Independent Association Of Luteinizing Hormone, But Not Testosterone, With Attention-Domain Cognitive Performance In Women With Polycystic Ovary Syndrome: A Case-Control Study

Abstract

BackgroundCognitive dysfunction in polycystic ovary syndrome (PCOS) has been variably reported and the hormonal correlates of attention-domain performance are poorly characterized. AimTo compare performance on the Attention subdomain of the Addenbrooke’s Cognitive Examination-III (ACE-III) and digit span between women with PCOS and controls, and to explore independent hormonal predictors of attention-domain performance after adjustment for metabolic, dyslipidaemic and inflammatory confounders. Methods This cross-sectional case-control study was conducted in 65 women with PCOS (Rotterdam criteria) and 65 age-matched controls, between 18 and 35 years old. The ACE-III Attention subdomain score and digit span were obtained. During the early follicular phase serum free testosterone, estrogen, LH and FSH were measured. Group comparisons were performed using Mann Whitney U test. Independent hormonal predictors were identified using multiple robust linear regression adjusted for age, BMI, dyslipidaemia, and hs-CRP. ResultsThe ACE-III Attention subdomain score was significantly higher in PCOS than controls (18 [16–18] vs. 17 [15–18], p=0.034), but scaled digit span did not significantly differ (p=0.579). Adjusted regression showed LH to be significantly and positively associated with ACE-III Attention score (β=0.027, 95% CI 0.008 to 0.045, p=0.006) but significantly and negatively associated with scaled digit span (β=-0.030, 95% CI -0.048 to -0.013, p=0.001). Testosterone was not associated significantly. ConclusionLH was the independent hormonal correlate of attention-domain performance, with opposite directions of association between two different attention-related measures. This isolated, directionally-inconsistent finding warrants cautious hypothesis-generating interpretation, and suggests gonadotropin signalling as an under-investigated target for attention domain research in PCOS.