Increase in cerebral blood flow of right prefrontal cortex in man during orgasm

doi:10.1016/0304-3940(94)90328-X

Neuroscience Letters

Volume 170, Issue 2, 11 April 1994, Pages 241-243

https://doi.org/10.1016/0304-3940(94)90328-X Get rights and content

Abstract

The functional anatomy of human emotional responses has remained poorly understood, mainly because invasive experiments in humans are unacceptable due to ethical reasons. The new functional imaging techniques such as positron emission tomography and single photon emission computed tomography have made it possible to study the neurophysiology of living humans non-invasively. We studied the regional cerebral blood flow with semi-quantitative ^99mTC-HMPAO single photon emission computed tomography in eight healthy right-handed heterosexual males during orgasm. The results showed decrease of cerebral blood flow during orgasm in all other cortical areas except in right prefrontal cortex, where the cerebral blood flow increased significantly (P < 0.005).

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Sexual offenses are a great concern worldwide due to the devastating physical and psychological consequences the victims of such crimes often experience. It is an important task to investigate potential mechanisms that may underlie sexual offending and predispose an individual for such antisocial behavior. Advanced techniques in neuroscience are increasingly used to uncover biomarkers in psychiatric disorders and organic brain disease. As this type of research is flourishing, preliminary studies with the aim to explore the neural basis of sex offenders have started to appear. To this purpose, researchers began to study the brain's structural and functional changes and the neurocognitive profiles of sex offenders, in comparison to nonoffenders and nonsex offenders, or among different subtypes of sex offenders. Most of the research to date has focused on pedophilia, with some inconsistent findings, which hampers the translation of the results into the forensic and clinical context. Any attempt to increase convergent evidence may profit from the harmonization of data analysis and avoidance of methodological inconsistencies, which can account for the different results across studies. Today, uncovering the neural basis of sex offences has to become a priority, not only for clinical interventions, but might also be important knowledge for crime prevention.
Brain Activity Unique to Orgasm in Women: An fMRI Analysis
2017, Journal of Sexual Medicine
Citation Excerpt :
The right angular gyrus has been implicated in states of altered perception (ie, “out-of-body experiences”27,28), which could be related to the “altered state of consciousness” at orgasm.29 This finding is consistent with previous studies showing right-side brain activation during orgasm30,31 and lateralization of brain injury effects on sexuality.32 The present findings obtained through the use of improved methodology, which decreased head-movement artifacts and corrected results for multiple comparisons, are consistent with our previous reports on brain activity at orgasm in women.14–19
Although the literature on imaging of regional brain activity during sexual arousal in women and men is extensive and largely consistent, that on orgasm is relatively limited and variable, owing in part to the methodologic challenges posed by variability in latency to orgasm in participants and head movement.
To compare brain activity at orgasm (self- and partner-induced) with that at the onset of genital stimulation, immediately before the onset of orgasm, and immediately after the cessation of orgasm and to upgrade the methodology for obtaining and analyzing functional magnetic resonance imaging (fMRI) findings.
Using fMRI, we sampled equivalent time points across female participants’ variable durations of stimulation and orgasm in response to self- and partner-induced clitoral stimulation. The first 20-second epoch of orgasm was contrasted with the 20-second epochs at the beginning of stimulation and immediately before and after orgasm. Separate analyses were conducted for whole-brain and brainstem regions of interest. For a finer-grained analysis of the peri-orgasm phase, we conducted a time-course analysis on regions of interest. Head movement was minimized to a mean less than 1.3 mm using a custom-fitted thermoplastic whole-head and neck brace stabilizer.
Ten women experienced orgasm elicited by self- and partner-induced genital stimulation in a Siemens 3-T Trio fMRI scanner.
