男性癫痫患者的性功能障碍-一项观察性病例对照研究

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES

Epilepsy & Behavior Pub Date : 2025-03-28 DOI:10.1016/j.yebeh.2025.110388

Sumant Jayadev Balagandi , Lakshminarayanapuram Gopal Viswanathan , Ezhumalai Sinu , Nandakumar Dalavaikodihalli Nanjaiah , Ajay Asranna , Mundlamuri Ravindranadh Chowdary , Raghavendra Kenchaiah , Thennarasu Kandavel , Sanjib Sinha

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引用次数: 0

摘要

背景：男性癫痫患者面临多方面的挑战，包括性功能障碍和精神合并症。了解癫痫、抗癫痫药物、激素改变和性功能障碍之间的相互作用对于量身定制的干预和改善生活质量至关重要。方法本病例对照研究招募了226名已婚男性（150名女性，76名对照），来自印度南部的一家三级神经内科医院。收集了人口统计学、临床和激素数据。性功能障碍评估使用亚利桑那性经验量表（ASEX）和早泄诊断工具（PEDT）。使用DASS-21问卷评估精神症状。结果19%的MWE表现出明显的性功能障碍。综合治疗组ASEX评分中位数（15分）明显高于单一治疗组（13分）和对照组（10分），p <；0.0001)。综合治疗组有20人出现性功能障碍的临界值（>18），单一治疗组有8人，对照组没有(p <；0.0001)。PEDT评分显示类似的模式，亚组之间有统计学上的显著差异。激素分析显示，MWE患者的LH和睾酮水平失调，并且在多疗法亚组中两两比较明显更多。在使用赤池信息标准的多变量回归模型中，癫痫持续时间、丙戊酸盐使用和焦虑/抑郁的存在与性功能障碍相关。结论本研究阐明了男性癫痫、药物、激素改变和性功能障碍之间的复杂关系。丙戊酸被发现与性功能障碍和荷尔蒙失调密切相关。进一步的研究是有必要的，以解决研究的局限性，并提高我们对MWE性功能障碍的理解。

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Sexual dysfunction in men with epilepsy – An observational case-control study

Background

Epilepsy presents multifaceted challenges, including sexual dysfunction and psychiatric comorbidities in men. Understanding the interplay between epilepsy, antiseizure medications, hormonal alterations, and sexual dysfunction is crucial for tailored interventions and improved quality of life.

Methods

This case-control study enrolled 226 married men (150 MWE, 76 controls) from a tertiary care neurology hospital in Southern India. Demographic, clinical, and hormonal data were collected. Sexual dysfunction was assessed using the Arizona Sexual Experience Scale (ASEX) and the Premature Ejaculation Diagnostic Tool (PEDT). Psychiatric symptoms were evaluated using the DASS-21 questionnaire.

Results

Nineteen percent of MWE exhibited significant sexual dysfunction. Median ASEX scores were significantly higher in polytherapy (15) compared with monotherapy (13) and controls (10), (p < 0.0001). The cut-off score for sexual dysfunction (>18) was present in 20 individuals in the polytherapy group, 8 in the monotherapy group and none in the control group (p < 0.0001). PEDT scores showed a similar pattern, with statistically significant differences between subgroups. Hormonal analysis revealed dysregulated LH and testosterone levels in MWE and were significantly more on pairwise comparisons in the polytherapy subgroup. Epilepsy duration, valproate usage, and presence of anxiety/depression were associated with sexual dysfunction on a multivariable regression model using the Akaike information criterion.

Conclusion

This study elucidates the complex relationship between epilepsy, medications, hormonal alterations, and sexual dysfunction in men. Valproate was found to be strongly associated with sexual dysfunction and hormonal imbalance. Further research is warranted to address study limitations and advance our understanding of sexual dysfunction in MWE.

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.