Study of Brain Function in Women With Insulin Resistant Polycystic Ovary Syndrome

Influence of Insulin Resistance on Cognitive, Emotional and Opioid System Functioning in Women With Polycystic Ovary Syndrome

The purpose of this study is to evaluate the effects of insulin resistance on brain function in women with Polycystic Ovary Syndrome (PCOS). PCOS affected women will be evaluated prior to and following 4-month treatment with Metformin. Additionally, brain function in women with PCOS will be compared to the brain activity in normal control subjects with regular menstrual cycles.

The pathogenesis of Polycystic Ovary Syndrome (PCOS), a reproductive and metabolic disorder, is associated with insulin resistance. The effects of insulin resistance on cognition, mood, opioid system and reproductive function in PCOS affected women are investigated in the current study. The identification of reversible changes in brain function and reproductive measures in insulin resistant PCOS patients would likely significantly influence treatment protocols for these young women.

1. Evaluate the differences in opioid tone in women with insulin resistant PCOS compared to normal controls.
2. Evaluate whether an oral hypoglycemic agent is capable of altering opioid tone in women with insulin resistant PCOS.

Inclusion Criteria:

• Insulin-resistant PCOS (Arm: PCOS Affected Women)
• Irregular menstrual cycle (Arm: PCOS Affected Women)
• Hyperandrogenism (Arm: PCOS Affected Women)
• Regular menstrual cycles (Arm: Normal Controls)
• Normal hormonal levels (Arm: Normal Controls)
• Lack of hirsutism (Arm: Normal Controls)
• Acne-free (Arm: Normal Controls)
• Candidates are BMI-matched and screened for insulin resistance prior to inclusion. (Arm: Normal Controls)

Exclusion Criteria:

• Left handedness
• Acute medical illness
• Uncorrected thyroid disease
• Diabetes renal
• Cardiac or pulmonary insufficiency
• Active liver disease
• Neurological disease
• Current psychiatric illness
• Claustrophobia
• Contraindications to MRI
• Smoking
• Use of hormones
• Centrally acting or insulin sensitizing mediations
• Allergy to any opioid medication
• Substance abuse
• Pregnancy
• BMI >35.