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White matter microstructure altered in PCOS
In adults with polycystic ovary syndrome, white matter microstructure is altered and cognitive performance is compromised, according to recent study findings published in The Journal of Clinical Endocrinology & Metabolism.
“PCOS was associated with both subtle decrements of cognitive function and alterations in microstructure of brain white matter,” the researchers wrote. “These differences are not attributable to BMI, which was closely matched between groups, as was general intelligence.”
Michael O’Sullivan, PhD, FRCP, of Maurice Wohl Clinical Neuroscience Institute in London, and colleagues evaluated 18 patients with PCOS (mean age, 31 years; BMI, 30 kg/m2) and 18 controls (mean age, 31 years; BMI, 29 kg/m2) to determine whether PCOS is linked to altered white matter microstructure and cognitive function.
Compared with controls, cognitive performance was reduced in the PCOS group. Differences were found in white matter microstructure between the two groups with areas of decreased axial diffusivity being found throughout the white matter skeleton in the PCOS group. The PCOS group also had increased tissue volume fraction in the rostral body of the corpus callosum and parts of the anterior white matter.
The relationship between insulin resistance and white matter microstructure differed between the PCOS group and controls. A reduction of axial diffusivity was found with increasing insulin resistance in controls, whereas increasing insulin resistance in the PCOS group was associated with increasing axial diffusivity.
Among the PCOS group, a positive association was found with serum testosterone and axial diffusivity and fractional anisotropy, whereas there was no relationship for controls. Increases in testosterone and insulin area under the curve (AUC) were associated with increasing values of axial diffusivity in the PCOS group.
Testosterone (P = .64) and insulin AUC (P = .98) were not linked to cognitive performance in the PCOS group. Similar results were found among controls.
“A key question that follows from these observations is whether alterations in brain structure and function can be reversed, reducing the risk of future cognitive decline,” the researchers wrote. “Interestingly, one study in PCOS suggested improvement in a single cognitive measure (verbal fluency) after combined treatment with an antiandrogen plus estrogen. Based on the current results, both insulin resistance and hyperandrogenism are potential targets, and advanced MRI has a potential role as a biomarker of treatment effect.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.