Mental Health

Open Access: No.

Abstract

Being choked or strangled during partnered sex is an emerging sexual behavior, prevalent among young adult women. The goal of this study was to test whether, and to what extent, frequently being choked or strangled during sex is associated with cortical surface functioning and functional connectivity. This case-control study consisted of two groups (choking vs. choking-naïve). Women who were choked 4 or more times during sex in the past 30 days were enrolled into the choking group, whereas those without were assigned to the choking-naïve group. We collected structural and resting-state functional magnetic resonance imaging (fMRI) data and analyzed the data for amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) using cortical surface-based resting-state fMRI analysis, followed by static and dynamic resting-state fMRI connectivity analysis. Forty-one participants (choking n = 20; choking-n-aïve n = 21) contributed to the analysis. An inter-hemispheric imbalance in neuronal activation pattern was observed in the choking group. Specifically, we observed significantly lower ALFF and ReHo in the left cortical regions (e.g., angular gyrus, orbitofrontal gyrus) and higher ALFF and ReHo in the right cortical regions (e.g., pre-central/post-central gyri) in the choking group compared with the choking-naïve group. A significant group difference was found in static functional connectivity between the bilateral angular gyrus and the whole brain, in which the choking group’s angular gyrus showed hyperconnectivity with, for example, the post-central gyrus, pre-central gyrus, and Rolandic operculum, relative to the choking-naïve group. The dynamic analysis revealed hyperconnectivity between the left angular gyrus and the bilateral postcentral gyrus in the choking group compared with the choking-naïve group. Taken together, our data show that multiple experiences of sexual choking/strangulation are associated with an inter-hemispheric imbalance in neural activation pattern and hyperconnectivity between the angular gyrus and brain regions related to motor control, consciousness, and emotion. A longitudinal study using multi-modal neurological assessments is needed to clarify the acute and chronic consequences of sexual choking/strangulation.

Relevance

“The current study presents a potential interaction between repetitive sexual choking and neurophysiological alterations…These data suggest that frequent choking/strangulation during sex may associate with a neuronal activation pattern distinct from that for women without sexual choking exposure.”

The data, too, show a “inter-hemispheric imbalance” that “has been shown to associate with declines in mental health.”

(The data are: “First, we noted significant differences in neural activation patterns between groups, in which the choking group exhibited significantly lower ALFF and ReHo in the left hemisphere (e.g., Rolandic operculum, angular gyrus) and higher ALFF and ReHo in the right hemispheres (e.g., pre/post-central gyri) compared with the choking-naïve group. Second, relative to the choking-naïve group, the choking group showed hyperconnectivity between the angular gyrus and widespread brain regions. The dynamic rs-FC analysis further validated the findings from the static analysis, by demonstrating a significant hyperconnectivity between the left angular gyrus and the bilateral post-central gyrus in the choking group compared with the choking-naïve group.”)

Citation

Hou, J., Huibregtse, M. E., Alexander, I. L., Klemsz, L. M., Fu, T. C., Fortenberry, J. D., Herbenick, D., & Kawata, K. (2023). Association of Frequent Sexual Choking/Strangulation With Neurophysiological Responses: A Pilot Resting-State fMRI Study. Journal of neurotrauma, 40(13-14), 1339–1351. https://doi.org/10.1089/neu.2022.0146