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. 2024 Aug 31;12(4):qfae047.
doi: 10.1093/sexmed/qfae047. eCollection 2024 Aug.

Altered brain activity associated with premature ejaculation improved by electroacupuncture in rats

Ning Wu  1   2 , Jian-Huai Chen  3 , Tong Wang  1 , Bai-Bing Yang  4 , Si-Yan Xing  4 , Song-Zhan Gao  5 , Da-Wei Ni  1 , Guang-Jun Du  4 , Tao Song  4 , You-Feng Han  4 , Guo-Hai Sun  4 , Qing-Qiang Gao  4 , Chun-Lu Xu  4 , Yu-Tian Dai  1
Affiliations

Altered brain activity associated with premature ejaculation improved by electroacupuncture in rats

Ning Wu et al. Sex Med. .

Abstract

Background: Premature ejaculation (PE) is linked with abnormal brain activity that is modifiable by electroacupuncture (EA).

Aim: In this study we aimed to explore the central pathological mechanism underlying EA in treating PE.

Methods: Six-week-old male Sprague-Dawley rats were divided into a PE group (n = 8) and a control group (n = 8) according to ejaculatory frequency during copulatory behavior. All rats underwent EA at the Zusanli acupoint (ST-36) for 4 weeks. Magnetic resonance imaging data were collected before and after EA.

Outcomes: The behavioral parameters, plasma norepinephrine levels, fractional amplitude of low frequency fluctuation (fALFF), and regional homogeneity (ReHo) were evaluated.

Results: The PE group ejaculated more times with shorter latency compared with controls. After EA, the ejaculation frequency of the PE group decreased, and the ejaculation latency period increased, with no changes observed in the control group. Norepinephrine levels were higher in the PE group than in the controls and were positively correlated with ejaculation frequency and negatively correlated with ejaculation latency. The PE group showed lower fALFF in the right striatum and higher ReHo in the brainstem compared with controls. After EA, controls showed decreased fALFF in the right striatum, left olfactory bulb, and dorsal fornix and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, prelimbic system, right basal forebrain region, septal region, and olfactory bulb, while the model group exhibited increased fALFF in the right hypothalamic region, decreased fALFF in the left globus pallidum and right basal forebrain region and increased ReHo in the right interpeduncular nucleus, as well as decreased ReHo in the left striatum, olfactory bulb, basal forebrain region, dentate gyrus, right dysgranular insular cortex, and striatum. Compared with the controls after EA, the model group showed increased ReHo of the right hypothalamic region and decreased ReHo of the right dysgranular insular cortex.

Clinical implications: These findings might enhance the understanding of PE and contribute to new, targeted therapies for PE.

Strengths and limitations: The therapeutic effects might be achieved by EA inhibiting the activity in brain regions involved in ejaculatory behavior. However, the curative effect of acupuncture might be underestimated due to some curative effects of sham acupuncture used in the control group.

Conclusion: In conclusion, the ejaculatory frequency of rats may be reduced and ejaculation latency could be extended by EA at ST-36, which might be achieved by the effects of this treatment on brain activity.

Keywords: electroacupuncture; fractional amplitude of low frequency fluctuation; functional magnetic resonance imaging; premature ejaculation; regional homogeneity; resting-state.

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Conflict of interest statement

All authors declared that they had no conflict of interest.

Figures

Figure 1
Figure 1
Correlation of the NE level with ejaculation frequency (A) and ejaculation latency (B). The plasma NE level was used as the indirect index of sympathetic neural activity. Both EL and EF were correlated with plasma NE (both P < .01). EF, ejaculation frequency; EL, ejaculation latency; NE, norepinephrine (nmol/L).
Figure 2
Figure 2
Altered brain regions in PE rats compared with controls before treatment. The significant differences were set at P < .005 and the minimum cluster size was 5 voxels, uncorrected. fALFF, fractional amplitude of low frequency fluctuation; PE, premature ejaculation; ReHo, regional homogeneity.
Figure 3
Figure 3
Altered brain regions in control rats after treatment compared with those before treatment. The significant differences were set at P < .005 and the minimum cluster size was 5 voxels, uncorrected. fALFF: fractional amplitude of low frequency fluctuation; ReHo: regional homogeneity.
Figure 4
Figure 4
Altered brain regions in PE rats after treatment compared with those before treatment. The significant differences were set at P < .005 and the minimum cluster size was 5 voxels, uncorrected. fALFF, fractional amplitude of low frequency fluctuation; PE, premature ejaculation; ReHo, regional homogeneity.
Figure 5
Figure 5
Altered brain regions in PE rats when compared with controls after treatment. The significant differences were set at P < .005 and the minimum cluster size was 5 voxels, uncorrected. fALFF, fractional amplitude of low frequency fluctuation; PE, premature ejaculation; ReHo, regional homogeneity.
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