White matter microstructure and cognitive function in young women with polycystic ovary syndrome

Rees, Dafydd Aled ORCID: https://orcid.org/0000-0002-1165-9092, Udiawar, Maneesh, Berlot, Rok, Jones, Derek K. ORCID: https://orcid.org/0000-0003-4409-8049 and O'Sullivan, Michael J. 2016. White matter microstructure and cognitive function in young women with polycystic ovary syndrome. Journal of Clinical Endocrinology & Metabolism 101 (1) , pp. 314-323. 10.1210/jc.2015-2318

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Abstract

Context: Polycystic ovary syndrome (PCOS) is a disorder characterised by insulin resistance and hyperandrogenism, which leads to an increased risk of type 2 diabetes in later life. Androgens and insulin signalling affect brain function but little is known about brain structure and function in younger adults with PCOS. Objective: To establish whether young women with PCOS display altered white matter microstructure and cognitive function. Patients, interventions and main outcome measures: Eighteen individuals with PCOS (age 31±6 years, BMI 30±6 kg/m2) and 18 control subjects (age 31±7 years, BMI 29±6 kg/m2), matched for age, IQ and body mass index, underwent anthropometric and metabolic evaluation, diffusion tensor MRI, a technique especially sensitive to brain white matter structure, and cognitive assessment. Cognitive scores and white matter diffusion metrics were compared between groups. White matter microstructure was evaluated across the whole white matter skeleton using tract based spatial statistics (TBSS). Associations with metabolic indices were also evaluated. Results: PCOS was associated with a widespread reduction in axial diffusivity (diffusion along the main axis of white matter fibers) and increased tissue volume fraction (the proportion of volume filled by white or grey matter rather than cerebrospinal fluid) in the corpus callosum. Cognitive performance was reduced compared with controls (first principal component, t=2.9, P=0.007), reflecting subtle decrements across a broad range of cognitive tests, despite similar education and premorbid intelligence. In PCOS, there was a reversal of the relationship seen in controls between brain microstructure and both androgens and insulin resistance. Conclusions: White matter microstructure is altered, and cognitive performance is compromised, in young adults with PCOS. These alterations in brain structure and function are independent of age, education and body mass index. If reversible, these changes represent a potential target for treatment.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Cardiff University Brain Research Imaging Centre (CUBRIC) Medicine Neuroscience and Mental Health Research Institute (NMHRI) Psychology
Subjects:	R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RG Gynecology and obstetrics
Additional Information:	First Published Online: November 17, 2015 This article has been published under the terms of the Creative Commons Attribution License
Publisher:	The Endocrine Society
ISSN:	0021-972X
Funders:	Medical Research Council
Date of First Compliant Deposit:	30 March 2016
Date of Acceptance:	6 November 2015
Last Modified:	04 May 2023 02:40
URI:	https://orca.cardiff.ac.uk/id/eprint/81849

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