kuxinzelelo okanye kubuntu, ngaphandle kokuba abafana abane-psychogenic ED babonwabe kancinane (i-dopamine esezantsi). Ewe ucinga ?? Umbuzo ngulo, "KUTHENI la mazwe ali-17 anama-psychogenic e-ED angamadoda angaphantsi kwegrey kwiziko labo lomvuzo kunye ne-hypothalamus xa kuthelekiswa nolawulo?" Andazi. Amaxesha asusela ku-19-63. Umyinge weminyaka yobudala = 32. Ngaba yayisebenzisa iphonografi?
PLoS One. I-2012; 7 (6): e39118. doi: 10.1371 / ijenali.pone.0039118. I-Epub 2012 Jun 18.
UCera N, UDelli Pizzi S, UDi Pierro ED, Gambi F, UTartaro A, IVicentini C, IParadiso Galoto G, URomani GL, UFerretti A.
imvelaphi
ISebe le-Neuroscience kunye neMifanekiso, iZiko leTekhnoloji ePhambili yezoBugcisa (i-ITAB), iYunivesithi G. d'Annunzio yaseChieti, eChieti, e-Itali. [imeyile ikhuselwe]
Abstract
I-Psychogenic erectile dysfunction (ED) ichazwe njengokungakwazi ukuqhubeka nokufumana kunye nokugcina ulwakhiwo olwaneleyo lokuvumela ukusebenza ngokwesondo. Ibonisa ukwenzeka okuphezulu kunye nokwanda phakathi kwamadoda, okunefuthe elibonakalayo kumgangatho wobomi. Zimbalwa izifundo ezinomdla wokuphanda ngesiseko sobuchopho bokungasebenzi kakuhle komzimba okuqwalasele indima edlalwe ngumbuso ongaphambili, ucalucalulo, kunye ne-cortices zeparietali ngexesha lokuvuselela i-erotic.
Ngaphandle kokubandakanyeka okwaziwayo kwemimandla engaphantsi njenge-hypothalamus kunye ne-caudate nucleus ekuphenduleni ngokwesini kwendoda, kunye nendima ephambili ye-nucleus accumbens kulonwabo kunye nomvuzo, ingqalelo engalunganga yahlawulwa kwindima yabo ekungasebenzi kakuhle ngokwesini kwamadoda.
Kolu phando, sagqiba ubukho bezinto ezingwevu ezingwevu (GM) kwiipateni zangaphakathi njenge-amygdala, hippocampus, i-nucleus accumbens, i-caudate nucleus, i-putamen, i-pallidum, i-thalamus, kunye ne-hypothalamus kwizigulana ezine-psychogenic ED kunye namadoda apholileyo. Emva kovavanyo lwe-Rigiscan, u-urological, unyango ngokubanzi, uvavanyo lwe-metabolic kunye ne-hormonal, uvavanyo lwengqondo kunye nengqondo, ukuphuma kwe-17 nge-psychogenic ED kunye ne-25 yokulawulwa okunempilo kwaqeqeshwa kwiseshoni ye-MRI yesakhiwo.
I-atrophy ebaluleke ye-GM ye-nucleus accumbens yajongwa ngokulandelelana kwizigulana ngokubhekisele kulawulo. Uhlalutyo lwe-Shape lubonise ukuba le atrophy ibekwe kwicala lasekhohlo medial-anterior kunye ne-posterior yecandelo le-accumbens. I-nucleus yasekhohlo iqokelele umthamo kwizigulana ezidityaniswe nokusebenza okungaphantsi kwe-erectile njengoko kulinganiswa yi-IIEF-5 (I-International Index ye-Erectile Function). Ukongeza, i-GM atrophy ye-hypothalamus yasekhohlo yabonwa. Iziphumo zethu zibonisa ukuba i-atrophy ye-nucleus accumbens idlala indima ebalulekileyo ekungasebenzi kakuhle kwe-psychogenic erectile. Sikholelwa ukuba olu tshintsho lunokuba nefuthe kwicandelo elinento yokwenza nokuziphatha ngokwesondo. Iziphumo zethu zinceda ukucacisa isiseko se-neural ye-psychogenic erectile dysfunction.
intshayelelo
I-Psychogenic Erectile Dysfunction (ED) ichazwe njengokungakwazi ukuqhubeka nokufumana kunye nokugcina ulwakhiwo olwaneleyo lokuvumela ukusebenza ngokwesondo.. Ngaphaya koko, i-psychogenic ED imele imeko yempilo yengqondo kwaye inefuthe elibonakalayo kumgangatho wobomi babo bagulayo kunye namaqabane abo. Izifundo ze-Epidemiological zibonise ukwanda okuphezulu kunye nesifo se-psychogenic ED phakathi kwamadoda.
