Association of sexual dysfunctions according to DSM-5 criteria with structural brain differences in women and men from the Hamburg City Health Study

Introduction Sexual dysfunctions are prevalent public health issues with understudied neurobiological correlates. This study explores structural brain differences in individuals with DSM-5 sexual dysfunctions vs. matched controls.Methods This cross-sectional study employed voxel-based morphometry (VBM) to analyse structural brain scans from the Hamburg City Health Study. Participants with erectile disorder (ED; n = 20), premature ejaculation (PE; n = 20), genito-pelvic pain/penetration disorder (GPPPD; n = 8), and female sexual interest/arousal disorder (FSIAD; n = 32) were compared with matched controls (n = 40,40,24,32, respectively). Whole-brain VBM analyses used SPM12 and CAT12. Statistical parametric maps were thresholded at uncorrected voxel-level (p < .001) and false discovery rate (FDR) correction (p_FDR < .05).Results ED showed clusters in right putamen with reduced rGMV and left postcentral gyrus with higher rGMV. PE displayed lower rGMV in cerebellar lobe VI/Crus I and left superior/medial temporal gyrus. GPPPD exhibited higher rGMV in right middle frontal gyrus. FSIAD showed no differences. No clusters survived FDR correction, underscoring the exploratory and hypothesis-generating nature of the reported findings.Conclusions This study identifies potential associations between sexual dysfunctions and structural brain differences in regions related to sexual function, arousal, inhibition, motor coordination, and pain processing. Results require cautious interpretation due to small sample sizes, but provide hypothesis-generating evidence for future research .