Neural bases of hypoactive sexual desire disorder in women: an event-related FMRI study.

INTRODUCTION: Although there is an abundant debate regarding the mechanisms sustaining one of the most common sexual complaints among women, i.e., female hypoactive sexual desire disorder (HSDD), little remains known about the specific neural bases of this disorder. AIM: The main goal of this study was to determine whether women with HSDD showed differential patterns of activation within the brain network that is active for sexual desire in subjects without HSDD. METHODS: A total of 28 right-handed women participated in this study (mean age 31.1±7.02 years). Thirteen out of the 28 women had HSDD (HSDD participants), while 15 women reported no hypoactive sexual desire disorder (NHSDD participants). Using event-related functional magnetic resonance imaging (fMRI), we compared the regional cerebral blood flow responses between these two groups of participants, while they were looking at erotic vs. non-erotic stimuli. MAIN OUTCOME MEASURE: Blood-oxygenation level dependent (BOLD) signal changes in response to erotic stimuli (compared with non-erotic stimuli). Statistical Parametric Mapping was used to identify brain regions that demonstrated significant differential activations between stimuli and between groups. RESULTS: As expected, behavioral results showed that NHSDD participants rated erotic stimuli significantly higher than HSDD participants did on a 10-point desirable scale. No rating difference was observed for the non-erotic stimuli between NHSDD and HSDD participants. Our functional neuroimaging results extended these data by demonstrating two distinct types of neural changes in participants with and without HSDD. In comparison with HSDD participants, participants without HSDD demonstrated more activation in brain areas involved in the processing of erotic stimuli, including intraparietal sulcus, dorsal anterior cingulate gyrus, and ento/perirhinal region. Interestingly, HSDD participants also showed additional activations in brain areas associated with higher order social and cognitive functions, such as inferior parietal lobule, inferior frontal gyrus, and posterior medial occipital gyrus. CONCLUSION: Together, these findings indicate that HSDD participants do not only show a hypo activation in brain areas mediating sexual desire, but also a different brain network of hyper activation, which might reflect differences in subjective, social, and cognitive interpretations of erotic stimuli. Collectively, these data are in line with the incentive motivation model of sexual functioning.

Intention, false beliefs, and delusional jealousy: insights into the right hemisphere from neurological patients and neuroimaging studies.

Jealousy sits high atop of a list comprised of the most human emotional experiences, although its nature, rationale, and origin are poorly understood. In the past decade, a series of neurological case reports and neuroimaging findings have been particularly helpful in piecing together jealousy's puzzle. In order to understand and quantify the neurological factors that might be important in jealousy, we reviewed the current literature in this specific field. We made an electronic search, and examined all literature with at least an English abstract, through Mars 2010. The search identified a total of 20 neurological patients, who experienced jealousy in relation with a neurological disorder; and 22 healthy individuals, who experienced jealousy under experimental neuroimaging settings. Most of the clinical cases of reported jealousy after a stroke had delusional-type jealousy. Right hemispheric stroke was the most frequently reported neurological disorder in these patients, although there was a wide range of more diffuse neurological disorders that may be reported to be associated with different other types of jealousy. This is in line with recent neuroimaging data on false beliefs, moral judgments, and intention [mis]understanding. Together the present findings provide physicians and psychologists with a potential for high impact in understanding the neural mechanisms and treatment of jealousy. By combining findings from case reports and neuroimaging data, the present article allows for a novel and unique perspective, and explores new directions into the neurological jealous mind.

Neuroimaging of love: fMRI meta-analysis evidence toward new perspectives in sexual medicine.

