{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:41:59Z","timestamp":1790390519669,"version":"4.1.0"},"reference-count":55,"publisher":"Bioscientifica","issue":"2","funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"crossref","award":["WT224267"],"award-info":[{"award-number":["WT224267"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5,1]]},"abstract":"<jats:p>Modern neuroimaging advances in methodology and data modelling allow for brain tissue structure and function to be imaged in increasing detail and specificity. These advances have promise when applied to polycystic ovary syndrome (PCOS), a common multisystem condition associated with psycho-cognitive symptomatology and an increased risk of cerebrovascular disease. This hot-topic review will outline three biological themes that encompass PCOS neurobiology and symptomatology and may benefit from the application of advanced neuroimaging techniques: i) the endocrine system and biorhythms, ii) the cerebrovascular system, and iii) neural structure and function. How modern neuroimaging advances can provide new insights to these areas will be discussed. While knowledge of brain health in PCOS is still an emerging field, advanced neuroimaging offers valuable opportunities to investigate the origins and enduring consequences of PCOS.<\/jats:p>","DOI":"10.1530\/joe-25-0421","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T14:14:53Z","timestamp":1777385693000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-5","source":"Crossref","is-referenced-by-count":1,"title":["Advanced neuroimaging in PCOS: state-of-the-art techniques and emerging trends"],"prefix":"10.1530","volume":"269","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2744-4504","authenticated-orcid":true,"given":"Melissa E","family":"Wright","sequence":"first","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D Aled","family":"Rees","sequence":"additional","affiliation":[{"name":"2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Murphy","sequence":"additional","affiliation":[{"name":"1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"2026070806144102800_bib1","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1210\/jc.2015-2318","article-title":"White matter microstructure and cognitive function in young women with polycystic ovary syndrome","volume":"101","author":"Rees","year":"2016","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070806144102800_bib2","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/s13030-024-00320-w","article-title":"The impact of polycystic ovary syndrome on attention: an empirical investigation","volume":"19","author":"Redkar","year":"2025","journal-title":"Biopsychosoc Med"},{"key":"2026070806144102800_bib3","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.yhbeh.2007.02.007","article-title":"Testosterone levels and cognitive functioning in women with polycystic ovary syndrome and in healthy young women","volume":"51","author":"Schattmann","year":"2007","journal-title":"Horm Behav"},{"key":"2026070806144102800_bib4","doi-asserted-by":"crossref","DOI":"10.1212\/WNL.0000000000208104","article-title":"Associations of polycystic ovary syndrome with indicators of brain health at midlife in the CARDIA cohort","volume":"102","author":"Huddleston","year":"2024","journal-title":"Neurology"},{"key":"2026070806144102800_bib5","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1007\/s00737-020-01043-x","article-title":"The mental health of women with polycystic ovary syndrome: a systematic review and meta-analysis","volume":"24","author":"Yin","year":"2021","journal-title":"Arch Womens Ment Health"},{"key":"2026070806144102800_bib6","doi-asserted-by":"crossref","first-page":"2895","DOI":"10.2147\/NDT.S91700","article-title":"Polycystic ovary syndrome and mental disorders: a systematic review and exploratory meta-analysis","volume":"12","author":"Blay","year":"2016","journal-title":"Neuropsychiatr Dis Treat"},{"key":"2026070806144102800_bib7","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.123.033572","article-title":"2023 international evidence-based polycystic ovary syndrome guideline update: insights from a systematic review and meta-analysis on elevated clinical cardiovascular disease in polycystic ovary syndrome","volume":"13","author":"Tay","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"2026070806144102800_bib8","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1038\/s41598-023-50650-y","article-title":"Risk of cardiocerebrovascular diseases is increased in Korean women with polycystic ovary syndrome: a nationwide