Previous functional magnetic resonance imaging (fMRI) studies showed an abnormal brainstem-to-cortex functional connectivity (FC) in major depressive disorder. However, only few studies analyzed brainstem substructures in treatment-resistant depression (TRD). In this study, we analyzed resting-state seed-based FC between midbrain, pons, medulla oblongata and cortical/subcortical brain regions in patients with TRD (n = 24) and age- and sex-matched healthy controls (n = 24). FC was analyzed in each group and compared between groups. Correlation analyses assessed the relationship between FC strength and depressive symptom severity in regions showing significant group differences in seed-based connectivity. Our findings reveal an increased FC in the midbrain and pons to the precentral gyrus, postcentral gyrus, and temporal gyrus in patients with TRD compared to healthy controls. Interestingly, in TRD patients, FC between midbrain and cortex was negatively correlated with BDI-II scores, indicating a relationship between altered connectivity and self-reported depression severity. It is essential to note that our naturalistic, cross-sectional approach precludes causal conclusions regarding the relationship between FC and pathophysiology of TRD. The small sample size necessitates confirmation in a larger cohort. Midbrain/pons-to-cortex FC was increased in patients with TRD compared to healthy controls. Future studies should explore the relationship between abnormal brainstem-to-cortex FC and depressive symptomatology in more detail.

Background Compulsive Sexual Behavior Disorder is a new category in the 11th version of the International Classification of Diseases and is showing neuropsychological similarities to substance dependencies and behavioral addictions.Aims This experimental study aims to further our knowledge on implicit associations in Compulsive Sexual Behavior (CSB) with a clinical sample.Methods Participants completed an Implicit Association Test modified with pornographic pictures. In addition, problematic sexual behavior and sensitivity toward sexual excitation were assessed.Outcomes We collected data on implicit associations from 47 heterosexual men with CSB (age, M = 36.51, SD = 11.47) and a control group of 38 men without the condition (age: M = 37.92, SD = 12.33).Results Results show significantly more positive relationships between implicit associations of pornographic pictures with positive emotions, as well as with problematic sexual behavior and sensitivity toward sexual excitation, in men with CSB vs. men without CSB. Furthermore, implicit associations, sexual excitation, and sexual inhibition due to threat of performance consequences differentiated significantly between groups using a binary stepwise logistic regression analysis. The findings are in line with those of previous subclinical investigations and support the assumption of pronounced positive implicit associations in CSB. Moreover, as suggested by the I-PACE model of addictive behaviors, implicit associations may be crucial to the maintenance of behavioral addictions.Clinical implications Implicit associations could be addressed in therapy to illustrate cognitive processes of those affected and as an outcome measure in research on treatment efficiency.Strengths & limitations The present study is the first to investigate implicit associations in CSB in a clinical sample. Findings are limited to heterosexual men.Conclusion Findings can be seen in accordance with a proposed classification of CSB as a behavioral addiction.

Persistent genital arousal disorder (PGAD) is a rare disease causing high emotional distress eminently impacting the individual’s quality of life. Experts in this field assume that the disease is caused by a multifaceted interplay of different etiologies which may share a common neurobiological basis. However, only one functional neuroimaging investigation exist, and a more in-depth comprehension of the neurobiological foundation is required. Therefore, this study aims to provide new insights into how the functional integration of brain regions may relate to PGAD. By using the functional magnetic resonance imaging (fMRI) technique, functional connectivity at rest (rs-FC) was compared between patients suffering PGAD (n = 26) and healthy controls (n = 26). Patients with PGAD showed different pattern in connectivity within brain structures putatively associated with the psychological and somatic dimensions of the disease including the right amygdala, left anterior cingulate cortex, right insula cortex, thalamic nuclei and prefrontal regions as seeds. The majority of these showed differences in brain connectivity pattern to the precuneus and prefrontal regions. The study offers preliminary insights into the characteristics and relevant neural mechanisms of PGAD. Nevertheless, since this study did not identify any peripheral correlates that would corroborate the interpretation of these findings, they were interpreted from a more theoretical perspective, thereby offering potential areas of focus for future research.

