Journal of Pediatric Neurology
DOI: 10.1055/s-0044-1788630
Original Article

Examining Neural Correlates of Sexual Preferences between Persian Homo- and Heterosexual Males Using Psychological Assessments and Functional Magnetic Resonance Imaging in Specifying Cognitive Map: A Limited and Cross-sectional Study

1   School of Paramedical, Gerash University of Medical Sciences, Gerash, Iran
› Author Affiliations
Funding None.

Abstract

Although the brain is an important part of a person's sexual life, little is known about the correlations between sexual response and brain activation. This study examines brain responses through clinical testing to reveal several brain structures whose activation is relevant to sexual arousal besides psychological testing according to the common traditional values and standards of Iranian society. Based on an initial self-report, 25 homosexual and 25 heterosexual males participated in this test to elucidate the identity and sexual trends via the Minnesota Multiphasic Personality Inventory (MMPI-2). Also, an fMRI technique—by presenting distinct homo- and heterosexual sex erotic pictures during the test—was employed in neural correlates of sexual arousal via blood oxygen level dependent (BOLD) signal measuring and Statistical Parametric Mapping analysis. In five selected homosexuals by the most appropriate MMPI test score, brain activities were significantly detected in the midbrain, amygdala, anterior cingulate gyrus, frontal cortex, orbitofrontal cortex, globus pallidus, thalamus, and putamen when the participant saw the erotic pictures during the test, which were responsive to sexual arousal. Also, bilateral caudate nucleus, left angular gyrus, and bilateral pallidum were activated but five selected heterosexuals showed no activation in these areas (p < 0.001). Likewise, the MMPI method confirmed that homosexuality was relevant to diverse life positions, and biological and socioeconomic aspects. The maximum positive correlations were pairwise found in the parietal lobule by r = 0.61 (p < 0.05) and in the frontal gyrus by r = 0.64 (p = 0.10), and the minimum negative correlations were in globus pallidus by r = − 0.18 (p < 0.10) and r = − 0.16 (p < 0.10) for homosexuals and heterosexuals, correspondingly. These results may be useful for understanding the different neural mechanisms of personality recognition and sexual orientation changes while incorporating the individual's history and experience simultaneously into the assessment.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the National Institutes of Health guide. The protocol of this research project has been approved by the ethics committee of the Gerash University of Medical Sciences and is in accordance with the provisions of the Helsinki Declaration.


Trial Registration

PAZHOUHAN, PAZHOUHAN98000034. Registered July 23, 2019 at: http://pazhouhan.gerums.ac.ir/webreclist/view.action?webreclist_code=19300


Patient Consent

All participants gave their informed consent in writing prior to inclusion in the study along with their identifying details, and their anonymities were preserved.


Authors' Contributions

Conceptualization, Data curation, Formal analysis, Investigation, Methodology, Software, Supervision, Validation, Visualization, Writing—original draft.




Publication History

Received: 27 December 2023

Accepted: 29 June 2024

Article published online:
30 July 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 
  • References

