Poster Session 04 Program Schedule
02/15/2024
12:00 pm - 01:15 pm
Room: Shubert Complex (Posters 1-60)
Poster Session 04: Neuroimaging | Neurostimulation/Neuromodulation | Teleneuropsychology/Technology
Final Abstract #56
White Matter Substrates of Altered Sexual Functioning in Mild Traumatic Brain Injury.
Aizad Kamal, Washington University Medical Campus in St. Louis, St. Louis, United States
Vigneswaran Veeramuthu, Thompson Hospital Kota Damansara, Kota Damansara, Malaysia
Category: Neuroimaging
Keyword 1: neuroimaging: functional connectivity
Keyword 2: neuroimaging: structural connectivity
Keyword 3: traumatic brain injury
Objective:
The study aims to investigate the complex relationship between neurotrauma-induced white matter microstructural damage and the dysregulation of human sexual responses and functioning, especially in patients with mild traumatic brain injury resulting from motor vehicle accidents.
Participants and Methods:
183 patients with mild traumatic brain injuries (mTBI) from the University of Malaya Medical Center's Emergency Department were considered for the study. After CT scans and patient consent, 61 participated. They had brain MRIs, including DTI. Three months later, 38 patients were evaluated for sexual function using the Nowinski and LoPiccolo’s Sexual History Form. Hormone tests were done for those with changes; one patient was excluded due to abnormal hormone levels. At six months post-injury, 28 patients completed the sexual function assessment and had another brain MRI.
Results:
Three months after mTBI, patients with poor functioning had lower sexual desire (t(36) = - 2.09; p = 0.044; d = 1.75), arousal (t(36) = -2.21; p = 0.034; d = 1.34), and orgasm during intercourse (t(13.04) = -11.65; p = 0.001; d = 1.82) compared to those functioning well. At six months, the poor-functioning group had even lower sexual activity frequency (t(26)= -3.51; p = 0.002; d = 1.34), desire (t(26) = -4.77; p = 0.001; d = 1.82), and more problems with arousal, erection, and orgasm. Overall, the sexual functioning of the poor-functioning group was significantly worse (t(20.72)= -10.06; p = 0.001; d = 3.45).
The study found significant differences between patient groups and over time in terms of sexual desire (F(1,25) = 4.33; p = 0.048; η² = 0.15), orgasm during intercourse (F(1,25) = 38.39; p = 0.001; η²= 0.61), and overall sexual functioning. Patients with poor functioning (PF) consistently had higher scores in these areas at both time points, and their scores got even worse at 6 months, indicating a decline in sexual function over time (F(1,25) = 4.56; p = 0.043; η² = 0.15.
Baseline fractional anisotropy (FA) values of left Superior Fronto-occipital Fasciculus (SFO-L) negatively correlated with the preferred frequency of sexual activity at 3 months (r = -0.42; p = 0.011). Baseline FA values of Right Superior Fronto-occipital Fasciculus (SFO-R) (r = -0.39; p = 0.018) and SFO-L (r = -0.40; p = 0.015) negatively correlated with orgasm (through partner caressing). The FA values of SFO-L (r = -0.42; p = 0.011) negatively correlated with Global Sexual Functioning (GSF) total score at baseline.
At 6 months, there is a positive correlation between the FA value of Left Cingulum-Corpus Callosum (CGC-L) and GSF total score (r = 0.42; p = 0.044). The RD value of SFO-L positively correlated with the frequency of sexual activity (r = 0.33; p = 0.044), preferred frequency of sexual activity (r = 0.44; p = 0.006); sexual desire (r = 0.37; p = 0.023) and arousal (erection trouble during coitus) (r = 0.37; p = 0.024).
Conclusions:
Significant associations between the white matter microstructural damage, evinced through the DTI absolute parameters (FA, MD, RD) and various aspects of sexual functioning were seen across the timepoints, although some potential recovery are noted at 6 months post injury. The association and projection fibers appear to be more susceptible to chronic changes. The study underscores the need for further research to fully elucidate this complex relationship.
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