Kwiminyaka elishumi edlulileyo, izifundo ezininzi ezisebenzayo ze-neuroimaging ziye zajolisa kwimimandla yobuchopho ekhutshwa zizinto ezifanelekileyo zesondo, zibonisa ukubandakanyeka kwezakhiwo ezahlukeneyo zecortical kunye ne-subcortical, ezinjenge-cingates cortex, insula caudate nucleus, putamen, thalamus, amygdala kunye ne-hypothalamus [1]-[5]. Olu phononongo luvumile ukwahlula-hlula indima edlalwa ziingingqi ezininzi zobuchopho kwimigangatho eyahlukeneyo yokuvuselela inkanuko yesini. Ngokwenyani ukuba indoda ivuseleleke ngokwesini iye yathatyathwa njengamava amaninzi ahlukeneyo abandakanya ukuqonda kwengqondo, iimvakalelo kunye nezinto zomzimba ezivuselela iseti ebanzi yemimandla yobuchopho. Kwelinye icala, zimbalwa izifundo ezinomdla wokuphanda ngesifo sokungasebenzi komzimba wesondo ekuziphatheni okubi ngokwesini. Olu phononongo lubonisa ukuba eminye imimandla yobuchopho, umzekelo, i-cingrate kunye ne-cortex yangaphambili, inokuba nefuthe lokuthintela kwimpendulo yesini yendoda. [6]-[8]. Nangona kunjalo, ubungqina obuninzi [9]-[12] bonakalisa ukubaluleka kokuma kwezinto eziphantsi kwamanqanaba ahlukeneyo okuziphatha. Ewe, i-hypothalamus idlala indima ephambili [4], [5] kulawulo oluphambili lwe-penile erection. NgokukaFerretti kunye noogxa [4] I-hypothalamus inokuba yindawo yobuchopho ebangela ukuba impendulo ye-erectile ikhutshwe ziifoto ezikrelekrele.
Into encinci iyaziwa ngendima edlalwe ngamacandelo asezantsi kwisenzo sokuziphatha ngokwesini samadoda. Phakathi kwemimandla enzulu yeengwevu (GM), i-nucleus accumbens idlala indima eyaziwayo kumvuzo kunye nemijikelezo yolonwabo [13]-[16] kunye ne-caudate nucleus kulawulo lokuphendula okungaphaya kokuziphatha komntu ngokwesondo [2].
Injongo yolu phononongo kukuphanda ukuba ngaba abaguli be-psychogenic ED babonisa ukuguqulwa okubonakalayo kwezakhiwo ezinzulu ze-GM ezichaphazelekayo kwimpendulo yesini yendoda, ngokuzonwabisa kunye nomvuzo.
Ukuvavanya le hypothesis, uvavanyo lwe-MRI olwakhiweyo lwezinto ezisibhozo ze-GM zengqondo, ezinje nge-nucleus accumbens, i-amygdala, i-caudate, i-hippocampus, i-pallidum, i-putamen, i-thalamus kunye ne-hypothalamus yenziwa kwisifundo sophando lwezigulana ze-psychogenic ED kunye nezifundo zokulawula. Ukuba kukho umahluko phakathi kwala maqela mabini kwezinye zezi ngingqi, umdla wethu kukubona ubukho bonxibelelwano phakathi kweenguqu kwindawo ezithile zobuchopho kunye neendlela zokuziphatha.
tindlela
Statement Ethics
Olu phando lwamkelwe yikomiti yokuziphatha yeDyunivesithi yaseChieti (PROT 1806 / 09 COET) kwaye yaqhutywa ngokungqinelana neSibhengezo saseHelsinki. Ukukhuselwa kolwazi lomntu kunye nesihloko sabo baqinisekiswa ngokusetyenziswa kwesikhokelo esacetyiswa nguRosen no-Beck [17]. Uyilo lwesifundo lucacisiwe gca kwaye imvume ebhaliweyo yafunyanwa kubo bonke ababandakanyekayo kwisifundo sethu.
IsiCwangciso soFundo
Izigulana ze-97 ezazindwendwela ikliniki yabakhuphele ngaphandle kwezesondo kwiCandelo le-Urology lesebe lezeNzululwazi zezeMpilo kwiYunivesithi yase-L'Aquila phakathi kukaJanuwari 2009 noMeyi 2010 baqeshwa kolu phononongo. Izigulana ezityelele ikliniki zakhalaza ngokungasebenzi kakuhle emzimbeni, ngelixa izifundo eziphilisayo zaqeshwa ngohlobo lwesaziso kwibhodi yezaziso kwiYunivesithi yaseChieti nakwisibhedlele iTeramo.
