Korean Journal of Radiology

  • 제13권3호
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  • Pages.257-264
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  • 2012
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  • 1229-6929(pISSN)
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  • 2005-8330(eISSN)
대한영상의학회 (The Korean Society of Radiology)
권호 표지
DOI QR코드

DOI QR Code

Brain Activation in Response to Visually Evoked Sexual Arousal in Male-to-Female Transsexuals: 3.0 Tesla Functional Magnetic Resonance Imaging

  • Oh, Seok-Kyun (Interdisciplinary Program of Biomedical Engineering, Chonnam National University) ;
  • Kim, Gwang-Won (Interdisciplinary Program of Biomedical Engineering, Chonnam National University) ;
  • Yang, Jong-Chul (Department of Psychiatry, Chonbuk National University Medical School) ;
  • Kim, Seok-Kwun (Department of Plastic and Reconstructive Surgery, Dong-A University College of Medicine) ;
  • Kang, Heoung-Keun (Department of Radiology, Chonnam National University Medical School, Chonnam National University Hospital) ;
  • Jeong, Gwang-Woo (Interdisciplinary Program of Biomedical Engineering, Chonnam National University)
  • 발행 : 2012.06.01
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: This study used functional magnetic resonance imaging (fMRI) to contrast the differential brain activation patterns in response to visual stimulation with both male and female erotic nude pictures in male-to-female (MTF) transsexuals who underwent a sex reassignment surgery. Materials and Methods: A total of nine healthy MTF transsexuals after a sex reassignment surgery underwent fMRI on a 3.0 Tesla MR Scanner. The brain activation patterns were induced by visual stimulation with both male and female erotic nude pictures. Results: The sex hormone levels of the postoperative MTF transsexuals were in the normal range of healthy heterosexual females. The brain areas, which were activated by viewing male nude pictures when compared with viewing female nude pictures, included predominantly the cerebellum, hippocampus, putamen, anterior cingulate gyrus, head of caudate nucleus, amygdala, midbrain, thalamus, insula, and body of caudate nucleus. On the other hand, brain activation induced by viewing female nude pictures was predominantly observed in the hypothalamus and the septal area. Conclusion: Our findings suggest that distinct brain activation patterns associated with visual sexual arousal in postoperative MTF transsexuals reflect their sexual orientation to males.