Brain activity gradually increased leading up to orgasm, peaked at orgasm, and then decreased. We found no evidence of deactivation of brain regions leading up to or during orgasm. The activated brain regions included sensory, motor, reward, frontal cortical, and brainstem regions (eg, nucleus accumbens, insula, anterior cingulate cortex, orbitofrontal cortex, operculum, right angular gyrus, paracentral lobule, cerebellum, hippocampus, amygdala, hypothalamus, ventral tegmental area, and dorsal raphe).
Insight gained from the present findings could provide guidance toward a rational basis for treatment of orgasmic disorders, including anorgasmia.
This is evidently the first fMRI study of orgasm elicited by self- and partner-induced genital stimulation in women. Methodologic solutions to the technical issues posed by excessive head movement and variable latencies to orgasm were successfully applied in the present study, enabling identification of brain regions involved in orgasm. Limitations include the small sample (N = 10), which combined self- and partner-induced stimulation datasets for analysis and which qualify the generalization of our conclusions.
Extensive cortical, subcortical, and brainstem regions reach peak levels of activity at orgasm.
Wise NJ, Frangos E, Komisaruk BR. Brain Activity Unique to Orgasm in Women: An fMRI Analysis. J Sex Med 2017;14:1380–1391.
The human sexual response cycle: Brain imaging evidence linking sex to other pleasures
2012, Progress in Neurobiology
Sexual behavior is critical to species survival, yet comparatively little is known about the neural mechanisms in the human brain. Here we systematically review the existing human brain imaging literature on sexual behavior and show that the functional neuroanatomy of sexual behavior is comparable to that involved in processing other rewarding stimuli. Sexual behavior clearly follows the established principles and phases for wanting, liking and satiety involved in the pleasure cycle of other rewards. The studies have uncovered the brain networks involved in sexual wanting or motivation/anticipation, as well as sexual liking or arousal/consummation, while there is very little data on sexual satiety or post-orgasmic refractory period. Human sexual behavior also interacts with other pleasures, most notably social interaction and high arousal states. We discuss the changes in the underlying brain networks supporting sexual behavior in the context of the pleasure cycle, the changes to this cycle over the individual's life-time and the interactions between them. Overall, it is clear from the data that the functional neuroanatomy of sex is very similar to that of other pleasures and that it is unlikely that there is anything special about the brain mechanisms and networks underlying sex.
Functional neuroimaging studies of sexual arousal and orgasm in healthy men and women: A review and meta-analysis
2012, Neuroscience and Biobehavioral Reviews
Citation Excerpt :
These studies (Ethofer et al., 2007; Georgiadis et al., 2009; Savic et al., 2001) suggest that gender differences in brain responses to VSS may not apply to other sensory modalities. The first neuroimaging study (Tiihonen et al., 1994) of male orgasm, based on single photon emission computed tomography (SPECT), found decreased rCBF in all cortical areas except in the right prefrontal cortex, where rCBF increased. In a first PET study of ejaculation (Holstege et al., 2003), rCBF during ejaculation was compared with rCBF recorded during manual penile stimulation performed by the volunteers’ female partners.
In the last fifteen years, functional neuroimaging techniques have been used to investigate the neuroanatomical correlates of sexual arousal in healthy human subjects. In most studies, subjects have been requested to watch visual sexual stimuli and control stimuli. Our review and meta-analysis found that in heterosexual men, sites of cortical activation consistently reported across studies are the lateral occipitotemporal, inferotemporal, parietal, orbitofrontal, medial prefrontal, insular, anterior cingulate, and frontal premotor cortices as well as, for subcortical regions, the amygdalas, claustrum, hypothalamus, caudate nucleus, thalami, cerebellum, and substantia nigra. Heterosexual and gay men show a similar pattern of activation. Visual sexual stimuli activate the amygdalas and thalami more in men than in women. Ejaculation is associated with decreased activation throughout the prefrontal cortex. We present a neurophenomenological model to understand how these multiple regional brain responses could account for the varied facets of the subjective experience of sexual arousal. Further research should shift from passive to active paradigms, focus on functional connectivity and use subliminal presentation of stimuli.
