Concomitant impact of polycystic ovarian syndrome and associated comorbidities on cognitive functions, neurotransmitters, and metabolic enzymes in Indian women

Abstract Introduction: Polycystic Ovarian Syndrome (PCOS) is a heterogeneous disorder leading to dysregulations in the homeostatic functions of the body, affecting reproductive, neural, and metabolic health. This study investigates the prevalence of PCOS-associated comorbidities and the effects of cognitive and metabolic alterations in Indian women. Methods: Female volunteers (aged 18-40) were grouped into control and PCOS groups as per the Rotterdam criteria. The volunteers were administered with a standard PCOS questionnaire, Cognitive Failures Questionnaire (CFQ), Mood and Feelings Questionnaire (MFQ), EDC exposure questionnaire, and neuropsychological tests including Corsi block-tapping test, Stroop color test, mental rotation test. Peripheral blood samples were collected from both groups (n=15 each). Serotonin and testosterone levels along with cholinesterase activity were estimated in plasma samples. Activity of rate-limiting metabolic enzymes of the glycolytic pathway (hexokinase, phosphofructokinase, pyruvate kinase), citric acid cycle (citrate synthase), and mitochondrial electron transport chain (cytochrome-c-oxidase) were estimated in peripheral blood mononuclear cells. Results: PCOS patients reported a significant increase in PCOS-related comorbidities. The CFQ and MFQ scores were significantly higher while the recall memory, Corsi, Stroop, mental rotation scores were significantly lower in PCOS patients, compared to control group. There was a significant increase in cholinesterase activity, and a significant decrease in the serotonin levels in women with PCOS compared to the control group. The activities of the rate limiting metabolic enzymes showed significant changes in the PCOS, compared to the control groups. Conclusion: Correlative effects of the altered cognitive functions and associated-physiological mechanisms are evident in Indian women with PCOS.