Hypersexuality [Neurosurgery Wiki]

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====== Hypersexuality ======

Hypersexuality (HS) accompanying neurological [[condition]]s remains poorly characterized despite profound psychosocial impacts. Objective We aimed to systematically review the literature on HS in patients with neurological [[disorder]]s. Study selection and analysis We conducted a systematic review to identify studies that reported HS in neurological disorders. HS was defined as a condition characterized by excessive and persistent preoccupation with sexual thoughts, urges, and behaviors that cause significant distress or impairment in personal, social, or occupational functioning. Data on demographics, assessment techniques, associated elements, phenotypic manifestations, and management strategies were also extracted. Findings The final analysis included 79 studies on HS, encompassing 32 662 patients across 81 cohorts with neurological disorders. Parkinson's disease was the most frequently studied condition (55.6%), followed by various types of dementia (12.7%). Questionnaires were the most common assessment approach for evaluating HS, although the techniques varied substantially. Alterations in the dopaminergic pathways have emerged as contributing mechanisms based on the effects of medication cessation. However, standardized treatment protocols still need to be improved, with significant heterogeneity in documented approaches. Critical deficiencies include risks of selection bias in participant sampling, uncontrolled residual confounding factors, and lack of blinded evaluations of reported outcomes. Conclusions and clinical implications Despite growth in the last decade, research on HS remains limited across neurological conditions, with lingering quality and methodological standardization deficits. Key priorities include advancing assessment tools, elucidating the underlying neurobiology, and formulating management guidelines
((Tayim N, Barbosa P, Panicker J. Hypersexuality in neurological disorders: A systematic review. BMJ Ment Health. 2024 May 22;27(1):e300998. doi: 10.1136/bmjment-2024-300998. PMID: 38777563.)).
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Pathologic [[hypersexuality]] has occasionally been reported in patients with PD, linked to [[dopamine agonist]]s. The first step in the treatment of hypersexuality consists of reducing the dose of dopaminergic medication
((Moussa M, Abou Chakra M, Papatsoris AG, Dellis A, Dabboucy B, Peyromaure M, Barry Delongchamps N, Bailly H, Duquesne I. Perspectives on the urological care in Parkinson's disease patients. Arch Ital Urol Androl. 2022 Mar 30;94(1):107-117. doi: 10.4081/aiua.2022.1.107. PMID: 35352535.)).