We analyzed the data of a randomized controlled trial to examine the effects of piano practice on cognitive flexibility in healthy older adults. Participants (N = 153, 69.5 ± 3.5 years of age, 57.5% females) were randomly assigned to a piano practice group (PP) or a control group engaged in active music listening (MC). Both groups underwent a year-long intervention with weekly 60-min lessons and daily homework. We assessed switch and mixing costs in terms of speed (mean reaction times) and variability (standard deviation of reaction times) with a number switch and a perceptual switch task. We employed scale analysis based on musical instrument digital interface to assess pianistic performance. Tests were conducted at baseline, after 6 months, postintervention (12 months), and at follow-up (18 months). Results revealed more pronounced improvements in pianistic performance in the PP group compared with the MC group over the course of the intervention. Both groups exhibited gains in several cognitive flexibility outcomes, which originated primarily in the latter half of the intervention. For mixing costs of the number switch test, the PP group showed greater improvements compared with the MC group. Changes in pianistic performance were not related to changes in cognitive flexibility. Additionally, the findings indicated a compensation account in both groups, which was more pronounced in the PP group for mixing costs. This study suggests that both piano practice and active music listening-with piano practice to a higher degree-enhance cognitive flexibility, particularly in sustained control mechanisms linked to mixing costs. Both interventions potentially require longer than 6 months to induce behavioral transfer effects and are especially beneficial for individuals with lower cognitive flexibility levels. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Abstract Background Older adults can acquire new skills across different domains. Practicing a musical instrument has been identified as a promising activity for improving cognition, promoting well-being, and inducing brain plasticity in older individuals. However, the mechanisms of these changes are still poorly understood. This study aims to assess musical skill acquisition in musically naïve older adults over one year of practice, focusing on individual factors influencing this process and the relations between musical skills. Methods One hundred fifty-six healthy older adults (age = 69.5 years ± 3.2) from Hannover and Geneva with no prior musical training participated in weekly piano practice (PP) or ‘music culture’ (MC) sessions over a one-year period. Baseline assessments included the Cognitive Reserve Index questionnaire (CRIq) and Cognitive Telephone Screening Instrument (CogTel). Musical abilities were measured using piano performance ratings (PP group), music quizzes (MC group), and aptitude tests such as the Beat Alignment Test (BAT), Melodic Discrimination Test (MDT) and Midi Scale Analysis (MSA) at baseline and six-, twelve and 18-month timepoints. The interrelationship between musical abilities was investigated through correlational analyses, and changes impacted through individual characteristics were modeled using Bayesian statistics. Results The PP group demonstrated moderate improvements in piano articulation and dynamics, while the MC group achieved higher scores in the music quiz. Modest improvements in MDT and MSA were observed in both groups, with the PP group showing greater progress is MSA. Higher global cognitive functioning and musical sophistication was associated with greater performance in MDT for both groups. We did not identify any links between individual characteristics, like age, CogTel, CRIq, and musical sophistication, and improvement in musical aptitude tests. Changes in different musical aptitude test scores were not correlated, and neither the development of piano skills nor the music quiz correlated with initial performances on the musical aptitude tests. Conclusion Musically naïve older adults can acquire diverse musical abilities, which progress independently, suggesting a broad spectrum of musical abilities rather than a single general musical aptitude. Future research should also explore genetic and psychosocial factors influencing musical development. Trial Registration The Ethikkomission of the Leibniz Universität Hannover approved the protocol on 14.08.17 (no. 3604–2017), the neuroimaging part and blood sampling was approved by the Hannover Medical School on 07.03.18. The full protocol was approved by the Commission cantonale d’éthique de la recherche de Genève (no. 2016–02224) on 27.02.18 and registered at clinicaltrials.gov on 17.09.18 (NCT03674931, no. 81185).

