Brain activation during vaginocervical self-stimulation and orgasm in women with complete spinal cord injury: fMRI evidence of mediation by the Vagus nerves

Department of Psychology, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA.
Brain Research (Impact Factor: 2.84). 11/2004; 1024(1-2):77-88. DOI: 10.1016/j.brainres.2004.07.029
Source: PubMed


Women diagnosed with complete spinal cord injury (SCI) at T10 or above report vaginal-cervical perceptual awareness. To test whether the Vagus nerves, which bypass the spinal cord, provide the afferent pathway for this response, we hypothesized that the Nucleus Tractus Solitarii (NTS) region of the medulla oblongata, to which the Vagus nerves project, is activated by vaginal-cervical self-stimulation (CSS) in such women, as visualized by functional magnetic resonance imaging (fMRI). Regional blood oxygen level-dependent (BOLD) signal intensity was imaged during CSS and other motor and sensory procedures, using statistical parametric mapping (SPM) analysis with head motion artifact correction. Physiatric examination and MRI established the location and extent of spinal cord injury. In order to demarcate the NTS, a gustatory stimulus and hand movement were used to activate the superior region of the NTS and the Nucleus Cuneatus adjacent to the inferior region of the NTS, respectively. Each of four women with interruption, or "complete" injury, of the spinal cord (ASIA criteria), and one woman with significant, but "incomplete" SCI, all at or above T10, showed activation of the inferior region of the NTS during CSS. Each woman showed analgesia, measured at the fingers, during CSS, confirming previous findings. Three women experienced orgasm during the CSS. The brain regions that showed activation during the orgasms included hypothalamic paraventricular nucleus, medial amygdala, anterior cingulate, frontal, parietal, and insular cortices, and cerebellum. We conclude that the Vagus nerves provide a spinal cord-bypass pathway for vaginal-cervical sensibility in women with complete spinal cord injury above the level of entry into spinal cord of the known genitospinal nerves.

