Altered Functional Coherence of the Right Anterior Insula in Men With Nonorganic Erectile Dysfunction: A
YuXin Bai1,2, Weilu Chai1,2, Min Guan3
1Engineering Research Center of Molecular and Neuro Imaging of Ministry of Education, School of Life Science and Technology, Xidian University, Xi'an, Shaanxi, China.
Background:
Nonorganic erectile dysfunction (nonorganic ED) is a common subtype of ED characterized by impaired erectile function in the absence of identifiable organic causes. Although ED is increasingly recognized as a multidimensional condition involving interacting biological, psychological, relational, and sociocultural factors, how these influences are integrated within central neural systems in nonorganic ED remains incompletely understood. Objective neurobiological markers are therefore still lacking.
Objectives:
To investigate whether patients with nonorganic ED exhibit abnormalities in local intrinsic brain activity and to examine the association between these alterations and erectile function.
Materials And Methods:
Resting-state functional magnetic resonance imaging data were acquired from 29 patients with nonorganic ED and 29 age-matched healthy controls. Regional homogeneity (ReHo) was used to assess local synchronization of spontaneous neural activity across the whole brain. Between-group differences were evaluated using voxel-wise analysis. Correlation analyses were performed to assess associations between altered ReHo and erectile function as measured by the International Index of Erectile Function (IIEF).
Results:
Compared with healthy controls, patients with nonorganic ED exhibited significantly decreased ReHo in the right anterior insula (family-wise error corrected). Furthermore, reduced ReHo in this region was significantly associated with greater ED severity.
Discussion:
These findings indicate that nonorganic ED is associated with disrupted local functional coherence in the anterior insula, a key region involved in integrating interoceptive, emotional, cognitive, and autonomic processes. The observed association with erectile function suggests that impaired integration of these processes may contribute to the central neural mechanisms underlying nonorganic ED.
Conclusion:
Patients with nonorganic ED exhibit reduced local functional coherence in the anterior insula, which is associated with ED severity. These findings provide preliminary evidence linking central neural dysfunction to clinical symptoms and support the further evaluation of resting-state fMRI metrics as candidate neurobiological markers for nonorganic ED.