Bonke abathathi-nxaxheba bahlolwa ngokomgaqo olungelelanisiweyo oquka uvavanyo oluqhelekileyo lwezonyango, u-urologic no-andrologic, ukuhlolwa kwengqondo kunye nokuhlolwa kwengqondo kunye ne-MRI yengqondo iphela.
I zifundo
Izigulana zaya kwiklinikhi yokuphuma kwezonyango ngenxa yokuxinana kwezesondo kunye nobunzima obafunyanwa zizigulana okanye zaziswe ngamaqabane abo. Izigulana zachongwa njengezinakho isifo sengqondo ukungasebenzi kakuhle kwe-erectile (iintlobo ngokubanzi okanye zeemeko ezithile) okanye eziphilayo ukungasebenzi kakuhle kwe-erectile (vasculogenic, neurogenic, ihormic, metabolic, iziyobisi. Uvavanyo lwe-Urologic lwenziwa emva kwezikhokelo zangoku zokufumana isifo se-erectile dysfunction [18].
Uvavanyo lokuqonda isifo sokungasebenzi kakuhle kwengqondo ye-psychogenic erectile dysfunction (Uhlobo oluDibeneyo) lwenziwa ngovavanyo lwasemzimbeni ngokugxininisa ikakhulu kwinkqubo ye-genitourinary, endocrine, misipha kunye nemithambo-luvo. Ukongeza, ukuvalwa kobusuku obuqhelekileyo kunye ne-erections kusasa kwavavanywa ngesixhobo seRigiscan ngexesha lasebusuku abathathu ngokulandelelana, ngelixa, i-hemodynamics eqhelekileyo ye-penodynamics yavavanywa kusetyenziswa umbala Doppler Sonography. Lilonke, izigulana ze-80 azifakwanga kuba uninzi lwazo aluzange luhlangabezane nenqobo yokubhaliswa kulingo. Abanye babo babephethwe ziintsholongwane, okanye benesiphene sehomoni. Nangona kunjalo, bonke abaguli abane-dysfunctions ye-psychogenic erectile babhaliswa. Iimviwo ezifanayo zeklinikhi zenziwa kwizifundo zokulawula. I-erection eqhelekileyo ebusuku yaze yaqinisekiswa kulawulo.
Ishumi elinantlanu ukuphuma kwesini ngaphandle kwesini kunye nokuxilongwa kwengqondo yokungasebenzi kwengqondo (kuthetha iminyaka yobudala ± SD = 34.3 ± 11; Uluhlu lwe-19-63) kunye namadoda angamashumi amabini anesihlanu aphilayo angatshatanga abesilisa abangamadoda (kuthetha ubudala ± SD =I-33.4 ± 10; Uluhlu lwe-21-67) bagaywa kolu phando. Izigulana kunye nolawulo olusempilweni bezingahambelani kuphela ngokobuzwe, ubudala, imfundo, kodwa kunye nokusetyenziswa kwesikotini [19].
Uvavanyo lweengqondo kunye noVavanyo lwezeMpilo
Zonke izifundo ziye zenziwa nodliwanondlebe nge-1-h kwimbali yezonyango kwaye zathatha iMibuzo ye-Mini-International Neuropsychiatric Udliwanondlebe (MINI) [20].
Umsebenzi we-Erectile, ukuvuseleleka ngokwesini, imeko yengqondo, uxinzelelo kunye nobuntu kwavavanywa kusetyenziswa le mibuzo ilandelayo: I-International Index ye-Erectile Function (IIEF) [21], Uluhlu lwezinto eziHlalayo ngokwesini (i-SAI) [22], I-SCL-90-R [23], I-State-Trait Anxcare Inventory (i-STAI) [24], kunye ne-Behaisheral Inhibition / iBali lokuSebenza lokuSebenza (umda we-BIS / BAS) [25], ngokulandelanayo.
Ukufunyanwa kweDatha ye-MRI
Yonke i-Mrain Brain yenziwe ngohlobo lwe-3.0 T "Achieva" IPhilippines isithwebuli somzimba wonke (uPhilips Medical System, Best, The Netherlands), esebenzisa i-coil radiation ye-body-body coil ekwi-excation yokukhuphela kunye ne-coil yentloko yesibhozo eyamkelayo yomqondiso.