  • 1 Ellis L, Ames M-A. Neurohormonal functioning and sexual orientation: a theory of homosexuality-heterosexuality. Psychol Bull 1987; 101 (02) 233-258
  • 2 Swaab D-F. Sexual differentiation of the human brain: relevance for gender identity, transsexualism and sexual orientation. Gynecol Endocrinol 2004; 19 (06) 301-312
  • 3 Bao A-M, Fischer D-F, Wu Y-H. et al. A direct androgenic involvement in the expression of human corticotropin-releasing hormone. Mol Psychiatry 2006; 11 (06) 567-576
  • 4 Savic I, Lindström P. PET and MRI show differences in cerebral asymmetry and functional connectivity between homo- and heterosexual subjects. Proc Natl Acad Sci U S A 2008; 105 (27) 9403-9408
  • 5 Swaab D-F. Sexual orientation and its basis in brain structure and function. Proc Natl Acad Sci U S A 2008; 105 (30) 10273-10274
  • 6 Savic I, Garcia-Falgueras A, Swaab D-F. Sexual differentiation of the human brain in relation to gender identity and sexual orientation. Prog Brain Res 2010; 186: 41-62
  • 7 Kallmann F-J. Comparative twin study on the genetic aspects of male homosexuality. J Nerv Ment Dis 1952; 115 (04) 283-297
  • 8 Hu S, Pattatucci A-M-L, Patterson C. et al. Linkage between sexual orientation and chromosome Xq28 in males but not in females. Nat Genet 1995; 11 (03) 248-256
  • 9 Pillard R-C, Bailey J-M. Human sexual orientation has a heritable component. Hum Biol 1998; 70 (02) 347-365
  • 10 Hamer D-H. Genetics and male sexual orientation. Science 1999; 285 (5429) 803
  • 11 Bailey J-M, Pillard R-C, Dawood K. et al. A family history study of male sexual orientation using three independent samples. Behav Genet 1999; 29 (02) 79-86
  • 12 Ellis L, Peckham W, Ames M-A, Burke D. Sexual orientation of human offspring may be altered by severe maternal stress during pregnancy. J Sex Med 1988; 25 (01) 152-157
  • 13 Bogaert A-F. The interaction of fraternal birth order and body size in male sexual orientation. Behav Neurosci 2003; 117 (02) 381-384
  • 14 Byne W, Parsons B. Human sexual orientation. The biologic theories reappraised. Arch Gen Psychiatry 1993; 50 (03) 228-239
  • 15 Legato M-J. Principles of Gender-specific Medicine. 2nd ed. United States:: Academic Press;; 2009
  • 16 Ponseti J, Bosinski H-A, Wolff S. et al. A functional endophenotype for sexual orientation in humans. Neuroimage 2006; 33 (03) 825-833
  • 17 Safron A, Barch B, Bailey J-M, Gitelman D-R, Parrish T-B, Reber P-J. Neural correlates of sexual arousal in homosexual and heterosexual men. Behav Neurosci 2007; 121 (02) 237-248
  • 18 Sennwald V, Pool E, Brosch T, Delplanque S, Bianchi-Demicheli F, Sander D. Emotional attention for erotic stimuli: cognitive and brain mechanisms. J Comp Neurol 2016; 524 (08) 1668-1675
  • 19 Stoléru S, Fonteille V, Cornélis C, Joyal C, Moulier V. Functional neuroimaging studies of sexual arousal and orgasm in healthy men and women: a review and meta-analysis. Neurosci Biobehav Rev 2012; 36 (06) 1481-1509
  • 20 Yang B, Zhang J-S, Wang T, Zhou Y-C, Liu J-H, Ma L. [An fMRI study on brain activation patterns of males and females during video sexual stimulation]. Zhonghua Nan Ke Xue 2007; 13 (08) 718-722
  • 21 Gillath O, Canterberry M. Neural correlates of exposure to subliminal and supraliminal sexual cues. Soc Cogn Affect Neurosci 2012; 7 (08) 924-936
  • 22 Parada M, Gérard M, Larcher K, Dagher A, Binik YM. How hot are they? Neural correlates of genital arousal: an infrared thermographic and functional magnetic resonance imaging study of sexual arousal in men and women. J Sex Med 2018; 15 (02) 217-229
