In the last fifteen years, functional neuroimaging techniques have been used to investigate
the neuroanatomical correlates of sexual arousal in healthy human subjects. In most
studies, subjects have been requested to watch visual sexual stimuli and control stimuli.
Our review and meta-analysis found that in heterosexual men, sites of cortical activation
consistently reported across studies are the lateral occipitotemporal, inferotemporal,
parietal, orbitofrontal, medial prefrontal, insular, anterior cingulate, and frontal
premotor cortices as well as, for subcortical regions, the amygdalas, claustrum, hypothalamus,
caudate nucleus, thalami, cerebellum, and substantia nigra. Heterosexual and gay men
show a similar pattern of activation. Visual sexual stimuli activate the amygdalas
and thalami more in men than in women. Ejaculation is associated with decreased activation
throughout the prefrontal cortex. We present a neurophenomenological model to understand
how these multiple regional brain responses could account for the varied facets of
the subjective experience of sexual arousal. Further research should shift from passive
to active paradigms, focus on functional connectivity and use subliminal presentation
of stimuli.
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