Erectile dysfunction (ED) is evidence of atherosclerosis and index of endothelial damage. Many authors demonstrated association with cardiovascular events and coronary artery diseases (CAD); the severity of ED was correlated with the angiographic extension of coronary atherosclerotic process. Few studies have given information about association between ED and subclinical cerebral ischaemic damage. This study was planned to test the hypothesis that patients with isolated ED, without signs of systemic and carotid atherosclerosis, compared to healthy population, have a reduced cerebral vasoreactivity ( CVR) as a marker of endothelial damage.

15 patients with erectile dysfunction (ED+ ) and 15 without erectile dysfunction(ED-) subjects, matched for age and vascular risk factors, were submitted to andrological and neurolological screening. Ecocolordoppler of cavernous arteries and nocturnal penil tumescence rigidometry were performed. Neurological assessment was performed by carotid duplex ultrasound and Transcranial Doppler and by assessing cerebrovascular reserve on both middle cerebral arteries calculating Vasomotor Reserve (VMR), after breath holding and hyperventilation.

Carotid Duplex showed a light carotid stenosis in 3 patients: 2 in the ED+ and 1 in the ED-. No differences about intima-media thickness between ED+ and ED-. Slight slower mean middle cerebral arteries (MCA) flow velocities in ED+ in respect to ED -. ED+ showed a reduced VMR in respect to ED.

Reduced VRM in ED+ may represent a marker of early cerebral vasomotor dysfunction due to subclinical endothelial damage. So performing neurological investigations is unnecessary, but further studies about the relation between ED and cerebral ischaemic damage are needed.