{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T21:59:52Z","timestamp":1785189592231,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Magnetic Resonance Imaging"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Erectile dysfunction (ED) and anxiety have a well\u2010documented bidirectional relationship, with anxiety affecting up to 37% of men with ED. While vascular and endocrine mechanisms are well studied, the central nervous system underpinnings linking anxiety to psychogenic ED (pED) remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To delineate the neural circuitry through which anxiety potentiates erectile dysfunction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Type<\/jats:title>\n                    <jats:p>Retrospective case\u2013control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>About 62 male patients (Age: 45.4\u2009\u00b1\u200912.3) with confirmed pED and 64 age\u2010 and education\u2010matched healthy male controls (Age: 46.1\u2009\u00b1\u200914.7).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Field Strength\/Sequence<\/jats:title>\n                    <jats:p>3.0\u2009T; T2*\u2010weighted gradient\u2010echo echo\u2010planar imaging sequence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Assessment<\/jats:title>\n                    <jats:p>Task\u2010based fMRI was performed using the Hariri picture\u2010matching task with negative and neutral emotional stimuli; state anxiety was measured with the State\u2013Trait Anxiety Inventory (STAI), and erectile dysfunction severity was assessed using the International Index of Erectile Function (IIEF); all assessments were conducted by trained research staff following standardized protocols.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Statistical Tests<\/jats:title>\n                    <jats:p>\n                      Whole\u2010brain activation analysis, seed\u2010based Granger causality mapping, and serial mediation analysis were conducted, with significance set at\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05 and family\u2010wise error correction for multiple comparisons.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>pED patients showed significant hypoactivation in the right amygdala and occipital cortex during negative emotion processing. In the pED group, amygdala activation significantly correlated with state anxiety (r\u2009=\u2009\u22120.54) and ED severity (r\u2009=\u2009\u22120.53). Medial prefrontal cortex (mPFC) was identified as the primary upstream regulator of amygdala activity. Elevated state anxiety showed both direct and indirect statistical associations on erectile function via the mPFC\u2010amygdala pathway.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dysfunction of the mPFC\u2013amygdala circuit is associated with the relationship between state anxiety and pED. This circuit represents a novel therapeutic target for pED management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>3.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Stage of Technical Efficacy<\/jats:title>\n                    <jats:p>Stage 3.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jmri.70466","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T21:29:02Z","timestamp":1785187742000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Medial Prefrontal Cortex\u2013Amygdala Circuit Involvement in State Anxiety and Psychogenic Erectile Dysfunction: A Task\u2010Based\n                    <scp>fMRI<\/scp>\n                    Study"],"prefix":"10.1002","author":[{"given":"Kechong","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Urology Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zewei","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Urology Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongzi","family":"Nie","sequence":"additional","affiliation":[{"name":"Department of Urology Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0103-1829","authenticated-orcid":false,"given":"Lianming","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Urology Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science  Xiangyang Hubei Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"issue":"9861","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0140-6736(12)60520-0","article-title":"Erectile Dysfunction","volume":"381","author":"Shamloul R.","year":"2013","journal-title":"Lancet"},{"issue":"9","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s11934-024-01213-9","article-title":"Erectile Dysfunction in Adolescents and Young Adults","volume":"25","author":"Pantazis A.","year":"2024","journal-title":"Current Urology Reports"},{"issue":"3","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/andr.13401","article-title":"Erectile Dysfunction, Anxiety, Perceived Stress, and Insomnia Are More Common Among Acquired Premature Ejaculation Patients in Contrast to Other Premature Ejaculation Syndromes","volume":"11","author":"Colonnello E.","year":"2023","journal-title":"Andrology"},{"issue":"8","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1093\/jsxmed\/qdad082","article-title":"Erectile Dysfunction, Depression, and Anxiety in Patients With Functional Anorectal Pain: A Case\u2010Control Study","volume":"20","author":"Ma H. 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