  • 23 Sylva D, Safron A, Rosenthal A-M, Reber P-J, Parrish T-B, Bailey JM. Neural correlates of sexual arousal in heterosexual and homosexual women and men. Horm Behav 2013; 64 (04) 673-684
  • 24 Altinay M, Anand A. Neuroimaging gender dysphoria: a novel psychobiological model. Brain Imaging Behav 2020; 14 (04) 1281-1297
  • 25 Anders S, Lotze M, Erb M, Grodd W, Birbaumer N. Brain activity underlying emotional valence and arousal: a response-related fMRI study. Hum Brain Mapp 2004; 23 (04) 200-209
  • 26 van Zutphen L, Siep N, Jacob G-A. et al. Impulse control under emotion processing: an fMRI investigation in borderline personality disorder compared to non-patients and cluster-C personality disorder patients. Brain Imaging Behav 2020; 14 (06) 2107-2121
  • 27 Poeppl T-B, Langguth B, Rupprecht R, Laird A-R, Eickhoff S-B. A neural circuit encoding sexual preference in humans. Neurosci Biobehav Rev 2016; 68: 530-536
  • 28 Safron A, Sylva D, Klimaj V. et al. Neural correlates of sexual orientation in heterosexual, bisexual, and homosexual men. Sci Rep 2017; 7: 41314
  • 29 Wehrum S, Klucken T, Kagerer S. et al. Gender commonalities and differences in the neural processing of visual sexual stimuli. J Sex Med 2013; 10 (05) 1328-1342
  • 30 Versace F, Engelmann J-M, Jackson E-F. et al. Brain responses to erotic and other emotional stimuli in breast cancer survivors with and without distress about low sexual desire: a preliminary fMRI study. Brain Imaging Behav 2013; 7 (04) 533-542
  • 31 Seok J-W, Sohn J-H, Cheong C. Neural substrates of sexual arousal in heterosexual males: event-related fMRI investigation. J Physiol Anthropol 2016; 35: 8
  • 32 Arnow B-A, Desmond J-E, Banner L-L. et al. Brain activation and sexual arousal in healthy, heterosexual males. Brain 2002; 125 (Pt 5): 1014-1023
  • 33 Janssen E, Everaerd W, Spiering M, Janssen J. Automatic processes and the appraisal of sexual stimuli: toward an information processing model of sexual arousal. J Sex Res 2000; 37 (01) 8-23
  • 34 Redouté J, Stoléru S, Grégoire M-C. et al. Brain processing of visual sexual stimuli in human males. Hum Brain Mapp 2000; 11 (03) 162-177
  • 35 Both S, Spiering M, Laan E, Belcome S, van den Heuvel B, Everaerd W. Unconscious classical conditioning of sexual arousal: evidence for the conditioning of female genital arousal to subliminally presented sexual stimuli. J Sex Med 2008; 5 (01) 100-109
  • 36 Oei N-Y, Rombouts S-A, Soeter R-P, van Gerven J-M, Both S. Dopamine modulates reward system activity during subconscious processing of sexual stimuli. Neuropsychopharmacology 2012; 37 (07) 1729-1737
  • 37 Georgiadis J-R. Functional neuroanatomy of human cortex cerebri in relation to wanting sex and having it. Clin Anat 2015; 28 (03) 314-323
  • 38 Camara W-J, Nathan J-S, Puente A-E. Psychological test usage: implications in professional psychology. Prof Psychol Res Pr 2000; 31 (02) 141-154
  • 39 McKinley J-C, Hathaway S-R. The Minnesota Multiphasic Personality Inventory. V. Hysteria, hypomania and psychopathic deviate. J Appl Psychol 1944; 28: 153-174
  • 40 Ashoor M, Khorshidi A. Estimation of the number of compartments associated with the apparent diffusion coefficient in MRI: the theoretical and experimental investigations. AJR Am J Roentgenol 2016; 206 (03) 455-462
  • 41 Ashoor M, Khorshidi A, Sarkhosh L. Estimation of microvascular capillary physical parameters using MRI assuming a pseudo liquid drop as model of fluid exchange on the cellular level. Rep Pract Oncol Radiother 2019; 24 (01) 3-11