Neuropsychology, neuroscience, volitional impairment and sexually violent predators: A review of the literature and the law and their application to civil commitment proceedings
2012, Aggression and Violent Behavior
Citation Excerpt :
Specifically, in the frontal/temporal areas, studies suggest reduced blood flow as compared to non-sex offenders (Graber, Hartmann, Coffman, Huey, & Golden, 1982; Hendricks, Fitzpatrick, Hartmann, Quaife et al., 1988; Hucker et al., 1986; Wright, Nobrega, Langevin, & Wortzman, 1990). Neuroimaging data has informed us that normal individuals experience activation of the right prefrontal cortex during sexual arousal and orgasm (Stoléru et al., 1999; Tihonen et al., 1994). Empirical evidence has demonstrated reduced blood flow in the brain and diminished skull density in sex offenders.
The U.S. Supreme Court held in Kansas v. Crane, the person's mental abnormality or personality disorder must cause the individual to have “serious difficulty in controlling his sexual behavior,” rather than “total or complete lack of control.” While most state civil commitment statutes do not mandate this volitional impairment language relevant to loss of control, they instead incorporate the requirement of findings of “likely” or “likelihood” to reoffend. Yet in some of these state SVP hearings, the forensic mental health expert witnesses testify as to the offender's ability to control his sex offending behaviors. Occasionally, some of these experts are neuropsychologists and neurologists who testify about a sex offender's neurological and cognitive impairment resulting in sexually deviant behavior, volitional impairment, and likelihood of reoffending. This article's focus is to assess deviant sexual offending behaviors and volitional impairment through a neuropsychological and neurological lens. The author will provide an analysis of the literature as to the structural and functional neurocognitive processes of sex offending pertaining to neuropathology, neuropsychology, and neuroimaging data. The author will attempt to apply these findings to the legal requirements outlined in Crane necessitating commitment of sex offenders who experience some volitional impairment in their behaviors that lead them to be likely to sexually reoffend. The author will review state case law addressing neuroscience in SVP proceedings.
Opposed hemispheric specializations for human hypersexuality and orgasm?
2011, Epilepsy and Behavior
Citation Excerpt :
Sexual release occurs only with orgasm and is associated with greater right hemisphere blood flow. Functional imaging studies reveal that during or just after self-induced orgasm in healthy participants, right hemisphere hyperperfusion and left hypoperfusion occur [41,42] or only left hemisphere hypoperfusion occurs [43]. The widespread asymmetries are maximal in the frontal and temporal lobes.
With a multiple case report analysis we demonstrate that hypersexuality more often results from right hemisphere (RH) (n = 26) than left hemisphere (LH) (n = 7) lesions, possibly because of LH release after the RH lesion, and that ictal orgasm more often occurs in patients with right-sided (n = 23) than left-sided (n = 8) seizure foci, with the symptom probably resulting from RH activation. The LH may be specialized for increasing sexual tension, whereas the RH may be specialized for release of this tension (orgasm), the former being catabolic and the latter anabolic. Several other interpretations of the findings are also discussed.

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Increase in cerebral blood flow of right prefrontal cortex in man during orgasm

Abstract

Selective and divided attention during visual discriminations of shape, color and speed: functional anatomy by position emission tomography

J. Neurosci.

PET images of blood flow changes during anxiety: correction (letter)

Science

Prefrontal Cortex

Polycystic lipomembranous osteodysplasia with sclerosing leukoencephalopathy (membranous lipodystrophy): a neuropsychiatric follow-up study

Physical performance of the Siemens MultiSPECT 3 gamma camera

Nucl. Med. Commun.

Hypersexuality of altered sexual preference following brain injury

J. Neurol. Neurosurg. Psychiatry

Technetium-99m d, I-HM-PAO: A new radiopharmaceutical for SPECT imaging of regional cerebral blood perfusion

J. Nucl. Med.

Neural Correlates of self-induced dysphoria

Am. J. Psychiatry