title: Functional neuroimaging of emotional processing in women with polycystic ovary syndrome: a case-control pilot study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Case-control pilot.
  
  
  METHODS
  Tertiary referring medical center.
  
  
  METHODS
  Seven women with IR-PCOS and five non-insulin-resistant controls, aged 21-40 years, recruited from the general population.
  
  
  METHODS
  Sixteen weeks of metformin (1,500 mg/day) in women with IR-PCOS.
  
  
  METHODS
  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).
  
  
  RESULTS
  We found that insulin-resistant PCOS patients [1] had greater limbic activation during an emotion task than controls (n = 5); [2] trended toward decreased positive affect and increased trait anxiety; [3] after metformin treatment, had limbic activation that no longer differed from controls; and [4] had positive correlations between fMRI limbic activation during emotional processing and mu-opioid binding potential.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan 48109–0276, USA. rowlandc@umich.edu
authors.forename: Courtney A
authors.initials: CA
authors.lastname: Marsh
authors.forename: Alison
authors.initials: A
authors.lastname: Berent-Spillson
authors.forename: Tiffany
authors.initials: T
authors.lastname: Love
authors.forename: Carol C
authors.initials: CC
authors.lastname: Persad
authors.forename: Rodica
authors.initials: R
authors.lastname: Pop-Busui
authors.forename: Jon-Kar
authors.initials: JK
authors.lastname: Zubieta
authors.forename: Yolanda R
authors.initials: YR
authors.lastname: Smith
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004644:Emotions / Q000502:physiology*; D005260:Female; D059907:Functional Neuroimaging / Q000379:methods*; D006801:Humans; D007333:Insulin Resistance / Q000502:physiology*; D010775:Photic Stimulation / Q000379:methods; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000523:psychology*; D055815:Young Adult
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