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참고문헌

  1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 3rd ed. Washington, DC: American Psychiatric Association, 1994
  2. World Health Organization. International statistical classification of diseases and related health problems. 10th revision. Geneva: World Health Organization, 1992
  3. Michel A, Mormont C, Legros JJ. A psycho-endocrinological overview of transsexualism. Eur J Endocrinol 2001;145:365- 376 https://doi.org/10.1530/eje.0.1450365
  4. Swaab DF. Sexual differentiation of the human brain: relevance for gender identity, transsexualism and sexual orientation. Gynecol Endocrinol 2004;19:301-312 https://doi.org/10.1080/09513590400018231
  5. Park JM, Kwon YS, Lee KC, Kim SK, Kwak H, Kim SB. Hormonal analysis of female transgender patients performed gender reassignment operation. J Korean Soc Plast Reconstr Surg 2005;32:699-705
  6. Stoléru S, Grégoire MC, Gérard D, Decety J, Lafarge E, Cinotti L, et al. Neuroanatomical correlates of visually evoked sexual arousal in human males. Arch Sex Behav 1999;28:1-21
  7. Redoute J, Stoleru S, Gregoire MC, Costes N, Cinotti L, Lavenne F, et al. Brain processing of visual sexual stimuli in human males. Hum Brain Mapp 2000;11:162-177 https://doi.org/10.1002/1097-0193(200011)11:3<162::AID-HBM30>3.0.CO;2-A
  8. Bocher M, Chisin R, Parag Y, Freedman N, Meir Weil Y, Lester H, et al. Cerebral activation associated with sexual arousal in response to a pornographic clip: A 150-H20 PET study in heterosexual men. Neuroimage 2001;14(1 Pt 1):105-117 https://doi.org/10.1006/nimg.2001.0794
  9. Park K, Kang HK, Seo JJ, Kim HJ, Ryu SB, Jeong GW. Bloodoxygenation- level-dependent functional magnetic resonance imaging for evaluating cerebral regions of female sexual arousal response. Urology 2001;57:1189-1194 https://doi.org/10.1016/S0090-4295(01)00992-X
  10. Arnow BA, Desmond JE, Banner LL, Glover GH, Solomon A, Polan ML, et al. Brain activation and sexual arousal in healthy, heterosexual males. Brain 2002;125(Pt 5):1014-1023 https://doi.org/10.1093/brain/awf108
  11. Hamann S, Herman RA, Nolan CL, Wallen K. Men and women differ in amygdala response to visual sexual stimuli. Nat Neurosci 2004;7:411-416 https://doi.org/10.1038/nn1208
  12. Ferretti A, Caulo M, Del Gratta C, Di Matteo R, Merla A, Montorsi F, et al. Dynamics of male sexual arousal: distinct components of brain activation revealed by fMRI. Neuroimage 2005;26:1086-1096 https://doi.org/10.1016/j.neuroimage.2005.03.025
  13. Jeong GW, Park K, Youn G, Kang HK, Kim HJ, Seo JJ, et al. Assessment of cerebrocortical regions associated with sexual arousal in premenopausal and menopausal women by using BOLD-based functional MRI. J Sex Med 2005;2:645-651. https://doi.org/10.1111/j.1743-6109.2005.00134.x
  14. Kim SW, Sohn DW, Cho YH, Yang WS, Lee KU, Juh R, et al. Brain activation by visual erotic stimuli in healthy middle aged males. Int J Impot Res 2006;18:452-457 https://doi.org/10.1038/sj.ijir.3901449
  15. Toledano R, Pfaus J. The Sexual Arousal and Desire Inventory (SADI): a multidimensional scale to assess subjective sexual arousal and desire. J Sex Med 2006;3:853-877 https://doi.org/10.1111/j.1743-6109.2006.00293.x
  16. Safron A, Barch B, Bailey JM, Gitelman DR, Parrish TB, Reber PJ. Neural correlates of sexual arousal in homosexual and heterosexual men. Behav Neurosci 2007;121:237-248 https://doi.org/10.1037/0735-7044.121.2.237
  17. Paul T, Schiffer B, Zwarg T, Krüger TH, Karama S, Schedlowski M, et al. Brain response to visual sexual stimuli in heterosexual and homosexual males. Hum Brain Mapp 2008;29:726-735 https://doi.org/10.1002/hbm.20435
  18. Yang JC, Park K, Eun SJ, Lee MS, Yoon JS, Shin IS, et al. Assessment of cerebrocortical areas associated with sexual arousal in depressive women using functional MR imaging. J Sex Med 2008;5:602-609 https://doi.org/10.1111/j.1743-6109.2007.00737.x
  19. Gizewski ER, Krause E, Schlamann M, Happich F, Ladd ME, Forsting M, et al. Specific cerebral activation due to visual erotic stimuli in male-to-female transsexuals compared with male and female controls: an fMRI study. J Sex Med 2009;6:440-448 https://doi.org/10.1111/j.1743-6109.2008.00981.x
  20. Ogawa S, Lee TM, Nayak AS, Glynn P. Oxygenation-sensitive contrast in magnetic resonance image of rodent brain at high magnetic fields. Magn Reson Med 1990;14:68-78 https://doi.org/10.1002/mrm.1910140108
  21. Tsuchita H, Kuwata T. Trace lipid from whey-mineral complex enhances calcium availability in young ovariectomized rats. Br J Nutr 1995;73:299-309 https://doi.org/10.1079/BJN19950031
  22. Green Cross Reference Lab. Sex hormones in green cross reference lab guidebook. Yongin, Korea: Green Cross Reference Lab, 2007:201-224
  23. Dove GA, Morley F, Batchelor A, Lunn SF. Oestrogenic function in postmenopausal women. J Reprod Fertil 1971;24:1-8 https://doi.org/10.1530/jrf.0.0240001
