Are brain lesions

related to sexual
dysfunction in
women with MS?
Sursa https://www.msif.org/news/2016/09/09/are-brain-lesions-related-to-sexualdysfunction-in-women-with-ms/
Researchers investigate a link between brain lesions and severity of sexual issues in
women with MS
Last updated: 9th September 2016

Approximately 80 per cent of women with MS experience sexual dysfunction

at some time during the course of the disease. Symptoms most commonly
reported include reduced genital sensation, reduced vaginal lubrication,
difficulty with arousal, and difficulty or inability reaching orgasm. Pain during
intercourse is also a frequently reported symptom in women with MS, which
may be due to vaginal dryness, spasticity or hypersensitivity.
In this study from University Hospital Erlangen, Erlangen-Nrnberg in
Germany, researchers asked whether there was an association between brain
lesions seen on MRI and the severity of sexual issues reported by women with
MS.
They used a questionnaire about female sexual function to assess the severity
of sexual issues, such as decreased arousal and vaginal lubrication both of
which are essential for satisfactory sexual intercourse. Next, they performed

advanced MRI analysis to find the location of lesions that could be related to
sexual dysfunction.
They found that lesions in specific regions of the brain, such as those in the
visual part of the brain or areas related to visceral functions (e.g. heart rate,
digestion, respiratory rate, urination, and sexual arousal) were linked to sexual
dysfunction.
The researchers acknowledge some limitations of their method, and therefore
future studies should replicate these findings before any causal relationship
could be proved between brain lesions and sexual dysfunction in women with
MS.
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Neuroanatomic Correlates of Female Sexual Dysfunction in Multiple

Sclerosis.
Winder K1, Linker RA1, Seifert F1, Deutsch M1, Engelhorn T2, Drfler A2, Lee DH1, Hsl KM3, Hilz
MJ1.

Author information
Abstract
OBJECTIVE:
This study intended to determine associations between alterations of female sexual arousal
as well as vaginal lubrication and the site of cerebral multiple sclerosis (MS) lesions.
METHODS:
In 44 women with MS (mean age: 36.5 9.9 years), we assessed their medical history and
evaluated sexual function using the Female Sexual Function Index scores for arousal and
vaginal lubrication. We determined potential confounding factors of sexual dysfunction: age;
disease duration; physical disability; depression; bladder or urinary dysfunction; and total
volume of cerebral lesions. Arousal and lubrication scores were correlated with one another
and with potential confounding factors. Cerebral MS lesions were recorded on imaging

scans. A voxel-based lesion symptom mapping (VLSM) analysis adjusted for confounding
variables was performed correlating cerebral sites of MS lesions with arousal and
lubrication scores.
RESULTS:
Decreased arousal scores correlated with decreased lubrication scores; decreased
lubrication scores were associated with bladder or urinary symptoms. Arousal and
lubrication scores were not associated with any other variables. Multivariate VLSM analysis,
including arousal and lubrication scores as covariables of interest, showed right occipital
lesions associated with impaired arousal and left insular lesions associated with decreased
lubrication. Impaired lubrication remained associated with left insular lesions after
adjustment for bladder or urinary dysfunction.
INTERPRETATION:
Our data indicate that impaired female sexual arousal is associated with MS lesions in the
occipital region, integrating visual information and modulating attention toward visual input.
Impaired lubrication correlated with lesions in the left insular region, contributing to mapping
and generating visceral arousal states. Ann Neurol 2016.
2016 American Neurological Association.
http://www.ncbi.nlm.nih.gov/pubmed/27464008