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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
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Insular multiple sclerosis lesions are associated with erectile dysfunction.

Klemens Winder1, Ralf A Linker1, Frank Seifert1

  • 1Department of Neurology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.

Journal of Neurology
|February 3, 2018
PubMed
Summary
This summary is machine-generated.

Multiple sclerosis (MS) can cause erectile dysfunction (ED) by damaging brain lesions, particularly in the left insular region. This area is crucial for sexual arousal, and its lesions correlate with ED in men with MS.

Keywords:
Autonomic dysfunctionErectile dysfunctionMultiple sclerosisSexual dysfunctionVoxel-based lesion symptom mapping

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Area of Science:

  • Neuroscience
  • Neurology
  • Urology

Background:

  • Erectile function (EF) is often impaired in men with multiple sclerosis (MS).
  • Brain imaging studies in healthy individuals have identified key brain regions involved in EF, including the insula, visual and somatosensory areas, cingulate gyrus, and prefrontal cortex.
  • Understanding the relationship between MS-related brain lesions and EF deterioration is crucial for patient care.

Purpose of the Study:

  • To investigate the association between the location of cerebral MS lesions and the deterioration of erectile function in men with MS.
  • To identify specific brain regions where MS lesions contribute to erectile dysfunction.

Main Methods:

  • The study included 31 men with MS, assessing erectile function using the International Index of Erectile Function-5 (IIEF5) questionnaire.
  • Erectile function deterioration was calculated by comparing current IIEF5 scores with scores from 3 months prior to MS diagnosis (DeltaIIEF5).
  • Magnetic resonance imaging (MRI) was used to identify and map MS lesions, with voxel-wise analysis comparing lesion locations with EF deterioration.

Main Results:

  • Erectile function deterioration was observed in 45.2% of the participants.
  • No significant associations were found between EF deterioration and patient age, disease duration, disease severity, depressiveness, or bladder/bowel symptoms.
  • Voxel-wise analysis revealed a significant association between erectile dysfunction and MS lesions predominantly in the bilateral, and especially the left, juxtacortical insular region.

Conclusions:

  • MS lesions in the insular region, particularly the left side, are significantly associated with erectile dysfunction in men with MS.
  • The insula's role in sexual arousal suggests that MS-related damage to this area directly impacts erectile function.
  • These findings highlight the importance of considering neurological factors, specifically insular lesions, in the management of erectile dysfunction in MS patients.