Download full-text


Available from: Barry Komisaruk
  • Source
    • "Woodburne reported earlier on the uncertain termination of the vagal and pelvic parasympathetic territories and suggested that there might be an overlap in the distribution of both in the autonomic plexuses (Woodburne, 1956). Also, there is an evidence for the existence of pelvic–vagal afferent pathways (Kaddumi et al., 2012; Komisaruk et al., 2004). Despite the fact that our study did not focus on the neurochemical composition of the vagus nerve, the abundant TH expression was a remarkable finding. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The superior hypogastric plexus (SHP) is an autonomic plexus, located ventrally to the abdominal aorta and its bifurcation, innervating pelvic viscera. It is classically described as being composed of merely sympathetic fibres. However, post-operative complications after surgery damaging the peri-aortic retroperitoneal compartment suggest the existence of parasympathetic fibres. This immunohistochemical study describes the neuroanatomical composition of the human mature SHP. Eight pre-determined retroperitoneal localizations including the lumbar splanchnic nerves, the SHP and the HN were studied in four human cadavers. Control tissues (white rami, grey rami, vagus nerve, splanchnic nerves, sympathetic ganglia, sympathetic chain and spinal nerve) were collected to verify the results. All tissues were stained with haematoxylin and eosin and antibodies S100, tyrosine hydroxylase (TH), vasoactive intestinal peptide (VIP) and myelin basic protein (MBP) to identify pre- and postganglionic parasympathetic and sympathetic nerve fibres. All tissues comprising the SHP and hypogastric nerves (HN) showed isolated expression of TH, VIP and MBP, revealing the presence of three types of fibres: postganglionic adrenergic sympathetic fibres marked by TH, unmyelinated VIP-positive fibres and myelinated preganglionic fibres marked by MBP. Analysis of control tissues confirmed that TH, VIP and MBP were well usable to interpret the neurochemical composition of the SHP and HN. The human SHP and HN contain sympathetic and most likely postganglionic parasympathetic fibres. The origin of these fibres is still to be elucidated, however surgical damage in the peri-aortic retroperitoneal compartment may cause pelvic organ dysfunction related to both parasympathetic and sympathetic denervation. Copyright © 2015 Elsevier B.V. All rights reserved.
    Full-text · Article · Feb 2015 · Autonomic Neuroscience
    • "tern and stimulates the vagus nerve , which con - trols the PNS and triggers the relaxation response . The vagus nerve also innervates the up - per vagina and cervix and bypasses the spinal cord to convey messages of vaginal - cervical stimulation directly to the medulla oblongata , which can be highly relevant to women with spinal cord injuries ( Komisaruk et al . , 2004 ; Schober & Pfaff , 2007 ) . Con - scious breathing increases the oxygen supply in the body at a steady rate , thus not causing panic , as opposed to rapidly increasing oxygen intake through hyperventilation . It is typi - cally mentioned in combination with other modalities , such as mindfulness , meditation , progressive relaxation , "
    [Show abstract] [Hide abstract]
    ABSTRACT: LINK: This article presents a four-stage literature review conducted as a first phase in determining the potential benefits of the proposed Sexual Wellness Enhancement and Enrichment Training (SWEET) model (a modified mind-body skills group), which combines a number of research-based healing modalities, including conscious breathing, mindfulness meditation, mindful eating, movement exercises, autogenics and biofeedback, as a possible alternative for improving sexual wellness through adequate and informed self-care. Educational and experiential components are geared toward teaching participants how to incorporate mind-body skills into their daily lives. The first stage of the literature review examines researched applications of the mind-body skills group (MBSG) model, upon which the SWEET model is based. As stress-reduction is a primary mechanism of the MBSG model, the second stage evaluates the relationship between stress and sexual function. The third stage summarizes research linking the primary modalities used in the SWEET model with aspects of sexual wellness. The final phase of this literature review focuses on the incorporation of targeted sexuality education and psychoeducation in addressing sexual concerns. Studies to determine the effectiveness of the model are called for. However, it appears that the approach is solidly grounded in the existing literature.
    No preview · Article · Feb 2013 · Sexual and Relationship Therapy
  • Source
    • "Their research was the underpinning for much subsequent investigation (Levin, 2001) and has informed social and political commentaries on female sexuality ever since (e.g., Hite, 1976; Lloyd, 2005). However, with the neurological (e.g., Komisaruk et al., 2004), anatomical (e.g., O'Connell et al., 1998, 2005; Zaviačičet al., 1988), and behavioral (e.g., Lightfoot-Klein , 1984; McCaughey & French, 2001) data subsequently available to us, their findings stand in need of revision. Indeed, there now seem grounds for arguing that not all female orgasms are the same. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Building on previous work that identified different types of orgasm in women (King, Belsky, Mah, & Binik, 2011), the goal of the present study was to extend such typological work and determine whether female orgasmic variability tracked potentially evolutionarily salient sexual partner characteristics (e.g., those displaying possible immune-system compatibility). A total of 265 females completed an Internet survey about their orgasmic experience-achieved either with partners or alone. For partnered orgasms, they also provided details of partner characteristics and sexual behaviors. Latent class analysis revealed two orgasm types which were meaningfully distinguishable in terms of sensations and location-either centered on the surface of genitalia or deep inside. Deep orgasms were associated with internal sensations consistent with proposed functions of female orgasm in terms of differential sperm insuck. Such orgasms were associated with partners who were perceived as considerate, dominant, with a noticeably attractive smell, and as providing firm penetration. However, some hypothesized reproductively significant partner characteristics were not differentially associated with deep orgasms (i.e., muscularity, aggression, masculinity). Results were discussed and future research directions outlined. In particular, it is suggested that sexual passion between partners is a non-accidental component of sexual functioning and that this has too frequently been missing in sex research involving humans. Direct physiological measures of the results of female orgasm need to be undertaken. Additionally, the intriguing phenomenon of female ejaculation deserves scientific attention.
    Full-text · Article · Oct 2012 · Archives of Sexual Behavior
Show more