INTRODUCTION: Brain imaging is becoming a powerful tool in the study of human cerebral functions related to close personal relationships. Outside of subcortical structures traditionally thought to be involved in reward-related systems, a wide range of neuroimaging studies in relationship science indicate a prominent role for different cortical networks and cognitive factors. Thus, the field needs a better anatomical/network/whole-brain model to help translate scientific knowledge from lab bench to clinical models and ultimately to the patients suffering from disorders associated with love and couple relationships. AIM: The aim of the present review is to provide a review across wide range of functional magnetic resonance imaging (fMRI) studies to critically identify the cortical networks associated with passionate love, and to compare and contrast it with other types of love (such as maternal love and unconditional love for persons with intellectual disabilities). METHODS: Retrospective review of pertinent neuroimaging literature. MAIN OUTCOME MEASURES: Review of published literature on fMRI studies of love illustrating brain regions associated with different forms of love. RESULTS: Although all fMRI studies of love point to the subcortical dopaminergic reward-related brain systems (involving dopamine and oxytocin receptors) for motivating individuals in pair-bonding, the present meta-analysis newly demonstrated that different types of love involve distinct cerebral networks, including those for higher cognitive functions such as social cognition and bodily self-representation. CONCLUSIONS: These metaresults provide the first stages of a global neuroanatomical model of cortical networks involved in emotions related to different aspects of love. Developing this model in future studies should be helpful for advancing clinical approaches helpful in sexual medicine and couple therapy.

Understanding actions of others: the electrodynamics of the left and right hemispheres. A high-density EEG neuroimaging study.

BACKGROUND: When we observe an individual performing a motor act (e.g. grasping a cup) we get two types of information on the basis of how the motor act is done and the context: what the agent is doing (i.e. grasping) and the intention underlying it (i.e. grasping for drinking). Here we examined the temporal dynamics of the brain activations that follow the observation of a motor act and underlie the observer's capacity to understand what the agent is doing and why. METHODOLOGY/PRINCIPAL FINDINGS: Volunteers were presented with two-frame video-clips. The first frame (T0) showed an object with or without context; the second frame (T1) showed a hand interacting with the object. The volunteers were instructed to understand the intention of the observed actions while their brain activity was recorded with a high-density 128-channel EEG system. Visual event-related potentials (VEPs) were recorded time-locked with the frame showing the hand-object interaction (T1). The data were analyzed by using electrical neuroimaging, which combines a cluster analysis performed on the group-averaged VEPs with the localization of the cortical sources that give rise to different spatio-temporal states of the global electrical field. Electrical neuroimaging results revealed four major steps: 1) bilateral posterior cortical activations; 2) a strong activation of the left posterior temporal and inferior parietal cortices with almost a complete disappearance of activations in the right hemisphere; 3) a significant increase of the activations of the right temporo-parietal region with simultaneously co-active left hemispheric sources, and 4) a significant global decrease of cortical activity accompanied by the appearance of activation of the orbito-frontal cortex. CONCLUSIONS/SIGNIFICANCE: We conclude that the early striking left hemisphere involvement is due to the activation of a lateralized action-observation/action execution network. The activation of this lateralized network mediates the understanding of the goal of object-directed motor acts (mirror mechanism). The successive right hemisphere activation indicates that this hemisphere plays an important role in understanding the intention of others.

[Unconscious sexual desire: fMRI and EEG evidences from self-expansion theory to mirror neurons]. / Inconscient et désir sexuel: evidences en IRMf et EEG de la théorie d'expansion de soi aux neurones miroirs.

Recent advances in cognitive-social neuroscience allow a better understanding of the mechanisms underlying dyadic relationships. From a neuronal viewpoint, desire in dyadic relationships involves a specific fronto-temporo-parietal network and also a subcortical network that mediates conscious and unconscious mechanisms of reward, satisfaction, attention, self representation and self-expansion. The integration of this neuroscientific knowledge on the unconscious neurobiological activation for sexual desire in the human brain will provide physicians with new therapeutical and neuroscientific tools to apprehend sexual disorders in couple.

"Sleeping Beauty paraphilia": deviant desire in the context of bodily self-image disturbance in a patient with a fronto-parietal traumatic brain injury.