  24. Pol HEH, Cohen-Kettenis PT, Van Haren NEM, Peper JS, Brans RGH, Cahn W, et al. Changing your sex changes your brain: influences of testosterone and estrogen on adult human brain structure. Eur J Endocrinol 2006;155:S107-S114 https://doi.org/10.1530/eje.1.02248
  25. Meyer WJ 3rd, Webb A, Stuart CA, Finkelstein JW, Lawrence B, Walker PA. Physical and hormonal evaluation of transsexual patients: a longitudinal study. Arch Sex Behav 1986;15:121- 138 https://doi.org/10.1007/BF01542220
  26. Barbas H. Connections underlying the synthesis of cognition, memory, and emotion in primate prefrontal cortices. Brain Res Bull 2000;52:319-330 https://doi.org/10.1016/S0361-9230(99)00245-2
  27. Karama S, Lecours AR, Leroux JM, Bourgouin P, Beaudoin G, Joubert S, et al. Areas of brain activation in males and females during viewing of erotic film excerpts. Hum Brain Mapp 2002;16:1-13 https://doi.org/10.1002/hbm.10014
  28. Llinas R, Ribary U, Contreras D, Pedroarena C. The neuronal basis for consciousness. Philos Trans R Soc Lond B Biol Sci 1998;353:1841-1849 https://doi.org/10.1098/rstb.1998.0336
  29. Martin JH. Neuroanatomy. Stanford: Appleton & Lange, 1996
  30. Beauregard M, Lévesque J, Bourgouin P. Neural correlates of conscious self-regulation of emotion. J Neurosci 2001;21:RC165
  31. Hamann SB, Ely TD, Grafton ST, Kilts CD. Amygdala activity related to enhanced memory for pleasant and aversive stimuli. Nat Neurosci 1999;2:289-293 https://doi.org/10.1038/6404
  32. Devinsky O, Morrell MJ, Vogt BA. Contributions of anterior cingulate cortex to behaviour. Brain 1995;118(Pt 1):279-306 https://doi.org/10.1093/brain/118.1.279
  33. Mesulam MM, Mufson EF. The insula of Reil in man and monkey. In: Peters A, Jones EG, eds. Architectonics, connectivity and function, 2nd ed. New York: Plenum Press, 1985:179-226
  34. Oppenheimer SM, Gelb A, Girvin JP, Hachinski VC. Cardiovascular effects of human insular cortex stimulation. Neurology 1992;42:1727-1732 https://doi.org/10.1212/WNL.42.9.1727
  35. Cechetto DF. Identification of a cortical site for stressinduced cardiovascular dysfunction. Integr Physiol Behav Sci 1994;29:362-373 https://doi.org/10.1007/BF02691356
  36. Guimaraes AR, Melcher JR, Talavage TM, Baker JR, Ledden P, Rosen BR, et al. Imaging subcortical auditory activity in humans. Hum Brain Mapp 1998;6:33-41 https://doi.org/10.1002/(SICI)1097-0193(1998)6:1<33::AID-HBM3>3.0.CO;2-M
  37. Fox SI. Human Physiology. New York: McGraw-Hill, 2009:226
  38. Pfaff DW, Schwartz-Giblin S, McCarthy MM, Kow LM. Cellular and molecular mechanisms of female reproductive behaviors. In: Knobil E, Neill JD, eds. Physiology of reproduction. New York: Raven Press, 1994:107-220
  39. Sachs BD, Meisel RL. The physiology of male sexual behavior. In: Knobil E, Neill JD, eds. Physiology of reproduction. New York: Raven Press, 1994:3-105
  40. Hofman MA, Swaab DF. The sexually dimorphic nucleus of the preoptic area in the human brain: a comparative morphometric study. J Anat 1989;164:55-72
  41. Allen LS, Hines M, Shryne JE, Gorski RA. Two sexually dimorphic cell groups in the human brain. J Neurosci 1989;9:497-506
  42. Hofman MA, Swaab DF. Sexual dimorphism of the human brain: myth and reality. Exp Clin Endocrinol 1991;98:161-170 https://doi.org/10.1055/s-0029-1211113
  43. Raisman G, Field PM. Sexual dimorphism in the preoptic area of the rat. Science 1971;173:731-733 https://doi.org/10.1126/science.173.3998.731
  44. Ferris CF, Snowdon CT, King JA, Duong TQ, Ziegler TE, Ugurbil K, et al. Functional imaging of brain activity in conscious monkeys responding to sexually arousing cues. Neuroreport 2001;12:2231-2236 https://doi.org/10.1097/00001756-200107200-00037
  45. Sakheim DK, Barlow DH, Beck JG, Abrahamson DJ. The effect of an increased awareness of erectile cues on sexual arousal. Behav Res Ther 1984;22:151-158 https://doi.org/10.1016/0005-7967(84)90103-7
  46. Gorman DG, Cummings JL. Hypersexuality following septal injury. Arch Neurol 1992;49:308-310 https://doi.org/10.1001/archneur.1992.00530270128029
  47. Kondo Y, Shinoda A, Yamanouchi K, Arai Y. Role of septum and preoptic area in regulating masculine and feminine sexual behavior in male rats. Horm Behav 1990;24:421-434 https://doi.org/10.1016/0018-506X(90)90019-T

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  3. Brain activation-based sexual orientation in female-to-male transsexuals vol.28, pp.1, 2012, https://doi.org/10.1038/ijir.2015.29
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  11. Brain activation in response to visual sexual stimuli in male patients with right middle cerebral artery infarction : The first case-control functional magnetic resonance imaging study vol.100, pp.21, 2012, https://doi.org/10.1097/md.0000000000025823
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