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
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.
AIM I. Determine whether identifiable differences can be observed in cognitive and
emotional processing between women with insulin resistant PCOS compared to normal controls
using validated fMRI tasks.
AIM II. Determine whether treatment with oral hypoglycemic agent will alter cognitive
processing as measured with validated fMRI cognitive and emotional tasks.
AIM III. Evaluate the differences in opioid tone in women with insulin resistant PCOS
compared to normal controls.
AIM IV. Evaluate whether an oral hypoglycemic agent is capable of altering opioid tone in
women with insulin resistant PCOS.
- Subjects with insulin resistant PCOS, irregular menstrual cycles and
- Normal controls with regular menstrual cycles
- Normal hormonal levels, without hirsutism and acne are BMI matched and screened for
insulin resistance prior to inclusion.
- Left handedness
- Acute medical illness
- Uncorrected thyroid disease
- Diabetes renal
- Cardiac or pulmonary insufficiency
- Active liver disease
- Neurological disease
- Current psychiatric illness
- Contraindications to MRI
- Use of hormones
- Centrally acting or insulin sensitizing mediations
- Allergy to any opioid medication
- Substance abuse
- BMI >35.
Yolanda R Smith, MD, MS
University of Michigan, Obstetrics and Gynecology