Umthamo omkhulu wokumiswa kwesakhiwo wafunyanwa nge-3D yentsimi ekhawulezileyo ye-echo T1Ulandelelwano lwe-weighted. Iiparamitha zokufumana yayimi ngolu hlobo lulandelayo: ubungakanani be-voxel 1 mm isotropic, TR / TE = 8.1 / 3.7 ms; inani lamacandelo = 160; akukho sikhewu phakathi kwamacandelo; ukugubungela ingqondo; i-flip angle = I-8 °, kunye ne-SENSE factor = 2.
Uhlalutyo lweenkcukacha
Idatha ye-MRI eyakhiweyo yahlalutywa kusetyenziswa isixhobo esivela kwiMisebenzi eSebenzayo yeBrain (FMRIB) Ithala leencwadi lesoftware [FLS, http://www.fmrib.ox.ac.uk/fsl/index.html] [26], [27] Inguqulelo 4.1. Ngaphambi kokulungiswa kwedatha, ukuncitshiswa kwengxolo yemifanekiso eqingqiweyo kwenziwa ngoSUSAN algorithm [http://www.fmrib.ox.ac.uk/analysis/research/susan/].
Imilinganiselo yeVolumu kunye noPhononongo lweShape lweZakhiwo eziNcinci
Isixhobo seFLIRT sasisetyenziselwa ukwenza ulungelelwaniso lwe-3D T1 Imifanekiso kwitemplate ye-MNI152 (iMontreal Neurological Institute) ngotshintsho lwe-affine olusekwe kumanqanaba enkululeko ye-12 (okt ukuguqulelwa kathathu, ukujikeleza kathathu, ukukalwa kathathu kunye neeskews ezintathu) [28], [29]. Umba we-subcortical grey factor (GM) ulwahlulo lwesakhiwo kunye noqikelelo olupheleleyo lwe-amygdala, i-hippocampus, i-nucleus accumbens, i-caudate nucleus, i-putamen, i-pallidum kunye ne-thalamus zenziwa kusetyenziswa i-YOKUQALA. [30]. Ngokuphumelelayo, imimandla engaphantsi komhlaba yaphononongwa ngokujonga iimpazamo.
Kwisakhiwo ngasinye se-GM subcortical, Iziphumo ZOKUQALA zibonelela nge-mesh yomphezulu (kwisithuba se-MNI152) esenziwe seseti esingunxantathu. Iziqwenga zexande ezihlangeneyo zibizwa ngokuba zii vertices. Ngenxa yokuba inani lezi vertices kulwakhiwo ngalunye lwe-GM luhleliwe, ii-vertices ezihambelanayo zinokuthelekiswa kumntu ngamnye naphakathi kwamaqela. Utshintsho lwepathological lungisa i-vertex oriental oriental / position. Ngale ndlela, utshintsho lobume bendawo luvavanywe ngokuthe ngqo ngokuhlalutya iindawo ze-vertex kunye nokujonga umohluko kwisikhundla se-vertex phakathi kolawulo kunye namaqela ezigulana. Ukuthelekiswa kweqela lee-vertices kwenziwa kwaye kusetyenziswa izibalo ze-F [30], [31]. Uyilo lwe-matrix luhlobo olulodwa oluchaza ubulungu beqela (zero kulawulo, zezabaguli).
Uqikelelo lweVolumu yeTishu yeBongo
I-SIENAX [http://www.fmrib.ox.ac.uk/fsl/fast4/index.html#FastGui] isetyenziselwe ukuqikelela umthamo weethishu zobuchopho. Emva kokukhutshwa kobuchopho kunye nogebhezi, umfanekiso oyilo wokuqala wesifundo ngasinye wawubhaliselwe indawo ye-MNI 152 njengoko kuchaziwe kwicandelo elandulelayo. Indawo yohlobo lwesahlulo [32] yenziwa ukuqikelela inani le-GM, into emhlophe (WM), GM yecala, CSF ye-ventricular kunye nomthamo opheleleyo wobuchopho. Umthamo we-Intracranial (ICV) wabalwa ngokudibanisa umyinge we-cerebral spinal fluid, i-GM iyonke kunye ne-WM iyonke.
Uhlalutyo lwe-ROI Voxel-based Morphometry (VBM)
Ngokweendlela ezichaziweyo zoncwadi [33], Uhlalutyo lwe-ROI-VBM lwe-hypothalamus lwenzelwa ukuvavanya utshintsho lwe-morphological olwenzeka kwizigulana ze-ED kunezifundo zokulawula. I-ROI ye-hypothalamus yasekunene nangasekhohlo yayitsalwa ngesandla kwisiseko se-MRI atlas [34].