BACKGROUND: Several case series and reports describe paraphilia as occurring after brain damage, mostly in the frontal lobes and diencephalic structures. Hypersexuality and paraphilic behaviors are also documented in a variety of other neurologic disorders, (e.g., Kluver Bucy syndrome, and more rarely in multiple sclerosis). In multiple sclerosis, hypersexual behavior and paraphilias have been associated with various focal brain lesions in the frontal and temporal lesions when inflammatory demyelination involves the hypothalamus and septal regions. CASE REPORT: A case of a patient who developed a particular and progressive sexual deviant behaviour after a head trauma. This men felt sexually aroused from seeing sleeping women as well as from taking care of their hands and nails while they were asleep. The patient was diagnosed with a moderate dysexecutive syndrome characteristic of a frontal disorder and a very specific parietal-related bodily self image disorder characterized by an incomplete mental image of his hands. The clinical hypothesis was that the paraphilia might be related to his post-traumatic disturbed bodily self image and more specifically to its related impulsive needs to complete his hands representation. CONCLUSIONS: This case report highlights the potential link between paraphilia, deviant and aggressive sexual behaviour, neurological disturbance and self-representation. The treatment of paraphilias remains very complex, and requires taking into account not only the social and psychological aspects of the disease, but also its organic dimensions.

Improving human brain mapping via joint inversion of brain electrodynamics and the BOLD signal.

We present several methods to improve the resolution of human brain mapping by combining information obtained from surface electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) of the same participants performing the same task in separate imaging sessions. As an initial step in our methods we used independent component analysis (ICA) to obtain task-related sources for both EEG and fMRI. We then used that information in an integrated cost function that attempts to match both data sources and trades goodness of fit in one regime for another. We compared the performance and drawbacks of each method in localizing sources for a dual visual evoked response experiment, and we contrasted the results of adding fMRI information to simple EEG-only inversion methods. We found that adding fMRI information in a variety of ways gives superior results to classical minimum norm source estimation. Our findings lead us to favor a method which attempts to match EEG scalp dynamics along with voxel power obtained from ICA-processed blood oxygenation level dependent (BOLD) data; this method of joint inversion enables us to treat the two data sources as symmetrically as possible.

Mental representation of subjective pleasure of partnered experiences in women's brain conveyed through event-related fMRI.

BACKGROUND: Functional neuroimaging demonstrates a combined role of central and peripheral mechanisms in human sexual response. Nevertheless, inter-individual subjective differences remain unresolved. Since Freud, controversy remains regarding the similarity of each type of partnered sexual pleasure experience. The authors hypothesized that the neural networks sustaining the memory of all types of subjective partnered sexual pleasure experiences might interact with the insula, a key brain area for integrating somatic experiences. MATERIAL/METHODS: Using a 3T Phillips MRI scanner, brain activity elicited when 29 healthy female volunteers were exposed to subliminal presentation of their sexual partner's names, an approach to investigating the brain network sustaining the mental representation of their partner, was assessed. This brain activity was compared with scores from the Female Sexual Functioning Index on satisfaction and the typologies of their partnered orgasmic experiences. No orgasmic responses were recorded during fMRI. This approach allowed the investigation of the memory of the different types of stored partnered orgasmic experiences. RESULTS: The memory of partnered pleasure obtained by clitoral stimulation correlated with brain responses in the left insula only, while that of partnered pleasure by sexual intercourse correlated with the left insula and also with the right superior temporal gyrus, thalamus, and right inferior prefrontal gyrus. CONCLUSIONS: The results suggest that the memory of sexual experiences is integrated a posteriori at different levels (i.e. by different neural networks) in a woman's brain. The authors believe these findings will open a new avenue towards understanding inter- and intra-individual differences in woman's sexual mind.

Spatio-temporal dynamics of human intention understanding in temporo-parietal cortex: a combined EEG/fMRI repetition suppression paradigm.

Inferring the intentions of other people from their actions recruits an inferior fronto-parietal action observation network as well as a putative social network that includes the posterior superior temporal sulcus (STS). However, the functional dynamics within and among these networks remains unclear. Here we used functional magnetic resonance imaging (fMRI) and high-density electroencephalogram (EEG), with a repetition suppression design, to assess the spatio-temporal dynamics of decoding intentions. Suppression of fMRI activity to the repetition of the same intention was observed in inferior frontal lobe, anterior intraparietal sulcus (aIPS), and right STS. EEG global field power was reduced with repeated intentions at an early (starting at 60 ms) and a later (approximately 330 ms) period after the onset of a hand-on-object encounter. Source localization during these two intervals involved right STS and aIPS regions highly consistent with RS effects observed with fMRI. These results reveal the dynamic involvement of temporal and parietal networks at multiple stages during the intention decoding and without a strict segregation of intention decoding between these networks.