Grapheme-color synesthesia is a normal and healthy variation of human perception. It is characterized by the association of letters or numbers with color perceptions. The etiology of synesthesia is not yet fully understood. Theories include hyperconnectivity in the brain, cross-activation of adjacent or functionally proximate sensory areas of the brain, or various models of lack of inhibitory function in the brain. The growth factor brain-derived neurotrophic (BDNF) plays an important role in the development of neurons, neuronal pathways, and synapses, as well as in the protection of existing neurons in both the central and peripheral nervous systems. ELISA methods were used to compare BDNF serum concentrations between healthy test subjects with and without grapheme-color synesthesia to establish a connection between concentration and the occurrence of synesthesia. The results showed that grapheme-color synesthetes had an increased BDNF serum level compared to the matched control group. Increased levels of BDNF can enhance the brain's ability to adapt to changing environmental conditions, injuries, or experiences, resulting in positive effects. It is discussed whether the integration of sensory information is associated with or results from increased neuroplasticity. The parallels between neurodegeneration and brain regeneration lead to the conclusion that synesthesia, in the sense of an advanced state of consciousness, is in some cases a more differentiated development of the brain rather than a relic of early childhood.

Abstract We analyzed data of a randomized controlled trial to examine the effects of piano practice on cognitive flexibility in healthy older adults. Participants (N = 153, 69.5 ± 3.5 years of age, 57.5% females) were randomly assigned to a piano practice group (PP) or a control group engaged in active music listening (MC). Both groups underwent a year-long intervention with weekly 60-minute lessons and daily homework. We assessed switch and mixing costs in terms of speed (mean RTs) and variability (standard deviation of RTs) with a number switch and a perceptual switch task. We employed MIDI-based Scale Analysis to assess pianistic performance. Tests were conducted at baseline, after 6 months, post-intervention (12 months), and at follow-up (18 months). Results revealed more pronounced improvements in pianistic performance in the PP compared to the MC group over the course of the intervention. Both groups exhibited gains in several cognitive flexibility outcomes, which originated primarily in the latter half of the intervention. For mixing costs, the PP group showed partly greater improvements compared to the MC group. Additionally, the findings indicated a compensation account in both groups, which was partially more pronounced in the PP group. This study suggests that both piano practice and active music listening – with piano practice to a slightly higher degree - enhance cognitive flexibility, particularly in sustained control mechanisms linked to mixing costs. Both interventions potentially require longer than 6 months to induce behavioral transfer effects and are especially beneficial for individuals with lower cognitive flexibility levels.

BackgroundMusicians' dystonia (MD) is a movement disorder with several established risk factors, but the exact pathophysiology remains unknown. Recent research suggests dysfunction in sensory-motor, basal ganglia, cerebellar, and limbic loops as potential causes. Adverse childhood experiences are also considered risk factors.ObjectiveThis study aimed to investigate whether MD patients have experienced more childhood trauma, leading to increased stress reactivity and neural vulnerability to movement disorders.MethodsUsing functional magnetic resonance imaging and the Montreal Imaging Stress Task, 40 MD patients were compared with 39 healthy musicians (HMs). Whole-brain analysis and regions of interest analysis were performed. Parameter estimates and subjective stress levels were compared between groups and correlated with the Childhood Trauma Questionnaire.ResultsMD patients reported significantly higher childhood trauma scores than healthy control subjects, but they did not differ in their subjective stress experiences. Stress-related activity of limbic areas was neither found in the whole sample nor between the two groups. Instead, increased activity of visual association and temporal areas was observed, but this activation did not differ between patients and HMs. However, patients showed a tendency toward reduced precuneus activity under stress. Adverse childhood experiences were negatively correlated with precuneus, thalamus, and substantia nigra activity across all participants.ConclusionsOverall, MD patients and HMs had similar subjective and neurological reactions to stress but differed in childhood trauma experiences and precuneus activity under stress. Further research about the functional connectivity between precuneus, cerebellum, thalamus, and basal ganglia in musicians is needed. (c) 2024 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Persistent genital arousal disorder (PGAD) is a rare disease causing high emotional distress eminently impacting the individual’s quality of life. Experts in this field assume that the disease is caused by a multifaceted interplay of different etiologies which may share a common neurobiological basis. However, only few functional neuroimaging investigations exists, and a more in-depth comprehension of the neurobiological foundation is required. Therefore, this study aims to provide new insights into how the functional integration of brain regions may relate to PGAD. By using the functional magnetic resonance imaging (fMRI) technique, functional connectivity at rest (rs-FC) was compared between patients suffering PGAD (n = 26) and healthy controls (n = 26) within the sensorimotor, salience, emotional-arousal and brain-bladder control networks. As hypothesized, patients with PGAD showed altered rs-FC within these four networks when compared to healthy controls. The brain regions exhibiting significant group differences in resting-state activity showed no correlation with clinical and behavioral measures. The study offers valuable insights into the anatomical, psychological and somatic dimensions of PGAD shedding light on its characteristics and underlying neural mechanisms. While the study examines exploratory hypotheses, future research is encouraged to validate these ideas, aiming to enhance the understanding of the central mechanisms of PGAD further.