Idatha yahlaziywa kusetyenziswa uhlalutyo lweVBM [35], [36]. Emva kokukhutshwa kobuchopho kusetyenziswa i-BET [37], isahlulo sohlobo lwethiski lwenziwa kusetyenziswa i-FAST4 [32]. Imifanekiso enesiphumo yomthamo othile we-GM yahambelana ne-MNI152 indawo esemgangathweni kusetyenziswa isixhobo sobhaliso lwesixhobo seFIRIRT [28], [29], kulandelwa ubhaliso olungelolayini usebenzisa i-FNIRT [38], [39]. Imifanekiso ebangelwe yiyo yatshintshwa ukwenza itemplate, apho imifanekiso ye-GM yomthonyama yabe ingabhaliswanga ngokusemthethweni. Ukulungiswa kokukhula kwendawo okanye ukusikwa, imifanekiso ebhalisiweyo enenxenye yabe sele ilungiswa ngokwahlula-hlulwa nguJacob wentsimi ye-warp. Okokugqibela, izigulana kunye namaqela olawulo athelekiswa kusetyenziswa i-voxel-Wisdomistic (imvume ye-5000) kunye nonyuselo-lwethamsanqa yokukhulisa ukuqiniswa kweqela kwi-FSL [http://www.fmrib.ox.ac.uk/fsl/randomise/index.html]. Ukoyisa umngcipheko weemposiso ezingezizo, ukubaluleka komqobo phakathi kweqela kwamiselwa kwi-p <0.05 elungisiweyo kwimpazamo yobulumko bosapho (FWE). Uhlalutyo lokuhambelana kunye ne-IIEF-5 kunye ne-SAI nayo yenziwa.
Uhlalutyo lweSatisati
I-Statistica® 6.0 yayisetyenziselwa uhlalutyo lwedatha. Izigulana ze-ED kunye nolawulo olusempilweni zathelekiswa kusetyenziswa uhlalutyo olungafaniyo lokwahluka (i-1-way ANOVA) yobudala, inqanaba lemfundo, ukusetyenziswa kwe-nicotine, i-ICV kunye nomthamo wezakhiwo ezingwevu ngokwahlukeneyo. Ukunciphisa ukubanakho kwempazamo yohlobo I, uhlalutyo olupheleleyo lwe-variance (MANOVA) kusetyenziswa inani elinye lezinto ezilungelelanisiweyo ezilungiselelwe ii-ICVs kuhlalutyo ngalunye njengokuhluka okuxhomekekileyo. Ke indlela eyi-1 yee-ANOVA (phakathi kwamaqela) yayiqhutywa ngexabiso levolumu nganye. Inqanaba lokubaluleka kwe-p <0.05 isetyenzisiwe. Ke ubudlelwane obunokubakho phakathi kwamanyathelo okuziphatha kunye namaxabiso evolumu ayaphandwa. Ixabiso lexabiso lexabiso kunye neendlela zokuziphatha, ezibandakanyiweyo kuhlalutyo lolungelelwaniso, zezo zibonise umahluko phakathi kweqela. Uhlalutyo lolungelelwaniso lwenziwa ngendlela yokulingana kwe-Spearman's rho coefficient, kula maqela mabini ngokwahlukeneyo, alungiswa ngokuthelekisa okuninzi (p <0.05).
iziphumo
Iimpawu ezibonakalayo zala maqela mabini zibonisiwe kwi 1 Table.
Izigulana ze-ED kunye nolawulo olusempilweni azange zahluke mpela kubudala, inqanaba lemfundo, ukusetyenziswa kwe-nicotine kunye ne-ICV (I-Intra Cranial Volume in mm3), izinto ezingwevu nezimhlophe zihamba nomthamo wengqondo opheleleyo.
Okubalulekileyo phakathi kokumahluko kweqela kwafunyanwa kumanqaku ewonke e-IIEF-5 ngamaxabiso aphezulu kwiqela lolawulo kuneqela lesigulana (F(1,40)= 79; p <0.001), kunye nenqaku elipheleleyo le-SAI ngo-F(1,40)= 13 kunye p <0.001). Ngokukodwa, kwinkxaso-mali "yokuncancisa" yolawulo lwe-SAI olusempilweni lubonise inani eliphakamileyo kakhulu kunabaguli bakwa-ED (F(1,40)= 22.3; p <0.001). Akukhoxhala, njengoko kulinganiswa yi-STAI, okanye ubuntu, njengoko kulinganiswa yi-BIS / BAS esikalini, akubonisanga nto phakathi kokungafani kweqela. Umahluko obonakalayo wabonwa ngokuhlawulwa "kokuNwaba okuKonwabayo" kwesikali se-BIS / BAS esinenqanaba eliphezulu lolawulo kunabaguli (F(1,40)= 5.2; p <0.05).
