4.7 Review

Polycystic Ovary Syndrome and Brain: An Update on Structural and Functional Studies

Journal

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 106, Issue 2, Pages E430-E441

Publisher

ENDOCRINE SOC
DOI: 10.1210/clinem/dgaa843

Keywords

polycystic ovary syndrome; brain imaging; appetite; insulin resistance; functional magnetic resonance imaging

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PCOS is associated with structural and functional abnormalities in the central nervous system, leading to nonhomeostatic eating, diminished appetitive responses, cognitive dysfunction, and mood disorders in patients.
Context Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of women in reproductive age and is associated with reproductive, endocrine, metabolic, cardiovascular, and psychological outcomes. All these disorders are thought to be affected by central mechanisms which could be a major contributor in pathogenesis of PCOS. Evidence Acquisition This mini-review discusses the relevance of central nervous system imaging modalities in understanding the neuroendocrine origins of PCOS as well as their relevance to understanding its comorbidities. Evidence Synthesis Current data suggest that central nervous system plays a key role in development of PCOS. Decreased global and regional brain volumes and altered white matter microstructure in women with PCOS is shown by structural imaging modalities. Functional studies show diminished reward response in corticolimbic areas, brain glucose hypometabolism, and greater opioid receptor availability in reward-related regions in insulin-resistant patients with PCOS. These structural and functional disturbances are associated with nonhomeostatic eating, diminished appetitive responses, as well as cognitive dysfunction and mood disorders in women with PCOS. Conclusion Structural and functional brain imaging is an emerging modality in understanding pathophysiology of metabolic disorders such as diabetes and obesity as well as PCOS. Neuroimaging can help researchers and clinicians for better understanding the pathophysiology of PCOS and related comorbidities as well as better phenotyping PCOS.

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