Disrupted topological properties of brain networks in erectile dysfunction patients owing predominantly to psychological factors: a structural and functional neuroimaging study.

Human brain was a complex network of interconnected regions. Recent neuroimaging studies had showed that the disruption of brain connectivity was associated with psychological disorders. Abnormal rich club and robustness of brain networks might have a key role in the pathophysiology of psychogenic erectile dysfunction (pED).Both diffusion and functional magnetic resonance imaging were performed in pED patients and healthy controls (HC). Measures of rich club organization and robustness under targeted attack were explored.Both pED and HC showed structural and functional rich club organization. However, reduced rich club coefficient was found in pED and different regions in the rich club of structural brain network were less than that of functional brain network. Moreover, decreased connectivity density and strength were only found in feeder connections of functional brain network in pED. In addition, pED showed remarkably reduced resilient to targeted attack and the stability of the functional brain network organization showed more vulnerable to targeted attack in pED.Together, our results provided evidence that pED was characterized by a selective disruption of rich club organization and reduced robustness to attack. The abnormal hub regions and connections of functional brain network, less stable organization of structural brain network, and the abnormal psychological factors might lead to the development of erectile dysfunction in pED.