Neurobiological insights into Persistent Genital Arousal Disorder (PGAD): A resting-state functional MRI analysis

Abstract 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.