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Potential biomarkers for distinguishing primary from acquired premature ejaculation: A diffusion tensor imaging based

Jianhuai Chen1, Qing Wang1, Xinfei Huang1

  • 1Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.

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Brain imaging reveals distinct white matter network differences in premature ejaculation (PE) subtypes. Abnormal left amygdala segregation may help differentiate primary PE from acquired PE.

Keywords:
acquired premature ejaculationdiffusion tensor imaginggraph theoretical analysisprimary premature ejaculationsegregation

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Area of Science:

  • Neuroscience
  • Medical Imaging
  • Urology

Background:

  • Premature ejaculation (PE) is a common sexual dysfunction with distinct primary and acquired forms.
  • The underlying central neuropathological mechanisms, particularly brain differences, among PE subtypes remain largely unknown.
  • Understanding these differences is crucial for targeted therapeutic strategies.

Purpose of the Study:

  • To investigate the differences in whole-brain white matter structural networks between healthy controls (HC) and patients with primary or acquired premature ejaculation (PE).
  • To identify potential neuroimaging biomarkers for differentiating PE subtypes using graph theoretical analysis and receiver operating characteristic (ROC) curves.

Main Methods:

  • Diffusion tensor imaging (DTI) data were acquired from 44 HC and 47 PE patients (24 primary PE, 23 acquired PE).
  • Whole-brain white matter structural networks were constructed, and nodal segregative parameters were analyzed using graph theory.
  • ROC curve analysis was performed to assess the diagnostic utility of identified altered parameters.

Main Results:

  • PE patients exhibited increased clustering coefficient and local efficiency in the left inferior frontal gyrus (IFGtriang.L) and left precental gyrus (PreCG.L) compared to HC.
  • Primary PE patients showed increased segregation in the left IFGtriang.L and left amygdala (AMYG.L).
  • Acquired PE patients displayed increased segregation in the left IFGtriang.L but decreased segregation in the left AMYG.L compared to HC. The left AMYG.L showed abnormal segregation, distinguishing primary from acquired PE with high sensitivity and specificity.

Conclusions:

  • The study identified distinct white matter network alterations in primary and acquired PE.
  • Abnormal segregation in the left amygdala (AMYG.L) emerged as a potential neuroimaging biomarker for differentiating primary PE from acquired PE.
  • These findings enhance the understanding of PE pathophysiology and suggest novel diagnostic markers.