Qualitative and Quantitative Measurement of Brain Activity Associated with Visual Sexual Arousal in Males and Females: 3.0 Tesla Functional MR Imaging

Purpose: The present study utilized 3.0 Tesla functional MR imaging to identify and quantify the activated brain regions associated with visually evoked sexual arousal, and also to discriminate the gender differences between the cortical activation patterns in response to sexual stimuli. Materials and Methods: A total of 24 healthy, right-handed volunteers, 14 males (mean age: 24) and 10 females (mean age: 23), with normal heterosexual function underwent functional MRI on a 3.0T MR scanner (Forte, Isole technique, Korea). The sexual stimulation consisted of a 1-minute rest with black screen, followed by a 3- minute stimulation by an erotic video film, and concluded with a 1-minute rest. The fMRI data was obtained from 20 slices (5mm slice thickness, no gap) parallel to the AC-PC (anterior commissure and posterior commissure) line on the sagittal plane, giving a total of 2,100 images. The brain activation maps and the resulting quantification were analyzed by the statistical parametric mapping program, SPM 99. The mean-activated images were obtained from each individual activation map using one sampled t-test. The FALBA program, which is a new algorithm based on the pixel differentiation method, was used to identify and quantify the brain activation and lateralization indices with respect to the functional and anatomical terms. Results: In both male and female volunteers, significant brain activation showed in the limbic areas of the parahippocampal gyrus, septal area, cingulate gyrus and thalamus. It is interesting to note that the septal areas gave a relatively lower activation ratio with high brain activities. On the contrary, the putamen, insula cortex, and corpus callosum gave a higher activation ratio with low brain activities. In particular, brain activation in the septal area, which was not reported in the previous fMRI studies under 1.5 Tesla, represents a distinct finding of this study using 3.0T MR scanner. The overall lateralization index of activation shows left predominance (LI=35.3%) in the limbic system during sexual stimulation. The gender differences of brain activation in response to sexual arousal were characterized as follows. The activation area observed in males was the hypothalamus in the limbic system, whereas in females it was the cingulate gyrus, head of caudate nucleus, insula and corpus callosum. These findings reveal dissimilarities between males and females in neuronal responses to sexual arousal. As for the overall lateralization of activation in the limbic system, male volunteers gave a lateralization index that was greater than that of females by 300%. Conclusion: Our findings confirmed that neuroanatomical regions are associated with visually evoked sexual arousal and also with gender differences in response to sexual stimulation. Given that data from time-course traces of activation pattern and findings are observed by different stimuli, such as tactile and olfactory sense, it might be helpful to evaluate the neurophysiological mechanism for sexual arousal, and furthermore, to develop new diagnostic tools for sexual dysfunction and disorder.