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Changes of insular function in lifelong premature ejaculation patients before and after SSRI administration

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Abstract

Objective

Lifelong premature ejaculation (PE) is regarded as one of the most common male sexual dysfunction. We aimed to detect whether insula-related brain functional networks are altered in lifelong PE patients and whether such alterations are “normalised” after selective serotonin reuptake inhibitors (SSRI) administration.

Methods

Twenty-three drug-naive lifelong PE patients and 30 healthy controls (HC) were recruited in current study. All subjects underwent resting-state functional magnetic resonance imaging (fMRI) scan at first. One hour after dapoxetine administration, all patients underwent fMRI scanning again. The degree centrality (DC), amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) analysis, and ROI-based functional connectivity (FC) analysis were applied to calculate the abnormalities in insula-related functions among three groups.

Results

Compared to HC group, PE patients at baseline showed significantly altered DC, ALFF, and ReHo value of the bilateral insula, which subsequently showed a “normalised” trend after dapoxetine administration. Additionally, compared to HC group, PE patients at baseline showed significantly decreased FC between insula and precentral gyrus, inferior frontal gyrus, middle/inferior temporal gyrus, and caudate, while patients after dapoxetine administration showed increased insula-related FC in anterior cingulate cortex and decreased FC in thalamus and middle/inferior temporal gyrus. The main effects of dapoxetine were located in precentral gyrus, inferior frontal gyrus, caudate, and limbic system.

Conclusions

Our findings report altered brain mechanism of insula in lifelong PE patients and also indicate that dapoxetine can “normalise” the abnormal function of the insula to certain extent in lifelong PE patients.

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Funding

This study was financially supported by the National Natural Science Foundation of China (No.82270696, 62001370, 81960570), China Postdoctoral Science Foundation Grant (No. 2019M650985), Young Science and Technology Stars in Shaanxi Province (No.2021KJXX-56), Health Research Talent Project of Xi'an Health Commission (No.2021yb61), Project for Improving Public Scientific Quality of Shaanxi Provincial (No.2021PSL115), Shaanxi Provincial Health Research Fund Project (No.2022D006), and Natural Science Basic Research Program of Shaanxi (Grand No. 2022JQ-649).

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Author notes

  1. Ming Gao and Bowen Geng contributed equally to this work.

Authors and Affiliations

  1. Department of Urology, Xi’An Daxing Hospital Affiliated to Yan’an University, Xi’an, China

    Ming Gao & Yanzhu Wang

  2. Life Science Research Center, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China

    Bowen Geng, Shuming Zhang, Ke Xu, Pengyu Li, Duoli Chen, Xiao Zeng & Peng Liu

  3. Engineering Research Center of Molecular and Neuro Imaging Ministry of Education, School of Life Science and Technology, Xidian University, Xi’an, Shaanxi, China

    Bowen Geng, Shuming Zhang, Ke Xu, Pengyu Li, Duoli Chen, Xiao Zeng & Peng Liu

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  1. Ming Gao
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Correspondence to Peng Liu or Yanzhu Wang.

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Gao, M., Geng, B., Zhang, S. et al. Changes of insular function in lifelong premature ejaculation patients before and after SSRI administration. Psychopharmacology 239, 3953–3962 (2022). https://doi.org/10.1007/s00213-022-06268-5

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  • DOI: https://doi.org/10.1007/s00213-022-06268-5

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