New electroencephalogram (EEG) neuroimaging methods of analyzing brain activity applicable to the study of human sexual response.

INTRODUCTION: Electroencephalogram (EEG) combined with brain source localization algorithms is becoming a powerful tool in the neuroimaging study of human cerebral functions. AIM: The present article provides a tutorial on the various EEG methods currently used to study the human brain activity, notably during sexual response. MAIN OUTCOME MEASURES: Review of published literature on standard EEG waveform analyses and most recent electrical neuroimaging techniques (microstate approach and two methods of brain source localization). METHODS: Retrospective overview of pertinent literature. RESULTS: Although the standard EEG waveform analyses enable millisecond time-resolution information about the human sexual responses in the brain, less is clear about their related spatial information. Nowadays, the improvement of EEG techniques and statistical approaches allows the visualization of the dynamics of the human sexual response with a higher spatiotemporal resolution. Here, we describe these enhanced techniques and summarize along with an overview of what we have learned from them in terms of chronoarchitecture of sexual response in the human brain. Finally, the speculation on how we may be able to use other enhanced approaches, such as independent component analysis, are also presented. CONCLUSIONS: EEG neuroimaging has already been proven as a strong worthwhile research tool. Combining this approach with standard EEG waveform analyses in sexual medicine may provide a better understanding of the neural activity underlying the human sexual response in both healthy and clinical populations.

Using ICA and realistic BOLD models to obtain joint EEG/fMRI solutions to the problem of source localization.

We develop two techniques to solve for the spatio-temporal neural activity patterns using Electroencephalogram (EEG) and Functional Magnetic Resonance Imaging (fMRI) data. EEG-only source localization is an inherently underconstrained problem, whereas fMRI by itself suffers from poor temporal resolution. Combining the two modalities transforms source localization into an overconstrained problem, and produces a solution with the high temporal resolution of EEG and the high spatial resolution of fMRI. Our first method uses fMRI to regularize the EEG solution, while our second method uses Independent Components Analysis (ICA) and realistic models of Blood Oxygen-Level Dependent (BOLD) signal to relate the EEG and fMRI data. The second method allows us to treat the fMRI and EEG data on equal footing by fitting simultaneously a solution to both data types. Both techniques avoid the need for ad hoc assumptions about the distribution of neural activity, although ultimately the second method provides more accurate inverse solutions.

Right hemisphere dominance for understanding the intentions of others: evidence from a split-brain patient.

Understanding the actions performed by other people is a key aspect of social interaction, including in clinical settings where patients are learning from therapists and caregivers. While lesions of the left cerebral hemisphere induce praxic disorders, the hemispheric specialisation of intention understanding remains unclear. Do patients with a right hemispheric lesion understand the intentions of other people properly? The present study investigates how a split-brain patient understands the means (what) and intentions (why) of the actions of other people. Results show a significant left hemispheric dominance for understanding what is done, and a significant right hemispheric dominance for understanding why an action is carried out. This discovery might have important clinical implications in neurological patients, especially when those with right hemisphere lesions are faced with important decisions related to the interpretation of other's intentions.

Differential recruitment of anterior intraparietal sulcus and superior parietal lobule during visually guided grasping revealed by electrical neuroimaging.

Dorsal parietal cortex is required for visually guided prehension. Transcranial magnetic stimulation to either the anterior intraparietal sulcus (aIPS) or superior parietal lobule (SPL) disrupts on-line adaptive adjustments of grasp when objects are perturbed. We used high-density electroencephalography during grasping to determine the relative timing of these two areas and to test whether the temporal contribution of each site would change when the task goal was perturbed. During object grasping with the right-hand, two distinct evoked responses were present over the 50-100 and 100-200 ms periods after movement onset. Distributed linear source estimation of these scalp potentials localized left lateralized sources, first in the aIPS and then the SPL. The duration of the response from the aIPS area was longer when there was an object perturbation. Initiation of a corrective movement coincided with activation in SPL. These data support a two-stage process: the integration of target goal and an emerging action plan within aIPS and subsequent on-line adjustments within SPL.

