Abnormal cortical surface-based spontaneous and functional connectivity in the whole brain in lifelong premature ejaculation patients

Abstract

Recent research has highlighted structural and functional abnormalities in the cerebral cortex of patients with premature ejaculation (PE). These anomalies could play a pivotal role in the physiological mechanisms underlying PE. This study leveraged functional magnetic resonance imaging (fMRI), a noninvasive technique, to explore these neural mechanisms. We conducted resting-state fMRI scans on 36 PE patients and 22 healthy controls (HC), and collected data on Premature Ejaculation Diagnostic Tool (PEDT) scores and intravaginal ejaculation latency time (IELT). Employing a surface-based regional homogeneity (ReHo) approach, we analyzed local neural synchronous spontaneous activity, diverging from previous studies that utilized a volume-based ReHo method. Areas with significant ReHo differences between PE and HC groups underwent surface-based functional connectivity (FC) analysis. Significant discrepancies in ReHo and FC across the cortical surface were observed in the PE cohort. Notably, PE patients exhibited decreased ReHo in the left triangular inferior frontal gyrus and enhanced ReHo in the right middle frontal gyrus. The latter showed heightened connectivity with the left lingual gyrus and the right orbital superior frontal gyrus. Furthermore, a correlation between ReHo and FC values with PEDT scores and IELT was found in the PE group. Our findings, derived from surface-based fMRI data, underscore specific brain regions linked to the neurobiological underpinnings of PE.

Figure 1

Significant differences of ReHo between PE and HC participants. Details of the abnormal brain regions between the two groups were shown in Table 2. The color bar indicated the T of independent samples t-test (P < 0.05, GRF corrected, vertex level P < 0.001, cluster level P < 0.05). ReHo: regional homogeneity; PE: premature ejaculation; HC: healthy control; L: left; R: right.

Figure 2

Functional connections altered. Based on using the rMFG as seeds, the functional connectivity was enhanced in the PE patients compared with the HC group. The color bar indicated the T of independent samples t-test (P < 0.05, GRF corrected, vertex level P < 0.001, cluster level P < 0.05). rMFG: right middle frontal gyrus; PE: premature ejaculation; HC: healthy control; L: left; R: right.

Figure 3

Correlation between clinical scale scores and brain activity in PE group (ReHo and FC). (a) The ReHo value in the lTIFG correlated with the IELT and PEDT score. (b) The ReHo value in the rMFG correlated with the IELT and PEDT score. (c) The FC from the rMFG to the lLG correlated with the IELT and PEDT score. ReHo: regional homogeneity; PE: premature ejaculation; HC: healthy control; lTIFG: left triangle inferior frontal gyrus; rMFG: right middle frontal gyrus; lLG: left lingual gyrus; PEDT: Premature Ejaculation Diagnostic Tool; IELT: intravaginal ejaculatory latency time.