Journal of Sexual Medicine

2012; 9: 1048–1054 DOI: 10.1111/j.1743-6109.2012.02651.x

Stephanie Cacioppo, PhD, Francesco Bianchi-Demicheli, MD, Chris Frum, James G. Pfaus, PhD, and James W. Lewis, PhD


Introduction. One of the most difficult dilemmas in relationship science and couple therapy concerns the interaction
between sexual desire and love. As two mental states of intense longing for union with others, sexual desire and love
are, in fact, often difficult to disentangle from one another.
Aim. The present review aims to help understand the differences and similarities between these two mental states
using a comprehensive statistical meta-analyses of all functional magnetic resonance imaging (fMRI) studies on
sexual desire and love.
Methods. Systematic retrospective review of pertinent neuroimaging literature.
Main Outcome Measures. Review of published literature on fMRI studies illustrating brain regions associated with
love and sexual desire to date.
Results. Sexual desire and love not only show differences but also recruit a striking common set of brain areas that
mediate somatosensory integration, reward expectation, and social cognition. More precisely, a significant posterior-to-anterior insular pattern appears to track sexual desire and love progressively.
Conclusions. This specific pattern of activation suggests that love builds upon a neural circuit for emotions and pleasure, adding regions associated with reward expectancy, habit formation, and feature detection. In particular, the
shared activation within the insula, with a posterior-to-anterior pattern, from desire to love, suggests that love grows out of and is a more abstract representation of the pleasant sensorimotor experiences that characterize desire. From these results, one may consider desire and love on a spectrum that evolves from integrative representations of affective visceral sensations to an ultimate representation of feelings incorporating mechanisms of reward expectancy and habit learning.