The chronoarchitecture of human sexual desire: a high-density electrical mapping study.

Recent neuroimaging research suggests that human sexual desire (SD) recruits both the limbic system and higher-order cognitive brain areas. Because of the temporal limitation of this technique, the chronoarchitecture of SD remains however unresolved. Here, we investigated the spatio-temporal dynamics of SD by combining a behavioral desire decision task with high-density visual event-related potential (VEP) recordings and brain source estimations. VEPs were recorded from thirteen healthy participants when presented with pictures from two different stimulus categories (i.e., high and low desirability). In agreement with the literature, behavioral results showed that participants were faster to rate non-desired stimuli than desired stimuli (p=0.028). Electrophysiological results extended these behavioral data. Group-averaged VEPs peaked at 90 to 140 ms (P100), at 142 to 220 ms (N200), and at 222 to 360 ms (P300). Desired stimuli (DS) were distinguished from non-desired stimuli (NDS) over the N200 period, notably from 142 to 187 ms. Over this time period, DS processing was characterized by a significant scalp potential field. Although both conditions (DS and NDS) showed the recruitment of the occipito-temporal region (including the extrastriate body area, EBA), LAURA source estimation of the DS scalp potential field revealed a more right-lateralized current source density maximum in the posterior superior temporal sulcus (STS) extending to the temporo-parietal junction (TPJ). The recruitment of STS and TPJ for desired stimuli indicates that these brain areas, known to be respectively involved in social cognition, attention, integration of body-related information and self-processing, play a crucial role for the coding of desirability of visual sexual human stimuli within the first 200 ms after stimulus onset. These findings support the hypothesis that complex cognitive processing for desire occurs much faster than previously thought and open new perspectives with respect to the role of both bottom-up and top-down mechanisms in visual processing of sexual stimuli.

Why is your spouse so predictable? Connecting mirror neuron system and self-expansion model of love.

The simulation theory assumes we understand actions and intentions of others through a direct matching process. This matching process activates a complex brain network involving the mirror neuron system (MNS), which is self-related and active when one does something or observes someone else acting. Because social psychology admits that mutual intention's understanding grows in close relationship as love grows, we hypothesize that mirror mechanisms take place in love relationships. The similarities between the mirror matching process and the mutual intention's understanding that occurs when two persons are in love suggest that exposure to love might affect functional and neural mechanisms, thus facilitating the understanding of the beloved's intentions. Congruent with our hypothesis, our preliminary results from 38 subjects strongly suggest a significant facilitation effect of love on understanding the intentions of the beloved (as opposed to control stimuli). Based on these phenomenological, and neurofunctional findings we suggest that the mirror mechanisms are involved in the facilitation effects of love for understanding intentions, and might further be extended to any types of love (e.g., passionate love, maternal love). Love experiences are important not only to the beloved himself, but also to any societal, cultural, and institutional patterns that relate to love. Yet, concerning its subjective character, love experiences are difficult to access. The modern procedures and techniques of socio-cognitive neuroscience make it possible to understand love and self-related experiences not only by the analysis of subjective self-reported questionnaires, but also by approaching the automatic (non-conscious) mirror experiences of love in healthy subjects, and neurological patients with a brain damage within the mirror neuron system. Although the psychology of love is now well admitted, the systematic study of the automatic facilitation effect of love through mirror mechanisms might open a new avenue towards the social mind and also self consciousness.

Correlation between insula activation and self-reported quality of orgasm in women.

