Functional neuroimaging of emotional processing in women with polycystic ovary syndrome a case control pilot study

Capsule:
Functional magnetic resonance imaging of limbic activation with emotional processing differed between healthy women and women with insulinresistant polycystic ovary syndrome.

Authors:
Courtney A. Marsh, M.D., M.P.H., Alison Berent-Spillson, Ph.D., Tiffany Love, Ph.D., Carol C. Persad, Ph.D., Rodica Pop-Busui, M.D., Ph.D., Jon-Kar Zubieta, M.D., Ph.D., Yolanda R. Smith, M.D., M.S.

Volume 100, Issue 1, Pages 200-207.e1, July 2013

Abstract:

Objective:
To evaluate emotional processing in women with insulin-resistant polycystic ovary syndrome (IR-PCOS) and its relationship to glucose regulation and the mu-opioid system.

Design:
Case-control pilot.

Setting:
Tertiary referring medical center.

Patient(s):
Seven women with IR-PCOS and five non-insulin-resistant controls, aged 21–40 years, recruited from the general population.

Intervention(s):
Sixteen weeks of metformin (1,500 mg/day) in women with IR-PCOS.

Main Outcome Measure(s):
Assessment of mood, metabolic function, and neuronal activation during an emotional task using functional magnetic resonance imaging (fMRI), and mu-opioid receptor availability using positive emission tomography (PET).

Result(s):
We found that insulin-resistant PCOS patients [1] had greater limbic activation during an emotion task than controls (n = 5); [2] trended toward decreased positive affect and increased trait anxiety; [3] after metformin treatment, had limbic activation that no longer differed from controls; and [4] had positive correlations between fMRI limbic activation during emotional processing and mu-opioid binding potential.

Conclusion(s):
Patients with IR-PCOS had greater regional activation during an emotion task than the controls, although this resolved with metformin therapy. Alterations in mu-opioid neurotransmission may underlie limbic system activity and mood disorders in IR-PCOS.

Clinical Trial Registration Number:
NCT00670800.

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