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Regional cerebral activation accompanies sympathoexcitation in women with polycystic ovary syndrome

Lansdown, Andrew, Warbert, Esther, Sverrisdottir, Yrsa, Wise, Richard ORCID: and Rees, Dafydd ORCID: 2019. Regional cerebral activation accompanies sympathoexcitation in women with polycystic ovary syndrome. Journal of Clinical Endocrinology and Metabolism 104 (9) , pp. 3614-3623. 10.1210/jc.2019-00065

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Context Polycystic ovary syndrome (PCOS) is associated with increased sympathetic nervous system (SNS) activation but the cerebral pathways involved are unclear. Objective To compare cerebral (blood oxygen level-dependent [BOLD] fMRI), pressor (blood pressure [BP], heart rate [HR]) and muscle sympathetic nerve activity (MSNA) responses to isometric forearm contraction (IFC) in women with PCOS and matched controls. Design Case-control study Setting Referral center Participants 20 subjects with PCOS (age 29.8 ± 4.8yrs, BMI 26.1 ± 4.9kg/ m2) and 20 age/BMI-matched controls (age 29.7 ± 5.0yrs, BMI 26.1 ± 4.8kg/ m2) Main outcome measures BP, HR, catecholamine and MSNA responses to 30% IFC. BOLD signal change modelled for blood pressure response to 30% IFC. Results Whilst HR and BP increased to a similar extent in both groups following IFC, MSNA burst frequency increased by 68% in the PCOS group (n=7) compared to 11.9% in controls (n=7) (p=0.002). Brain activation indexed by the BOLD signal in response to IFC was significantly greater in the PCOS group (n=15) compared to controls (n=15) in the right orbitofrontal cortex (p<0.0001). Adjustment for insulin sensitivity, but not hyperandrogenism, abolished these between-group differences. Conclusions Our study confirms enhanced sympathoexcitation in women with PCOS and demonstrates increased regional brain activation in response to IFC. The right orbitofrontal cortex BOLD signal change in women with PCOS is associated with insulin sensitivity. Further studies are warranted to clarify whether this may offer a novel target for cardiovascular risk reduction.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Cardiff University Brain Research Imaging Centre (CUBRIC)
Neuroscience and Mental Health Research Institute (NMHRI)
Publisher: Endocrine Society
ISSN: 0021-972X
Date of First Compliant Deposit: 24 April 2019
Date of Acceptance: 18 April 2019
Last Modified: 16 Nov 2023 08:48

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