IntroductionMultisensory integration (MSI) enhances perception by combining information from different sensory modalities. In schizophrenia, individuals often exhibit impaired audiovisual processing, resulting in broader temporal binding windows (TBWs) which appear to be associated with symptom severity. Since the underlying mechanisms of these aberrations are not yet fully understood, the present study aims to investigate multisensory processing in schizophrenia in more detail.MethodsIndividuals with schizophrenia (SZ) and healthy controls (HC) performed a simultaneity judgement task, a paradigm that is suitable for the examination of multisensory integration processes. The paradigm was also conducted to allow for the comparison of perceptions under ecologically valid and invalid conditions. Additionally, EEG recordings were made to explore underlying neural mechanisms.ResultsIn line with previous research, we replicated enlarged TBWs in SZ compared to HC, independent of ecological validity. Neurophysiological data further revealed reduced amplitudes in the early ERP complex N1/P2 in SZ compared to HC.DiscussionSince amplitude reduction in the N1/P2 complex is often associated with audiovisual integration processes, the results highlight perceptual dysfunction in SZ, particularly concerning the disengagement of auditory and visual stimuli.

Normal aging is associated with brain atrophy and cognitive decline. Working memory, involved in cognitive functioning and daily living, is particularly affected. Music training gained momentum in research on brain plasticity and possible transfer effects of interventions on working memory, especially in the context of healthy aging. This longitudinal voxel-based morphometry study evaluated effects of 6-month music interventions on grey matter volume plasticity and auditory working memory performance in 132 healthy older adults. This study is part of a randomized controlled trial comparing two interventions: piano practice (experimental group) and musical culture (musical listening awareness, active control). We report significant grey matter volume increase at whole-brain level in the caudate nucleus, Rolandic operculum and inferior cerebellum when merging both groups, but no group differences. Cerebellar grey matter increase, training intensity metrics and sleep were positively associated with tonal working memory improvement. Digit Span Backward verbal working memory performance also increased. Using region of interest analyses, we showed a group difference in the right primary auditory cortex grey matter volume, decreasing in the musical group while staying stable in the piano group. In contrast, a significant 6-month whole-brain atrophy pattern consistent with longer-term investigations of the aging brain was revealed. We argue that education for seniors should become a major policy priority in the framework of healthy aging, to promote brain plasticity and cognitive reserve, through stimulating group interventions such as music-making and active listening.

Introduction The Attention Training Technique (ATT) developed as part of metacognitive therapy is a psychotherapeutic treatment method used to enhance top-down attentional flexibility and control. This study investigated potential neurocognitive changes due to ATT and its underlying neural mechanisms using pre-to-post functional magnetic resonance imaging (fMRI). Materials and methods Fifty-four healthy participants were subjected to a randomized, sham-controlled attention training and evaluated using a neurocognitive test battery that partly took place in an fMRI environment. Participants received two doses ATT or sham ATT daily for 1 week. On day eight, all subjects completed the neurocognitive test battery again. Results After the training, the ATT group showed a significant improvement in reaction times regarding attentional disengagement compared to the sham ATT group. fMRI data showed decreased levels of activation in the anterior cingulate cortex (ACC) when comparing the ATT group to the sham ATT group during attentional disengagement post intervention. No ATT > sham ATT effects were found regarding selective auditory attention, working memory performance and inhibitory control. Discussion These findings putatively indicate that ATT facilitates faster attention allocation and increased attentional flexibility in healthy subjects. The fMRI results suggest this ATT-dependent improvement is accompanied by reduced ACC activity, indicating a more flexible attentional state.