cohort study","volume":"14","author":"Ryu","year":"2024","journal-title":"Sci Rep"},{"key":"2026070806144102800_bib9","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.3390\/ijms25021158","article-title":"A cross-sectional study of Alzheimer-related proteins in women with polycystic ovary syndrome","volume":"25","author":"Butler","year":"2024","journal-title":"Int J Mol Sci"},{"key":"2026070806144102800_bib10","doi-asserted-by":"crossref","DOI":"10.1016\/j.yfrne.2020.100874","article-title":"The scientific body of knowledge \u2013 whose body does it serve? A spotlight on oral contraceptives and women\u2019s health factors in neuroimaging","volume":"60","author":"Taylor","year":"2021","journal-title":"Front Neuroendocrinol"},{"key":"2026070806144102800_bib11","doi-asserted-by":"crossref","DOI":"10.1016\/j.neuroimage.2020.117091","article-title":"Functional reorganization of brain networks across the human menstrual cycle","volume":"220","author":"Pritschet","year":"2020","journal-title":"Neuroimage"},{"key":"2026070806144102800_bib12","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1016\/j.neuron.2025.04.014","article-title":"The estrous cycle modulates hippocampal spine dynamics, dendritic processing, and spatial coding","volume":"113","author":"Wolcott","year":"2025","journal-title":"Neuron"},{"key":"2026070806144102800_bib13","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1038\/s44220-023-00125-w","article-title":"Ultra-high-field 7T MRI reveals changes in human medial temporal lobe volume in female adults during menstrual cycle","volume":"1","author":"Zsido","year":"2023","journal-title":"Nat Ment Health"},{"key":"2026070806144102800_bib14","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1210\/jcem-65-2-233","article-title":"Circulating luteinizing hormone pulse frequency in women with polycystic ovary syndrome","volume":"65","author":"Kazer","year":"1987","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070806144102800_bib15","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2021.667422","article-title":"Central regulation of PCOS: abnormal neuronal-reproductive-metabolic circuits in PCOS pathophysiology","volume":"12","author":"Liao","year":"2021","journal-title":"Front Endocrinol"},{"key":"2026070806144102800_bib16","first-page":"2248","article-title":"Determinants of abnormal gonadotropin secretion in clinically defined women with polycystic ovary syndrome","volume":"82","author":"Taylor","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070806144102800_bib17","doi-asserted-by":"crossref","first-page":"R51","DOI":"10.1530\/REP-22-0343","article-title":"Microglia: sculptors of the polycystic ovary syndrome (PCOS)-like brain?","volume":"166","author":"Sati","year":"2023","journal-title":"Reproduction"},{"key":"2026070806144102800_bib18","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1111\/j.1365-2826.2010.02033.x","article-title":"Gonadotrophin-releasing hormone nerve terminals, tanycytes and neurohaemal junction remodelling in the adult median eminence: functional consequences for reproduction and dynamic role of vascular endothelial cells","volume":"22","author":"Prevot","year":"2010","journal-title":"J Neuroendocrinol"},{"key":"2026070806144102800_bib19","doi-asserted-by":"crossref","first-page":"488","DOI":"10.3389\/fncel.2018.00488","article-title":"Microglia in neurological diseases: a road map to brain-disease dependent-inflammatory response","volume":"12","author":"Bachiller","year":"2018","journal-title":"Front Cell Neurosci"},{"key":"2026070806144102800_bib20","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1111\/j.1365-2362.2006.01712.x","article-title":"Inflammatory and endothelial markers in women with polycystic ovary syndrome","volume":"36","author":"Diamanti-Kandarakis","year":"2006","journal-title":"Eur J Clin Invest"},{"key":"2026070806144102800_bib21","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1038\/s41574-024-01057-w","article-title":"Polycystic ovary syndrome as a metabolic disease","volume":"21","author":"Helvaci","year":"2025","journal-title":"Nat Rev Endocrinol"},{"key":"2026070806144102800_bib22","doi-asserted-by":"crossref","DOI":"10.1002\/hbm.26785","article-title":"Menstrual cycle-driven hormone concentrations co-fluctuate with white and gray matter architecture changes across the whole brain","volume":"45","author":"Rizor","year":"2024","journal-title":"Hum Brain Mapp"},{"key":"2026070806144102800_bib23","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1038\/s44294-024-00023-1","article-title":"Hippocampal volume