High-intensity Erotic Visual Stimuli De-activate the Primary Visual Cortex in Women Hieu K. Huynh, MD, PhD student,* Caroline Beers, BSc,* Antoon Willemsen, PhD, † Erna Lont, RN, ‡ Ellen Laan, PhD, § Rudi Dierckx, MD, PhD, † Monique Jansen, MSc, ¶ Michael Sand, PhD,** Willibrord Weijmar Schultz, PhD, § and Gert Holstege, MD, PhD* *Center Uroneurology, University Medical Center Groningen, Groningen, the Netherlands; † Nuclear Med. and Mol. Imaging, Univ. Med. Ctr. Groningen, Groningen, the Netherlands; ‡ Obstetrics and Gynecology, Univ. Med. Ctr. Groningen, Groningen, the Netherlands; § Dept. of Sexology and Psychosomatic Obstetrics and Gynecology, Academic Med. Ctr., Amsterdam, the Netherlands; ¶ Boehringer-Ingelheim Pharma., Inc., Alkmaar, the Netherlands; **Boehringer-Ingelheim Pharma., Inc., Ridgefield, CT, USA DOI: 10.1111/j.1743-6109.2012.02706.x ABSTRACT Introduction. The primary visual cortex, Brodmann’s area (BA 17), plays a vital role in basic survival mechanisms in humans. In most neuro-imaging studies in which the volunteers have to watch pictures or movies, the primary visual cortex is similarly activated independent of the content of the pictures or movies. However, in case the volunteers perform demanding non-visual tasks, the primary visual cortex becomes de-activated, although the amount of incoming visual sensory information is the same. Aim. Do low- and high-intensity erotic movies, compared to neutral movies, produce similar de-activation of the primary visual cortex? Methods. Brain activation/de-activation was studied by Positron Emission Tomography scanning of the brains of 12 healthy heterosexual premenopausal women, aged 18–47, who watched neutral, low- and high-intensity erotic film segments. Main Outcome Measures. We measured differences in regional cerebral blood flow (rCBF) in the primary visual cortex during watching neutral, low-intensity erotic, and high-intensity erotic film segments. Results. Watching high-intensity erotic, but not low-intensity erotic movies, compared to neutral movies resulted in strong de-activation of the primary (BA 17) and adjoining parts of the secondary visual cortex. Conclusions. The strong de-activation during watching high-intensity erotic film might represent compensation for the increased blood supply in the brain regions involved in sexual arousal, also because high-intensity erotic movies do not require precise scanning of the visual field, because the impact is clear to the observer. Huynh HK, Beers C, Willemsen A, Lont E, Laan E, Dierckx R, Jansen M, Sand M, Weijmar Schultz W, and Holstege G. High-intensity erotic visual stimuli de-activate the primary visual cortex in women. J Sex Med 2012;9: 1579–1587. Key Words. De-activation; Primary visual cortex; Low-/high-intensity erotic stimuli; PET-scanning; cerebral blood flow Introduction I t is common knowledge that sex is between the ears, which means that most people realize that the brain plays a crucial role in sexual activities. The next question is how the brain processes sexual activity. One approach is to show men and women erotic movies and study brain activation and de-activation by neuro-imaging. Almost all neuro-imaging studies, using visual information, result in many different activation patterns in the brain. The activation level of the primary visual cortex, also known as Brodmann’s area (BA) 17, which plays a crucial role in receiv- ing the visual information, remains the same, independent of the content of the visual informa- tion. However, auditory task signals, which require demanding judgments, resulted in the 1579 © 2012 International Society for Sexual Medicine J Sex Med 2012;9:1579–1587