Learning to play an instrument at an advanced age may help to counteract or slow down age-related cognitive decline. However, studies investigating the neural underpinnings of these effects are still scarce. One way to investigate the effects of brain plasticity is using resting-state functional connectivity (FC). The current study compared the effects of learning to play the piano (PP) against participating in music listening/musical culture (MC) lessons on FC in 109 healthy older adults. Participants underwent resting-state functional magnetic resonance imaging at three time points: at baseline, and after 6 and 12 months of interventions. Analyses revealed piano training-specific FC changes after 12 months of training. These include FC increase between right Heschl’s gyrus (HG), and other right dorsal auditory stream regions. In addition, PP showed an increased anticorrelation between right HG and dorsal posterior cingulate cortex and FC increase between the right motor hand area and a bilateral network of predominantly motor-related brain regions, which positively correlated with fine motor dexterity improvements. We suggest to interpret those results as increased network efficiency for auditory-motor integration. The fact that functional neuroplasticity can be induced by piano training in healthy older adults opens new pathways to countervail age related decline.

Aim Compulsive Sexual Behavior Disorder (CSBD) is a new category in ICD-11. Research examining underlying brain mechanisms is sparse. Research into neurobiological differences can be helpful in advancing the possibilities of new diagnostic approaches and therapeutic methods. The present study aimed to examine brain matter volume and resting state functional connectivity (rs-FC) in CSBD. Methods Structural and rs-FC magnetic resonance imaging and data from questionnaires were collected in 30 men with CSBD and 32 age- and education-matched controls. Whole brain voxel based morphometry (VBM) and seed based rs-FC in a-priori defined seeds were analyzed. Results Structural analyses showed that men with CSBD had significantly increased gray matter volume in the right cerebellum, middle occipital and superior frontal lobe. No differences in rs-FC could be detected when using these brain structures as seed regions in rs-FC. In contrast, literature based rs-FC analysis revealed decreased rs-FC between the right orbital middle frontal cortex (mOFC) and the right gyrus rectus, as well as between left pallidum and right post/precentral gyrus in men with CSBD. In the left amygdala we observed increased rs-FC with precuneus in this group. In addition, most of these measures correlated with symptom severity. Conclusion Structural findings may underscore the idea that the cerebellum plays an important role in sexual arousal and CSBD. Perhaps, a simultaneous activation of the left amygdala and the precuneus reflects a constant sexual occupation of men with CSBD. Furthermore, lower connectivity between mOFC and gyrus rectus in CSBD may support the assumption that sexual stimuli are evaluated more positively because inhibition is decreased.

Introduction:Little is known about cognitive control in adults with high-functioning forms of autism spectrum disorder because previous research focused on children and adolescents. Cognitive control is crucial to monitor and readjust behavior after errors to select contextually appropriate reactions. The congruency effect and conflict adaptation are measures of cognitive control. Post-error slowing, error-related negativity and error positivity provide insight into behavioral and electrophysiological correlates of error processing. In children and adolescent with autism spectrum disorder deficits in cognitive control and error processing have been shown by changes in post-error slowing, error-related negativity and error positivity in the flanker task.Methods:We performed a modified Eriksen flanker task in 17 adults with high-functioning autism spectrum disorder and 17 healthy controls. As behavioral measures of cognitive control and error processing, we included reaction times and error rates to calculate congruency effects, conflict adaptation, and post-error slowing. Event-related potentials namely error-related negativity and error positivity were measured to assess error-related brain activity.Results:Both groups of participants showed the expected congruency effects demonstrated by faster and more accurate responses in congruent compared to incongruent trials. Healthy controls exhibited conflict adaptation as they obtained performance benefits after incongruent trials whereas patients with autism spectrum disorder did not. The expected slowing in reaction times after errors was observed in both groups of participants. Individuals with autism spectrum disorder demonstrated enhanced electrophysiological error-processing compared to healthy controls indicated by increased error-related negativity and error positivity difference amplitudes.Discussion:Our findings show that adults with high-functioning autism spectrum disorder do not show the expected upregulation of cognitive control in response to conflicts. This finding implies that previous experiences may have a reduced influence on current behavior in these patients which possibly contributes to less flexible behavior. Nevertheless, we observed intact behavioral reactions after errors indicating that adults with high-functioning autism spectrum disorder can flexibly adjust behavior in response to changed environmental demands when necessary. The enhancement of electrophysiological error-processing indicates that adults with high-functioning autism spectrum disorder demonstrate an extraordinary reactivity toward errors reflecting increased performance monitoring in this subpopulation of autism spectrum disorder patients.