  • 42 Box GEP. A general distribution theory for a class of likelihood criteria. Biometrika 1949; 36 (3-4): 317-346
  • 43 Morrison D. Multivariate Statistical Methods. New York:: McGraw-Hill;; 1990. : p. 495.
  • 44 Yates R-D, Goodman D-J. Probability and Stochastic Processes: A Friendly Introduction for Electrical and Computer Engineers. 3rd ed. United States:: John Wiley & Sons;; 2014
  • 45 Fisher R-A. Statistical Methods for Research Workers. New Delhi, India:: Gyan Books Pvt. Ltd.;; 2017
  • 46 Hardy-Vallée B. Cognitive Decision-Making: Empirical and Foundational Issues. Newcastle:: Cambridge Scholars Publishing;; 2009
  • 47 Rauch S-L, Jenike M-A, Alpert N-M. et al. Regional cerebral blood flow measured during symptom provocation in obsessive-compulsive disorder using oxygen 15-labeled carbon dioxide and positron emission tomography. Arch Gen Psychiatry 1994; 51 (01) 62-70
  • 48 Hu S-H, Wei N, Wang Q-D. et al. Patterns of brain activation during visually evoked sexual arousal differ between homosexual and heterosexual men. AJNR Am J Neuroradiol 2008; 29 (10) 1890-1896
  • 49 Zhang M, Hu S, Xu L. et al. Neural circuits of disgust induced by sexual stimuli in homosexual and heterosexual men: an fMRI study. Eur J Radiol 2011; 80 (02) 418-425
  • 50 Stoléru S, Redouté J, Costes N. et al. Brain processing of visual sexual stimuli in men with hypoactive sexual desire disorder. Psychiatry Res 2003; 124 (02) 67-86
  • 51 Karama S, Lecours A-R, Leroux J-M. et al. Areas of brain activation in males and females during viewing of erotic film excerpts. Hum Brain Mapp 2002; 16 (01) 1-13
  • 52 Hamann S, Herman R-A, Nolan C-L, Wallen K. Men and women differ in amygdala response to visual sexual stimuli. Nat Neurosci 2004; 7 (04) 411-416
  • 53 Bramble M-S, Lipson A, Vashist N, Vilain E. Effects of chromosomal sex and hormonal influences on shaping sex differences in brain and behavior: lessons from cases of disorders of sex development. J Neurosci Res 2017; 95 (1-2): 65-74
  • 54 Drescher J. Queer diagnoses: parallels and contrasts in the history of homosexuality, gender variance, and the diagnostic and statistical manual. Arch Sex Behav 2010; 39 (02) 427-460
  • 55 Müller A. Scrambling for access: availability, accessibility, acceptability and quality of healthcare for lesbian, gay, bisexual and transgender people in South Africa. BMC Int Health Hum Rights 2017; 17 (01) 16
  • 56 Schleim S. Subjective experience, heterophenomenology, or neuroimaging? A perspective on the meaning and application of mental disorder terms, in particular major depressive disorder. Front Psychol 2018; 9: 702
  • 57 Webster Jr CR, Telingator C-J. Lesbian, gay, bisexual, and transgender families. Pediatr Clin North Am 2016; 63 (06) 1107-1119
  • 58 Harfouch O, German D. The absence of Middle Eastern and North African sexual and gender minority Americans from health research. LGBT Health 2018; 5 (05) 330-331
  • 59 Bailey J-M, Vasey P-L, Diamond L-M, Breedlove S-M, Vilain E, Epprecht M. Sexual orientation, controversy, and science. Psychol Sci Public Interest 2016; 17 (02) 45-101
  • 60 Cantor J-M. Is homosexuality a paraphilia? The evidence for and against. Arch Sex Behav 2012; 41 (01) 237-247
  • 61 Filip-Crawford G, Neuberg S-L. Homosexuality and pro-gay ideology as pathogens? Implications of a disease-spread lay model for understanding anti-gay behaviors. Pers Soc Psychol Rev 2016; 20 (04) 332-364
