Central neural mechanisms of lifelong premature ejaculation: a narrative synthesis of neuroimaging and electrophysiological evidence

LPE is associated with distributed neural network dysfunction, characterized by impaired inhibitory control, exaggerated sensory processing, and dysregulation of serotonergic, dopaminergic, and other neuromodulatory systems. Although central changes may be both a cause and a consequence of LPE, these findings primarily advance mechanistic understanding and should be considered research-level indicators rather than diagnostic biomarkers.