Multisensory, as opposed to unisensory processing of stimuli, has been found to enhance the performance (e.g., reaction time, accuracy, and discrimination) of healthy individuals across various tasks. However, this enhancement is not as pronounced in patients with schizophrenia (SZ), indicating impaired multisensory integration (MSI) in these individuals. To the best of our knowledge, no study has yet investigated the impact of MSI deficits in the context of working memory, a domain highly reliant on multisensory processing and substantially impaired in schizophrenia. To address this research gap, we employed two adopted versions of the continuous object recognition task to investigate the effect of single-trail multisensory encoding on subsequent object recognition in 21 schizophrenia patients and 21 healthy controls (HC). Participants were tasked with discriminating between initial and repeated presentations. For the initial presentations, half of the stimuli were audiovisual pairings, while the other half were presented unimodal. The task-relevant stimuli were then presented a second time in a unisensory manner (either auditory stimuli in the auditory task or visual stimuli in the visual task). To explore the impact of semantic context on multisensory encoding, half of the audiovisual pairings were selected to be semantically congruent, while the remaining pairs were not semantically related to each other. Consistent with prior studies, our findings demonstrated that the impact of single-trial multisensory presentation during encoding remains discernible during subsequent object recognition. This influence could be distinguished based on the semantic congruity between the auditory and visual stimuli presented during the encoding. This effect was more robust in the auditory task. In the auditory task, when congruent multisensory pairings were encoded, both participant groups demonstrated a multisensory facilitation effect. This effect resulted in improved accuracy and RT performance. Regarding incongruent audiovisual encoding, as expected, HC did not demonstrate an evident multisensory facilitation effect on memory performance. In contrast, SZs exhibited an atypically accelerated reaction time during the subsequent auditory object recognition. Based on the predictive coding model we propose that this observed deviations indicate a reduced semantic modulatory effect and anomalous predictive errors signaling, particularly in the context of conflicting cross-modal sensory inputs in SZ.

In everyday verbal communication, auditory speech perception is often disturbed by background noise. Especially in disadvantageous hearing conditions, additional visual articulatory information (e.g., lip movement) can positively contribute to speech comprehension. Patients with schizophrenia (SZs) demonstrate an aberrant ability to integrate visual and auditory sensory input during speech perception. Current findings about underlying neural mechanisms of this deficit are inconsistent. Particularly and despite the importance of early sensory processing in speech perception, very few studies have addressed these processes in SZs. Thus, in the present study, we examined 20 adult subjects with SZ and 21 healthy controls (HCs) while presenting audiovisual spoken words (disyllabic nouns) either superimposed by white noise (-12 dB signal-to-noise ratio) or not. In addition to behavioral data, event-related brain potentials (ERPs) were recorded. Our results demonstrate reduced speech comprehension for SZs compared to HCs under noisy conditions. Moreover, we found altered N1 amplitudes in SZ during speech perception, while P2 amplitudes and the N1-P2 complex were similar to HCs, indicating that there may be disturbances in multimodal speech perception at an early stage of processing, which may be due to deficits in auditory speech perception. Moreover, a positive relationship between fronto-central N1 amplitudes and the positive subscale of the Positive and Negative Syndrome Scale (PANSS) has been observed.