Kwisifundo ngasinye se-7 subcortical zvakhiwo (thalamus, hippocampus, caudate, putamen, pallidum, amygdala, and accumbens) zahlulwahlulwa kwaye imiqulu yazo yalinganiswa ngesixhobo sokuqala (Umzobo.1). 2 Table inika ingxelo yevolumes yentsingiselo (M) kunye nokuphambuka okuqhelekileyo (SD) kwezi ndawo zikhankanywe apha ngasentla kwii-cubic millimitha zezigulana ze-ED kunye namaqela olawulo. 3 Table bonisa ubungakanani bezinto ezincinci zokwakhiwa kwamalungu ezigulana kunye namaqela olawulo kwezi hemispheres ezimbini zengqondo ngokwahlukeneyo. I-MANOVA ibonakalise ubukho phakathi kokungafani kweqela kwiindawo ezincinci (iWilks λ = 0.58; F = 3,45; p = 0.006). Emva koko, uthotho lokulandela i-ANOVA yendlela enye yatyhila ukwehla okukhulu kwe umthamo we-nucleus accumbens kwiziguli ze-ED xa kuthelekiswa nolawulo (F(1,40)= 11,5; p = 0.001).
I-MANOVA eyongezelelweyo, eyenziwa kwimigangatho yeengingqi zemiqolo engaphantsi nakwesobunxele, ityhile umahluko obonakalayo phakathi kwabaguli be-ED kunye nolawulo (iWilks λ = 0.48; F = 2,09; p = 0.04). Ngenxa yoko, landela-indlela enye yee-ANOVA bonisa ukwehla okukhulu kweesyukeli zekhohlo kunye nelungelo lokungena kwizigulana ze-ED ngokubhekisele kulawulo olusempilweni (F(1,40)= 9.76; p = 0.003; F(1,40)= 9.19; p = 0.004 ngokwahlukeneyo).
Iziphumo zohlalutyo lobume ezenziwa kwi-nucleus accumbens ziboniswe ngaphakathi Umzobo 2.
Umzobo 2 Ukuthelekiswa kwendawo ye-vertex phakathi kwala maqela mabini kubonise i-atrophy yommandla obalulekileyo kwizigulana ze-ED ngembalelwano kwi-medial-anterior yangaphakathi kunye, ngaphakathi, kwinxalenye engasemva ye-nucleus accumbens.
Njengoko kuxelwe kuyo Umzobo 3, RUhlalutyo lwe-OI-VBM lubonise i-atrophy ye-GM kwi-hypothalamus yasekhohlo (p <0.05, inqanaba le-FWE lilawulwa). Ngokukodwa, ilahleko ye-GM yafunyanwa kwi-supraoptic nucleus yendawo engaphandle ye-hypothalamic area (I-x, y, z inxibelelanisa: −6, −2, −16, p = I-0.01 ikwakhiwe), i-nucleus ye-ventromedial ye-hypothalamus (I-x, y, z inxibelelanisa: −4, −4, −16, p = 0.02 ilungisiwe), kunye ne-medial preoptic nucleus (I-x, y, z inxibelelanisa: −4, 0, −16, p = 0.03 ilungisiwe).
Umzobo 3 Uhlalutyo lolungelelwaniso lwenziwa phakathi kweendlela zokuziphatha (IIEF kunye ne-SAI) kunye neziphumo zokuQala kunye ne-ROI-VBM. Unxibelelwano olufanelekileyo lwabonwa phakathi kwamanqaku e-IIEF kunye ne-nucleus eqokelelweyo kwiqela lesigulana (rho = 0,6; p <0.05, ilungisiwe ngokuthelekisa okuninzi) naphakathi kwamanqaku e-SAI kunye ne-hypothalamus yasekhohlo (p = 0.01, i-FWE rate ayilawulwa).
