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Functional neuroimaging of emotional processing in women with polycystic ovary syndrome: a case-control pilot study
Courtney A Marsh1, Alison Berent-Spillson, Tiffany Love
1Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan 48109–0276, USA. rowlandc@umich.edu
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.
