(516) Persistent Genital Arousal Disorder/Genitopelvic Dysesthesia (PGAD/GPD): Clinical Features and Brain Activity at Rest (rsfMRI)

Introduction PGAD/GPD is a rare disease causing high somatic and mental distress. Experts in this field assume that the disease is caused by a multifaceted interplay of different etiologies, which may share a common neurobiological basis. Objective Only few clinical and one functional neuroimaging investigation exist, and a more in-depth comprehension of clinical as well as neurobiological foundation is required. Methods Therefore, this study (iPGAD-study, funded by ESSM) aimed to provide new insights into how the functional integration of brain regions may relate to PGAD and its specific symptoms. By using comprehensive clinical assessments and functional magnetic resonance imaging (fMRI) technique, clinical features and functional connectivity at rest were compared between patients suffering PGAD (n = 26) and healthy controls (n = 26). Results All patients perceived prolonged unwanted genital arousal without sexual desire and without relief after sexual stimulation. The majority of routine clinical findings were equally distributed among patients and controls (e.g. Tarlov cysts, venous congestion). Patients with PGAD showed different patterns 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. Conclusions The study offers first insights into the clinical characteristics and neural mechanisms of PGAD/GPD and offers a starting point for systematic investigations of the etiopathology of a serious disease and treatment strategies. Disclosure No