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Isifundo sethu siphonononge iipateni zecandelo le-subcortical atrophic dysfunction yamadoda. Uhlalutyo lwe-MRI yesakhiwo lubonakalise i-atrophic ebalulekileyo ye-GM yazo zombini i-nucleus yasekhohlo kunye nasekunene kwe-hypothalamus kwizigulana ezifunyaniswa ukuba zinengxaki yokusebenza kwengqondo ye-ED yoluhlobo ngokubanzi ngokubhekisele kulawulo olusempilweni. Olu tshintsho lwenziwe macro lwalungazimeleyo kubudala, ukusetyenziswa kwe-nicotine, amanqanaba emfundo kunye nomthamo we-intracranial. Fi-urther, i-atrophy ye-GM ye-nucleus yasekhohlo ibonakalise ukudibana okuhle nokusebenza kakubi kwe-erectile kwizigulana, njengoko kulinganiswa yi-International Index ye-Erectile Function (IIEF). Moreover, ilahleko yevolumu ye-GM kwimimandla yasekhohlo ye-hypothalamic yayinxulumene nezikolo zeSondo Arousability Inventory (SAI) emele elinye inyathelo lokuziphatha ngokwesondo. Zombini ezi ndawo zingaphantsi zithatha inxaxheba kwiindlela ezininzi ze-neural ezinemisebenzi yolawulo lwe-autonomic kunye neemvakalelo.
Ngokusekwe kwiziphumo zethu, eyona nto iphambili ifunyenwe kwisifundo esikhoyo imelwe yi-GM atrophy eqapheleke kwi-nucleus accumbens yeqela lesigulana. Indima edlalwe yinyuksi yokuzibandakanya kwindlela yokuziphatha ngokwesondo yamadoda yaxhaswa bubungqina bomzimba kumqolo wamadoda [40] kunye nophando olusebenzayo lwe-neuroimaging kumadoda asempilweni ngexesha lokukhuthaza okubonakalayo [2]. Tukhupha i-dopamine kwi-nucleus accumbens iqhuba inkqubo ye-mesolimbic ebandakanyekayo ekusebenzeni kokuziphatha ekuphenduleni kwimikhondo yeemvakalelo ebonisa ubukho bezinto zokukhuthaza okanye zokuqinisa [41]. Oku kuxhaswa bubungqina bomzimba obudibanisa umsebenzi we-dopaminergic kwi-NAcc kukuziphatha komnqweno wesini kumqolo wamadoda [40], [41]. Ngokwenene inqanaba elonyukayo le-dopamine kwi-nucleus ye-nucleus ye-rat yamadoda ibonwa xa kuziswa i-fem ye-rat kuye. Oku kunyuka kuncitshisiwe ngexesha lokuguqula ikopi.
Ukukhanya koku, imisebenzi kwi-nucleus accumbens yayanyaniswa nolawulo lweempendulo zemvakalelo. I-nucleus ye-nucleus yomntu ibonakala ngathi ikhetha ukusebenza ngokufanelekileyo kwimifanekiso emnandi ekhuthazayo endaweni yokuba sisithukuthezi [42]. NgokukaRedoutè kunye noogxa [2] I-nucleus accumbens inokwenzeka ukuba ithathe inxaxheba kwicandelo lesishukumiso sokuvuselelwa kwesini sowesilisa. I-nucleus ye-nucleus yomntu ivuselelwa ngexesha lokuvuselelwa kwezinto ezikhuthazwayo ezibonakalayo [1], [2].
Ngaphaya koko, iziphumo zethu kwimilo yokuma zibonakala zihambelana nenkuthazo, ngokunikwa ukuba i-atrophy eqaphelekileyo ibandakanya ikakhulu iqokobhe le-nucleus accumbens. I-Shell imele indawo ebonakala inxulumene ngokukodwa nokuziphatha kunye nokuziphatha [43], [44]. Kumqolo wamadoda ukhetho olukhethiweyo lwe-electrophysiological yeqokobhe, kodwa hayi eyona nto iphambili kwii-nucleus accumbens, kubonakala ngathi kunyusa ukuphendula kwi-cue enganiki mvuzo [45].
Iziphumo zethu zihambelana nobungqina bezilwanyana ezidlulileyo obuye baqwalasele indlela ukukhutshwa kwe-dopamine kwi-nucleus accumbens kunye nendawo ye-medial preoptic ye-hypothalamus kubonakala ngathi ilawula ngokuqinisekileyo isigaba sokuqhubela phambili sokuziphatha kokuziphathar.
Ngale ndlela, i-hypothalamus imele ummandla obalulekileyo wokukhuthaza ukusebenza kwe-erectile [3], [4]. Sifumene ukwehla komthamo wegrey ye-hypothalamus yamuva kwizigulana ezinokungasebenzi kakuhle kwengqondo. Olu tshintsho kumthamo wempunga luye lwabonwa kwindawo ye-supraoptic nucleus yendawo engaphandle ye-hypothalamic, medial preoptic kunye ne-ventromedial nucleus.