  • 62 Anderson J-E, Kanters S. Lack of sexual minorities' rights as a barrier to HIV prevention among men who have sex with men and transgender women in Asia: a systematic review. LGBT Health 2015; 2 (01) 16-26
  • 63 Jannini E-A, Blanchard R, Camperio-Ciani A, Bancroft J. Male homosexuality: nature or culture?. J Sex Med 2010; 7 (10) 3245-3253
  • 64 Shaeer O, Shaeer K. The Global Online Sexuality Survey (GOSS): male homosexuality among Arabic-speaking internet users in the Middle East–2010. J Sex Med 2014; 11 (10) 2414-2420
  • 65 Campo-Arias A, Vanegas-García J-S, Herazo E. Sexual orientation and social anxiety disorder: a systematic review. Rev Chil Neuro-psiquiatr 2017; 55 (02) 93-102
  • 66 Qin J-B, Zhao G-L, Wang F. et al. Childhood abuse experiences and the COMT and MTHFR genetic variants associated with male sexual orientation in the Han Chinese populations: a case-control study. J Sex Med 2018; 15 (01) 29-42
  • 67 Jannini E-A, Burri A, Jern P, Novelli G. Genetics of human sexual behavior: where we are, where we are going. Sex Med Rev 2015; 3 (02) 65-77
  • 68 Alipour M. Islamic Shari'a law, neotraditionalist Muslim scholars and transgender sex-reassignment surgery: a case study of Ayatollah Khomeini's and Sheikh al-Tantawi's fatwas. Int J Transgenderism 2017; 18 (01) 91-103
  • 69 Jahangir J-B, Abdul-Latif H. Investigating the Islamic perspective on homosexuality. J Homosex 2016; 63 (07) 925-954
  • 70 Korycki K, Nasirzadeh A. Desire recast: the production of gay identity in Iran. J Gend Stud 2016; 25 (01) 50-65
  • 71 Hiatt D, Hargrave G-E. Psychological assessment of gay and lesbian law enforcement applicants. J Pers Assess 1994; 63 (01) 80-88
  • 72 Martin H, Finn S-E. Masculinity and Femininity in the MMPI-2 and MMPI-A. Minneapolis, London:: University of Minnesota Press;; 2010
  • 73 Hope D-A. Contemporary Perspectives on Lesbian, Gay, and Bisexual Identities. University of Nebraska, Lincoln, NE: Springer Science & Business Media; 2008
  • 74 Kagerer S, Klucken T, Wehrum S. et al. Neural activation toward erotic stimuli in homosexual and heterosexual males. J Sex Med 2011; 8 (11) 3132-3143
  • 75 Swaab D-F, Garcia-Falgueras A. Sexual differentiation of the human brain in relation to gender identity and sexual orientation. Funct Neurol 2009; 24 (01) 17-28
  • 76 Drescher J. Controversies in gender diagnoses. LGBT Health 2014; 1 (01) 10-14
  • 77 Hartal G, Sasson-Levy O. Re-reading homonationalism: an Israeli spatial perspective. J Homosex 2018; 65 (10) 1391-1414
  • 78 Itzhaky H, Kissil K. “It's a horrible sin. If they find out, I will not be able to stay”: orthodox Jewish gay men's experiences living in secrecy. J Homosex 2015; 62 (05) 621-643
  • 79 van Lisdonk J, Keuzenkamp S. Towards bi-inclusive policies: suggestions based on research on Dutch same-sex attracted young people. Sex Res Soc Policy 2017; 14 (02) 206-222
  • 80 Schrimshaw E-W, Downing Jr M-J, Siegel K. Sexual venue selection and strategies for concealment of same-sex behavior among non-disclosing men who have sex with men and women. J Homosex 2013; 60 (01) 120-145
  • 81 Langarita Adiego J-A. On sex in fieldwork: notes on the methodology involved in the ethnographic study of anonymous sex. Sexualities 2017; 22: 1253-1267
  • 82 Reece M, Dodge B. Exploring the physical, mental and social well-being of gay and bisexual men who cruise for sex on a college campus. J Homosex 2003; 46 (1–2): 111-136
  • 83 Katz-Wise S-L. Sexual fluidity in young adult women and men: associations with sexual orientation and sexual identity development. Psychol Sex 2015; 6 (02) 189-208
