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

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

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


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.

Case-control pilot.

Tertiary referring medical center.

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

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).

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.

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:

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