Courtney A. Marsh, M.D., M.P.H., Alison Berent-Spillson, Ph.D., Tiffany Love, Ph.D., Carol C. Persad, Ph.D., Rodica Pop-Busui, M.D., Ph.D., Jon-Kar Zubieta, M.D., Ph.D., Yolanda R. Smith, M.D., M.S.
Volume 100, Issue 1, Pages 200-207.e1, July 2013
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.
Tertiary referring medical center.
Seven women with IR-PCOS and five non-insulin-resistant controls, aged 21–40 years, recruited from the general population.
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).
We found that insulin-resistant PCOS patients  had greater limbic activation during an emotion task than controls (n = 5);  trended toward decreased positive affect and increased trait anxiety;  after metformin treatment, had limbic activation that no longer differed from controls; and  had positive correlations between fMRI limbic activation during emotional processing and mu-opioid binding potential.
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.
Clinical Trial Registration Number:
Read the full text at: http://www.fertstert.org/article/S0015-0282(13)00400-7/fulltext