  • 84 Pennington S. Bisexuals “doing gender” in romantic relationships. J Bisex 2009; 9 (01) 33-69
  • 85 Hudson J-H. Comprehensive literature review pertaining to married men who have sex with men (MMSM). J Bisex 2013; 13 (04) 417-601
  • 86 Scherrer K. Culturally competent practice with bisexual individuals. Clin Soc Work J 2013; 41 (03) 238-248
  • 87 Mohr J-J, Jackson S-D, Sheets R-L. Sexual orientation self-presentation among bisexual-identified women and men: patterns and predictors. Arch Sex Behav 2017; 46 (05) 1465-1479
  • 88 Herek G-M, Norton A-T, Allen T-J, Sims C-L. Demographic, psychological, and social characteristics of self-identified lesbian, gay, and bisexual adults in a US probability sample. Sex Res Soc Policy 2010; 7 (03) 176-200
  • 89 Macefield V-G, James C, Henderson L-A. Identification of sites of sympathetic outflow at rest and during emotional arousal: concurrent recordings of sympathetic nerve activity and fMRI of the brain. Int J Psychophysiol 2013; 89 (03) 451-459
  • 90 Heinzel A, Bermpohl F, Niese R. et al. How do we modulate our emotions? Parametric fMRI reveals cortical midline structures as regions specifically involved in the processing of emotional valences. Brain Res Cogn Brain Res 2005; 25 (01) 348-358
  • 91 Feng C, Feng X, Wang L. et al. The neural signatures of egocentric bias in normative decision-making. Brain Imaging Behav 2019; 13 (03) 685-698
  • 92 Haas A-P, Lane A. Working Group for Postmortem Identification of SO/GI. Collecting sexual orientation and gender identity data in suicide and other violent deaths: a step towards identifying and addressing LGBT mortality disparities. LGBT Health 2015; 2 (01) 84-87
  • 93 O'Brien K-H-M, Putney J-M, Hebert N-W, Falk A-M, Aguinaldo L-D. Sexual and gender minority youth suicide: understanding subgroup differences to inform interventions. LGBT Health 2016; 3 (04) 248-251
  • 94 Egger J-I, Delsing P-A, De Mey H-R. Differential diagnosis using the MMPI-2: Goldberg's index revisited. Eur Psychiatry 2003; 18 (08) 409-411
  • 95 Ben-Porath Y-S, Butcher J-N, Graham J-R. Contributions of the MMPI-2 content scales to the differential diagnosis of schizophrenia and major depression. Psychol Assess 1991; 3 (04) 634-640
  • 96 Wetzler S, Khadivi A, Moser R-K. The use of the MMPI-2 for the assessment of depressive and psychotic disorders. Assessment 1998; 5 (03) 249-261
  • 97 Greenblatt R-L, Davis W-E. Differential diagnosis of PTSD, schizophrenia, and depression with the MMPI-2. J Clin Psychol 1999; 55 (02) 217-223
  • 98 Benazzi F. Sensitivity and specificity of clinical markers for the diagnosis of bipolar II disorder. Compr Psychiatry 2001; 42 (06) 461-465
  • 99 Bagby R-M, Marshall M-B, Basso M-R, Nicholson R-A, Bacchiochi J, Miller L-S. Distinguishing bipolar depression, major depression, and schizophrenia with the MMPI-2 clinical and content scales. J Pers Assess 2005; 84 (01) 89-95
  • 100 Sellbom M, Bagby R-M, Kushner S, Quilty L-C, Ayearst L-E. Diagnostic construct validity of MMPI-2 Restructured Form (MMPI-2-RF) scale scores. Assessment 2012; 19 (02) 176-186
  • 101 Friedman A-F, Bolinskey P-K, Levak R-W, Nichols D-S. Psychological assessment with the MMPI-2/MMPI-2-RF. 3rd ed. New York:: Routledge;; 2015
  • 102 Carter J-W, Nordgaard J, Parnas J. Identifying non-affective psychosis in first admission patients: MMPI-2, structured diagnostic interview, and consensus lifetime best estimate. Psychiatry Res 2019; 279: 71-76
  • 103 Tran US, Kossmeier M, Voracek M. Associations of bisexuality and homosexuality with handedness and footedness: a latent variable analysis approach. Arch Sex Behav 2019; 48 (05) 1451-1461
