Sensory Issues and Fatigue Are Key Factors Contributing to Sexual Dysfunction in Women With Multiple Sclerosis

IF 1.1 3区医学 Q2 CLINICAL NEUROLOGY

Acta Neurologica Scandinavica Pub Date : 2026-01-15 DOI:10.1155/ane/9946835

K. Novotna, L. Friedova, J. Motyl, M. Vaneckova, D. Horakova, M. Andelova

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Abstract

Background/Aim

Sexual dysfunction (SD) is a prevalent yet underrecognized concern among women with multiple sclerosis (MS), substantially affecting quality of life. This study was aimed at investigating the magnetic resonance imaging (MRI) correlates of SD, with a particular focus on the spinal cord (SC), and to explore associations between SD and other disability metrics.

Methods

SD was assessed using the Female Sexual Function Index (FSFI) questionnaire, administered to 251 female patients with multiple sclerosis (PwMSs). All PwMSs underwent brain and cervical SC MRI at 3T, alongside EDSS, assessment of depression, fatigue, cognition, manual dexterity, and gait. Quantitative brain and SC MRI measures were obtained, including global and regional brain volumes, SC volume, and lesion counts in the brain and SC. Associations between quantitative MRI metrics, disability, and SD were analyzed using partial correlation, controlling for age and disease duration. Subsequently, the predictive value of MRI and clinical variables for SD severity was evaluated using linear regression models adjusted for age and disease duration.

Results

The response rate was 58.5%, with 32.7% PwMS meeting the criteria for SD. PwMS with SD exhibited significantly reduced right and left cingulate (p = 0.03 and 0.04) volumes. However, no significant correlations were observed between SD severity and quantitative MRI measures when controlling for age and disease duration. Fatigue and depression demonstrated moderate correlations with overall SD severity (rho = −0.491/−455, p < 0.001). Shorter 2-min walking test distance was associated with a higher risk of SD (p = 0.029). Sensory dysfunction (p = 0.025) and depression (p < 0.030) were the only independent predictors of SD severity.

Conclusion

Among MRI predictors of SD, we identified only a reduction of cingulate volume in PwMS with SD. Walking performance, depression, and sensory dysfunction were key predictors for SD presence and severity, highlighting the need for targeted screening for SD in PwMS with these risk factors. Exploring the role of contributing factors (use of antidepressants and medication for neuropathic pain) and interventions, that is, physical exercise, is warranted.

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感觉问题和疲劳是导致多发性硬化症女性性功能障碍的关键因素

背景/目的：性功能障碍（SD）是多发性硬化症（MS）女性患者普遍存在但未被充分认识的问题，严重影响生活质量。本研究旨在探讨SD的磁共振成像（MRI）相关性，特别关注脊髓（SC），并探讨SD与其他残疾指标之间的关联。方法采用女性性功能指数（FSFI）问卷对251例多发性硬化症（PwMSs）女性患者进行SD评估。所有PwMSs患者在3T时进行脑和颈椎SC MRI，同时进行EDSS，评估抑郁、疲劳、认知、手灵巧性和步态。获得定量脑和SC MRI测量，包括整体和局部脑体积、SC体积以及脑和SC中的病变计数。定量MRI指标、残疾和SD之间的关联使用部分相关分析，控制年龄和疾病持续时间。随后，使用调整年龄和病程的线性回归模型评估MRI和临床变量对SD严重程度的预测价值。结果有效率为58.5%，其中32.7%的PwMS符合SD标准。SD组PwMS右侧和左侧扣带体积明显减少（p = 0.03和0.04）。然而，在控制年龄和疾病持续时间的情况下，SD严重程度与定量MRI测量之间没有显著相关性。疲劳和抑郁与总体SD严重程度有中度相关性（rho = - 0.491/ - 455, p < 0.001）。较短的2分钟步行测试距离与较高的SD风险相关（p = 0.029）。感觉功能障碍（p = 0.025）和抑郁（p < 0.030）是SD严重程度的唯一独立预测因子。结论在SD的MRI预测指标中，我们只发现了PwMS伴SD的扣带体积减少。行走表现、抑郁和感觉功能障碍是SD存在和严重程度的关键预测因素，强调有必要对具有这些危险因素的PwMS进行有针对性的SD筛查。探索促成因素（使用抗抑郁药和神经性疼痛药物）和干预措施（即体育锻炼）的作用是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Neurologica Scandinavica 医学-临床神经学

CiteScore

6.70

自引率

2.90%

发文量

161

审稿时长

4-8 weeks

期刊介绍： Acta Neurologica Scandinavica aims to publish manuscripts of a high scientific quality representing original clinical, diagnostic or experimental work in neuroscience. The journal''s scope is to act as an international forum for the dissemination of information advancing the science or practice of this subject area. Papers in English will be welcomed, especially those which bring new knowledge and observations from the application of therapies or techniques in the combating of a broad spectrum of neurological disease and neurodegenerative disorders. Relevant articles on the basic neurosciences will be published where they extend present understanding of such disorders. Priority will be given to review of topical subjects. Papers requiring rapid publication because of their significance and timeliness will be included as ''Clinical commentaries'' not exceeding two printed pages, as will ''Clinical commentaries'' of sufficient general interest. Debate within the speciality is encouraged in the form of ''Letters to the editor''. All submitted manuscripts falling within the overall scope of the journal will be assessed by suitably qualified referees.