Brain structural and functional differences in anejaculation and sleep disorders: A functional magnetic resonance imaging-based approach.

Abstract

Background and aims: Sleep disorders (SDs) have been identified as an independent risk factor for ejaculatory dysfunctions; yet the neurophysiological mechanisms underlying the comorbidity between anejaculation (AE) and SDs remain poorly understood. This study aims to investigate the potential pathways that connect SDs and AE, comparing findings across a sample of affected patients and healthy controls (HCs) to better elucidate these complex interactions.

Methods: Resting-state functional magnetic resonance imaging (rs-fMRI) data were obtained for 21 AE patients, 20 patients with anejaculation accompanied by sleep disorders (AESD), and 18 HCs. We analyzed group differences in fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), voxel-based morphometry (VBM), and functional connectivity (FC) values between brain regions of interest (ROIs).

Results: FALFF significant differences were seen in the medial superior frontal gyrus as well as in the left middle occipital gyrus. ReHo analysis demonstrated significant differences among groups in the left middle occipital gyrus, left superior parietal lobe, and left middle temporal gyrus. Different cerebellar area 7b volumes in the AE group compared to the other groups were also reported. Additionally, the AESDs group demonstrated different FC signals in multiple brain areas compared to the other groups.

Conclusion: Rs-fMRI reported structural and functional differences in the brain activity across three groups. This study was the first to disentangle potential links between sleep disorders and AE, generating insights that may guide future therapeutic approaches.