  • 104 Lajtos M, Barradas-Chacón LA, Wriessnegger SC. Effects of handedness on brain oscillatory activity during imagery and execution of upper limb movements. Front Psychol 2023; 14: 1161613
  • 105 Saari TT, Vuoksimaa E. The role of hand preference in cognition and neuropsychiatric symptoms in neurodegenerative diseases. Brain Commun 2023; 5 (03) fcad137
  • 106 Ellika SK, Chadha M, Yang Z. Imaging in nontraumatic pediatric head and neck emergencies. J Pediatr Neurol 2017; 15 (05) 263-293
  • 107 Winegar BA, Udayasankar UK. Imaging of pediatric paranasal sinus and orbital infections. J Pediatr Neurol 2017; 15 (05) 251-262
  • 108 Kara A, Choudhary G, Udayasankar UK. Imaging of meningitis and meningoencephalitis in children. J Pediatr Neurol 2017; 15 (05) 221-227
  • 109 Bernal B. Practical aspects of functional magnetic resonance imaging in children. J Pediatr Neurol 2022; 20 (02) 83-96
  • 110 Ho ML, Welker KM. Pediatric functional magnetic resonance imaging: clinical applications. J Pediatr Neurol 2018; 16 (02) 78-93
  • 111 Mohandoss V, Kumar V, Vyas S, Saini AG. Dengue encephalitis: don't forget to list it when the brain is hit. J Pediatr Neurol 2021; 19 (03) 217-220
  • 112 Ayadi B, Feki FK, Nsir SB. et al. Brain tuberculomas as BCGitis complication presenting with epileptic spasms: a case report. J Pediatr Neurol 2020; 18 (02) 114-117
  • 113 Ashoor M, Khorshidi A. Improving signal-to-noise ratio by maximal convolution of longitudinal and transverse magnetization components in MRI: application to the breast cancer detection. Med Biol Eng Comput 2024; 62 (03) 941-954
  • 114 Khorshidi A. Introducing extended algorithm for respiratory tumor segmentation. In: Multimedia Tools and Applications;. 2024. . Accessed July 3, 2024 at: https://doi.org/10.1007/s11042-024-18496-2
  • 115 Khorshidi A. Tumor segmentation via enhanced area growth algorithm for lung CT images. BMC Med Imaging 2023; 23 (01) 189
  • 116 Ashoor M, Khorshidi A. Modelling cardiovascular system using Fermi functions on capillary bed. Sadhana 2023; 48: 151
  • 117 Ashoor M, Khorshidi A. Modeling modulation transfer function based on analytical functions in imaging systems. Eur Phys J Plus 2023; 138: 249
  • 118 Ashoor M, Khorshidi A, Pirouzi A, Abdollahi A, Mohsenzadeh M, Barzi SMZ. Estimation of Reynolds number on microvasculature capillary bed using diffusion and perfusion MRI: the theoretical and experimental investigations. Eur Phys J Plus 2021; 136: 152
  • 119 Georgiadis J-R. Exposing orgasm in the brain: a critical eye. Sex Relationship Ther 2011; 26 (04) 342-355
  • 120 Khorshidi A, Ashoor M. Modulation transfer function assessment in parallel beam and fan beam collimators with square and cylindrical holes. Ann Nucl Med 2014; 28 (04) 363-370
  • 121 Nabipour JS, Khorshidi A. Spectroscopy and optimizing semiconductor detector data under X and γ photons using image processing technique. J Med Imaging Radiat Sci 2018; 49 (02) 194-200
  • 122 Ashoor M, Khorshidi A. Evaluation of crystals' morphology on detection efficiency using Modern Classification Criterion and Monte Carlo Method in nuclear medicine. Proc Natl Acad Sci, India, Sect A Phys Sci 2019; 89 (03) 579-585
  • 123 Khorshidi A. Assessment of SPECT images using UHRFB and other low-energy collimators in brain study by Hoffman phantom and manufactured defects. Eur Phys J Plus 2020; 135: 261