Ngokwechungechunge lobungqina bovavanyo, indawo yangaphambi kokunxibelelana kunye nenxalenye engaphandle ye-hypothalamus idlala indima ebalulekileyo kulawulo lokuziphatha ngokwesondo kwamadoda kuyo yonke into yesidalwa saseMelika.s [46]. Ngokukodwa, izilonda zamazwe amabini ale mimandla ye-hypothalamic iyiphelisa ngokungaguqukiyo indlela yokuqhuba ngokwesondo emadodeni [47], [48]. Zithathiwe kunye, ezi zifundo zibonisa ukuba izilonda ezibini zenzululwazi ye-medial preoptic nucleus kunye ne-anterior hypothalamus iphazamisa ukushukunyiswa kwesini kumagundane [40], [47], [49]. Ngapha koko, umsebenzi owandisiweyo ngexesha lokuvuselelwa ngokwesondo, indlala kunye nobukrwada sele ubonile [50]. I-Georgiadis kunye noogxa [5] bonise ukwahlulahlula-hlukana kwamacandelo e-hypothalamus ngokukhethekileyo kunxulumene njani namanqanaba ahlukeneyo endawo kumadoda aphilile. Ewe, i-hypothalamus ye-lateral idityaniswa kunye nokujikeleza kwe-penile kwaye kubonakala ngathi inxulumene namazwe avusiweyo.
Izifundo ezisebenzayo ze-neuroimaging zibonisa ukuba ezinye izakhiwo eziphantsi, ezinjenge-hippocampus, i-amygdale kunye ne-thalamus zivelise imisebenzi ephezulu ngokunxulumene nokukhuthaza okubonakalayo kunye namanqanaba athile okuqanjwa kwe penile [4]. Ngokweziphumo zethu, akukho lutshintsho kumthamo wolu luhlu olunzulu lwegrey kwiqela lesigulana.
Kuyaphawuleka ukuba olu phononongo luneentsilelo ezithile. Kuba isixhobo sokuqala asiquki isahlulo se-hypothalamus, uhlalutyo lwe-ROI-VMB lumele isisombululo esithembekileyo sokuvavanya ngokuzenzekelayo utshintsho olwenziwe macro kwi-hypothalamus. Kodwa le ndlela ayiyenzelwanga ukuba ihlalutye izakhiwo ezincinci zecortical, ekubeni ithambekele kwisizukulwana se-artefact kwi-subcortical GM. I-VMB isekwe kwisahlulo se-GM esijikelezwe kwindawo yengingqi kwaye ke sijongwa ngokungachanekanga kokuhlelwa kohlobo lweethishu kunye nolwandiso olukhawulezayo lokucoca [30], [51]-[53]. Ngesi sizathu ukucaciswa kweziphumo ze-ROI-VBM kufuna ulumkiso.
isiphelo
Ngaphandle komdla okhulayo wezinto ezihambelana nokuziphatha ngokwesondo, ukungasebenzi ngokwesondo kwamadoda kuye kwafumana uqwalaselo olungelulo. Iziphumo zethu zigxininisa ubukho botshintsho olwenziwe macro kwi-GM yemimandla emibini engezantsi, i-nucleus accumbens kunye ne-hypothalamus, ezibonakala zidlala indima ebalulekileyo kwimicimbi ekhuthazayo yokuziphatha ngokwesondo kwamadoda. Iziphumo zethu zibonisa ukubaluleka kwento ekhuthazayo yokuziphatha ngokwesondo ukuze kuvumeleke ukusebenza okwanelisayo ngokwesondo kumadoda aphilayo. Ngaphezu koko, kunokuba yinto yokuba ukuthintelwa kwempendulo yesondo kwizigulana ezichaphazeleke ngokungasebenzi kwengqondo ye-erectile dysfunction inokusebenza kweli candelo. Utshintsho lolwakhiwo lwesakhiwo esenziwe kunye nobungqina obudlulileyo bobuchwephetsha bukhanyisela ukukhanya kwezinto ezintsonkothileyo zesondo kwabesilisa.
Ngapha koko, ezi ziphumo zinokuncedisa ekuphuhliseni amayeza onyango amatsha kunye nokuvavanya ukusebenza kwezi zisetyenziswayo ngoku.
Imihlathi
Ukugqiba Inzala: Ababhali baye bavakalisa ukuba akukho mfuno ekhuphisanayo.
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Ucaphulo
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