Meta-analyses suggest a sustained alleviation of depressive symptoms through glabellar botulinum toxin (BTX) injections. This can be explained by the disruption of facial feedback loops, which may moderate and reinforce the experience of negative emotions. Borderline personality disorder (BPD) is characterized by excessive negative emotions. Here, a seed-based resting-state functional connectivity (rsFC) analysis following BTX (N = 24) or acupuncture (ACU, N = 21) treatment in BPD is presented on areas related to the motor system and emotion processing. RsFC in BPD using a seed-based approach was analyzed. MRI data were measured before and 4 weeks after treatment. Based on previous research, the rsFC focus was on limbic and motor areas as well as the salience and default mode network. Clinically, after 4 weeks both groups showed a reduction of borderline symptoms. However, the anterior cingulate cortex (ACC) and the face area in the primary motor cortex (M1) displayed aberrant rsFC after BTX compared to ACU treatment. The M1 showed higher rsFC to the ACC after BTX treatment compared to ACU treatment. In addition, the ACC displayed an increased connectivity to the M1 as well as a decrease to the right cerebellum. This study shows first evidence for BTX-specific effects in the motor face region and the ACC. The observed effects of BTX on rsFC to areas are related to motor behavior. Since symptom improvement did not differ between the two groups, a BTX-specific effect seems plausible rather than a general therapeutic effect.

Persistent Genital Arousal Disorder (PGAD) is a rare condition—mostly in women—where patients perceive prolonged genital arousal without any sexual desire or stimulation. Etiopathological considerations reach from peripheral to central issues over local disturbance of the pudendal nerve to neuropathy, psychosocial, and pharmacological theories. Since well controlled clinical studies about PGAD in conjunction with a mental and somatic health status are missing, this study is a detailed clinical investigation of PGAD patients compared to healthy controls. 26 women who fulfilled diagnostic criteria for PGAD were compared to 26 age matched healthy controls. Investigations included comparison of vegetative, gynaecological and sexual history, psychiatric features as well as a (neuro-)radiological, neurophysiological and gynaecological examination. Moreover, a detailed clinical characterisation of PGAD symptoms was performed. PGAD symptoms were mostly characterised as tingling or prickling and were permanently present. In over 80%, PGAD symptoms were located in the clitoris. Almost 70% reported radiations to other regions of the body. Most frequent trigger factors were tight clothes, mental stress, driving a car/bus/bicycle and sexual intercourse. Relieving factors were mainly distraction, relaxation, physical exercise, masturbation and swimming. In group comparisons, PGAD presented with significant higher rates of sexual dysfunctions, spontaneous orgasms, swelling of the genitals, extraordinary lubrication as well as higher rates in depression, agoraphobia, generalized anxiety disorder and lifetime panic disorder. Significantly more PGAD patients were diagnosed with restless legs symptoms. In contrast childhood traumatization, somatization disorder, suicidality, gynaecological as well as neurophysiological examination of the pudendal nerve were not different between the groups. MRI of the brain, pelvis and spinal cord was unsuspicious and incidental findings - including Tarlov cysts or pelvic venous congestion - were equally distributed among the groups. In summary, our study provides a careful characterization of women with PGAD highlighting a serious mental burden, most probably as a consequence of PGAD. With the current set of clinical investigations there was no evidence of a clear causal relationship to a specific clinical finding as it has been previously discussed. Future studies and additional techniques will have to further explore where and how in the peripheral or central nervous systems PGAD develops.

Background and aims: Hypersexual disorder is characterized by recurrent and intense sexual fantasies, sexual urges, or sexual behaviors that can lead to clinically relevant levels of distress and adverse consequences for affected individuals. Earlier research has established a connection between sexual phenomena, such as compulsive sexual behavior, and personality features. The aim of the present study was to gain further insights into the associations of personality maladjustment and HD. Methods: The present study applied the dimensional approach of personality maladjustment presented in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) to connect compulsive sexual behavior to personality maladjustment. We investigated 47 men suffering from HD (age: M = 36.51, SD = 11.47) and 38 matched men without HD (age: M = 37.92, SD = 12.33) regarding personality maladjustment using a 100-item version of the Personality Inventory for DSM-5 (PID-5-BF). Results: The men with HD showed higher levels of personality maladjustment regarding all PID-5-BF domains (negative affect, detachment, psychoticism, antagonism, and disinhibition) and significantly differentiated from men without HD in the level of subordinate facets. However, no domain of personality differentiated significantly between groups using a binary stepwise logistic regression analysis. Discussion and conclusions: In sum, the findings of the study underline the extent of personality maladjustment in men with HD. Interpersonal difficulties which men with HD frequently experience can contribute to clinically relevant levels of distress and adverse consequences reported by affected individuals.