  • 124 Salari S, Khorshidi A, Soltani-Nabipour J. Simulation and assessment of 99mTc absorbed dose into internal organs from cardiac perfusion scan. Nucl Eng Technol 2023; 55 (01) 248-253
  • 125 Ashoor M, Khorshidi A. Point-spread-function enhancement via designing new configuration of collimator in nuclear medicine. Radiat Phys Chem 2022; 190: 109783
  • 126 Khorshidi A. Gold nanoparticles production using reactor and cyclotron based methods in assessment of (196,198)Au production yields by (197)Au neutron absorption for therapeutic purposes. Mater Sci Eng C 2016; 68: 449-454
  • 127 Khorshidi A. Neutron activator design for 99Mo production yield estimation via lead and water moderators in transmutation's analysis. Instrum Exp Tech 2018; 61 (02) 198-204
  • 128 Khorshidi A. Accelerator-based methods in radio-material 99Mo/99mTc production alternatives by Monte Carlo Method: the scientific-expedient considerations in nuclear medicine. J Multiscale Model 2020; 11 (01) 1930001
  • 129 Khorshidi A. Radiochemical parameters of molybdenum-99 transmutation in cyclotron-based production method using a neutron activator design for nuclear-medicine aims. Eur Phys J Plus 2019; 134: 249
  • 130 Khorshidi A. Molybdenum-99 production via lead and bismuth moderators and milli-structure-98Mo samples by indirect production technique using Monte Carlo method. Phys Uspekhi 2019; 62 (09) 931-940
  • 131 Asgari A, Ashoor M, Sarkhosh L, Khorshidi A, Shokrani P. Determination of gamma camera's calibration factors for quantitation of diagnostic radionuclides in simultaneous scattering and attenuation correction. Curr Radiopharm 2019; 12 (01) 29-39
  • 132 Khorshidi A. Nano Yttrium-90 and Rhenium-188 production through medium medical cyclotron and research reactor for therapeutic usages: a simulation study. Nucl Eng Technol 2023; 55 (05) 1871-1877
  • 133 Rabiei M, Khorshidi A, Soltani-Nabipour J. Production of Yttrium-86 radioisotope using genetic algorithm and neural network. Biomed Signal Process Control 2021; 66: 102449
  • 134 Jannini EA, Fisher WA, Bitzer J, McMahon CG. Is sex just fun? How sexual activity improves health. J Sex Med 2009; 6 (10) 2640-2648
  • 135 Kamen C, Mustian KM, Dozier A, Bowen DJ, Li Y. Disparities in psychological distress impacting lesbian, gay, bisexual and transgender cancer survivors. Psychooncology 2015; 24 (11) 1384-1391
  • 136 Khorshidi A, Ahmadinejad M, Hamed Hosseini S. Evaluation of a proposed biodegradable 188Re source for brachytherapy application: a review of dosimetric parameters. Medicine (Baltimore) 2015; 94 (28) e1098
  • 137 Ghorbani M. P-03-027 Hypoactive sexual desire as well as erectile dysfunction of a homosexual male in heterosexual marital relationship. J Sex Med 2016; 13 (05) S184-S185
  • 138 Khorshidi A. Accelerator driven neutron source design via beryllium target and 208Pb moderator for boron neutron capture therapy in alternative treatment strategy by Monte Carlo method. J Cancer Res Ther 2017; 13 (03) 456-465
  • 139 Khorshidi A, Abdollahi A, Pirouzi A, Hosseini SH. Band pass filter plan in fluoroscopy for high energy range. SN Appl Sci 2020; 2: 90
  • 140 Soltani-Nabipour J, Khorshidi A, Shojai F, Khorami K. Evaluation of dose distribution from 12C ion in radiation therapy by FLUKA code. Nucl Eng Technol 2020; 52 (10) 2410-2414
  • 141 Patel J, Rothner DA. Primary headache associated with sexual activity in adolescents: illustrative cases. J Pediatr Neurol 2021; 19 (06) 436-439
  • 142 Stanton B, Knight A. Central nervous system involvement in pediatric systemic autoimmune diseases. J Pediatr Neurol 2018; 16 (03) 148-163