Current multidimensional models of women's sexual function acknowledge the implicit impact of psychosocial factors on women's sexual function. Interaction between human sexual function and intensity of love has been also assumed, even if love is not an absolute condition. Yet, whereas great insights have been made in understanding the central mechanisms of the peripheral manifestations of women's sexual response, including orgasm, the cerebral correlates sustaining the interaction between women's sexual satisfaction and the unconscious role of the partner in this interpersonal experience remain unknown. Using functional imaging, we assessed brain activity elicited when 29 healthy female volunteers were unconsciously exposed to the subliminal presentation of their significant partner's name (a task known to elicit a partner-related neural network) and correlated it with individual scores obtained from different sexual dimensions: self-reported partnered orgasm quality (ease, satisfaction, frequency), love intensity and emotional closeness with that partner. Behavioral results identified a correlation between love and self-reported partnered orgasm quality. The more women were in love/emotionally close to their partner, the more they tended to report being satisfied with the quality of their partnered orgasm. However, no relationship was found between intensity of love and partnered orgasm frequency. Neuroimaging data expanded these behavioral results by demonstrating the involvement of a specific left-lateralized insula focus of neural activity correlating with orgasm scores, irrespective of dimension (frequency, ease, satisfaction). In contrast, intensity of being in love was correlated with a network involving the angular gyrus. These findings strongly suggest that intimate and sexual relationships are sustained by partly different mechanisms, even if they share some emotional-related mechanisms. The critical correlation between self-reports of orgasm quality and activation of the left anterior insula, a part of the partner-related neural network known to play a pivotal role in somatic processes, suggests the importance of somatic information in the integration of sexual experience. On the other hand, the correlation between activation of the angular gyrus and love intensity reinforces the assumption that the representation of love calls for higher order cognitive levels, such as those related to the generation of abstract concepts. By highlighting the specific role of the anterior insula in the way women integrate components of physical satisfaction in the context of an intimate relationship with a partner, the current findings take a step in the understanding of a woman's sexual pleasure.

Toward an understanding of the cerebral substrates of woman's orgasm.

The way women experience orgasm is of interest to scientists, clinicians, and laypeople. Whereas the origin and the function of a woman's orgasm remains controversial, the current models of sexual function acknowledge a combined role of central (spinal and cerebral) and peripheral processes during orgasm experience. At the central level, although it is accepted that the spinal cord drives orgasm, the cerebral involvement and cognitive representation of a woman's orgasm has not been extensively investigated. Important gaps in our knowledge remain. Recently, the astonishing advances of neuroimaging techniques applied in parallel with a neuropsychological approach allowed the unravelling of specific functional neuroanatomy of a woman's orgasm. Here, clinical and experimental findings on the cortico-subcortical pathway of a woman's orgasm are reviewed and compared with the neural basis of a man's orgasm. By defining the specific brain areas that sustain the assumed higher-order representation of a woman's orgasm, this review provides a foundation for future studies. The next challenge of functional imaging and neuropsychological studies is to understand the hierarchical interactions between these multiple cortical areas, not only with a correlation analysis but also with high spatio-temporal resolution techniques demonstrating the causal necessity, the temporal time course and the direction of the causality. Further studies using a multi-disciplinary approach are needed to identify the spatio-temporal dynamic of a woman's orgasm, its dysfunctions and possible new treatments.

[Interactions between human sexual arousal and sexual desire: a challenge for social neuroscience]. / Interactions entre excitation et désir sexuel: des relations inter- personnelles aux réseaux neuronaux.

The frequent interaction and synergy between sexual arousal and sexual desire occuring during a sexual experience explains the difficulty in disentagling these two phenomena in the human sexual response. Sexual desire is defined as a goal-directed motivational state integrating the other in one's personal sphere on the basis of intentionality, rather than by instinct only. Sexual arousal includes physical manifestations and subjective perception of excitement. Interest in sexual arousal has engendered a growing body of research concerning its nature and function as well as the biological basis of the mechanisms sustaining it. Recent functional imaging has played a key role in seeking to isolate brain regions specific to sexual arousal. This field may represent a new challenge for social neuroscience.

Induction of an illusory shadow person.

Stimulation of a site on the brain's left hemisphere prompts the creepy feeling that somebody is close by. The strange sensation that somebody is nearby when no one is actually present has been described by psychiatric and neurological patients, as well as by healthy subjects, but it is not understood how the illusion is triggered by the brain. Here we describe the repeated induction of this sensation in a patient who was undergoing presurgical evaluation for epilepsy treatment, as a result of focal electrical stimulation of the left temporoparietal junction: the illusory person closely 'shadowed' changes in the patient's body position and posture. These perceptions may have been due to a disturbance in the multisensory processing of body and self at the temporoparietal junction.