and affect in response to fluctuating estrogens in menstrual cycle irregularity: a longitudinal single-subject study","volume":"2","author":"Heller","year":"2024","journal-title":"Npj Womens Health"},{"key":"2026070806144102800_bib24","doi-asserted-by":"crossref","DOI":"10.1038\/srep32833","article-title":"In-vivo dynamics of the human hippocampus across the menstrual cycle","volume":"6","author":"Barth","year":"2016","journal-title":"Sci Rep"},{"key":"2026070806144102800_bib25","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1159\/000088448","article-title":"Effects of estrogen treatment on expression of brain-derived neurotrophic factor and cAMP response element-binding protein expression and phosphorylation in rat amygdaloid and hippocampal structures","volume":"81","author":"Zhou","year":"2005","journal-title":"Neuroendocrinology"},{"key":"2026070806144102800_bib26","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1111\/j.1469-7580.2005.00421.x","article-title":"Functional neuroanatomy of remote episodic, semantic and spatial memory: a unified account based on multiple trace theory: a unified account based on multiple trace theory","volume":"207","author":"Moscovitch","year":"2005","journal-title":"J Anat"},{"key":"2026070806144102800_bib27","first-page":"1","article-title":"The role of neural plasticity in depression: from hippocampus to prefrontal cortex","volume":"2017","author":"Liu","year":"2017","journal-title":"Neural Plast"},{"key":"2026070806144102800_bib28","doi-asserted-by":"crossref","DOI":"10.1016\/j.ebiom.2023.104535","article-title":"Hypothalamic neuroglial plasticity is regulated by anti- Mullerian hormone and disrupted in polycystic ovary syndrome","volume":"90","author":"Barbotin","year":"2023","journal-title":"EBioMedicine"},{"key":"2026070806144102800_bib29","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1159\/000017321","article-title":"N-Acetyl aspartate: a marker for neuronal loss or mitochondrial dysfunction","volume":"20","author":"Clark","year":"1998","journal-title":"Dev Neurosci"},{"key":"2026070806144102800_bib30","doi-asserted-by":"crossref","DOI":"10.1038\/srep19880","article-title":"Magnetic resonance spectroscopy discriminates the response to microglial stimulation of wild type and Alzheimer\u2019s disease models","volume":"6","author":"Pardon","year":"2016","journal-title":"Sci Rep"},{"key":"2026070806144102800_bib31","doi-asserted-by":"crossref","DOI":"10.1016\/j.nicl.2020.102359","article-title":"Imaging Alzheimer\u2019s genetic risk using diffusion MRI: a systematic review","volume":"27","author":"Harrison","year":"2020","journal-title":"Neuroimage Clin"},{"key":"2026070806144102800_bib32","doi-asserted-by":"crossref","first-page":"3317","DOI":"10.1038\/s41467-025-58604-w","article-title":"MRI signatures of cortical microstructure in human development align with oligodendrocyte cell-type expression","volume":"16","author":"Genc","year":"2025","journal-title":"Nat Commun"},{"key":"2026070806144102800_bib33","doi-asserted-by":"crossref","DOI":"10.1126\/sciadv.abq2923","article-title":"Mapping microglia and astrocyte activation in vivo using diffusion MRI","volume":"8","author":"Garcia-Hernandez","year":"2022","journal-title":"Sci Adv"},{"key":"2026070806144102800_bib34","article-title":"Endocrine modulation of cortical and retinal baseline perfusion across the menstrual cycle","volume":"16","author":"Wright","year":"2026","journal-title":"J Cereb Blood Flow Metab"},{"key":"2026070806144102800_bib35","doi-asserted-by":"crossref","DOI":"10.7189\/jogh.15.04154","article-title":"Association of age at menarche and menopause, reproductive lifespan, and stroke among Chinese women: results from a national cohort study","volume":"15","author":"Chen","year":"2025","journal-title":"J Glob Health"},{"key":"2026070806144102800_bib36","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1111\/cen.70067","article-title":"Cerebrovascular function in women with polycystic ovary syndrome: a pilot multi-parameter magnetic resonance imaging study","volume":"104","author":"Wright","year":"2025","journal-title":"Clin Endocrinol"},{"key":"2026070806144102800_bib37","doi-asserted-by":"crossref","DOI":"10.1113\/EP092467","article-title":"Uncovering the impact of the cardiovascular system on cerebrovascular health using MRI","author":"Driver","year":"2025","journal-title":"Exp Physiol"},{"key":"2026070806144102800_bib38","doi-asserted-by":"crossref","DOI":"10.3389\/fnins.2021.795749","article-title":"Measuring arterial pulsatility with dynamic inflow magnitude contrast","volume":"15","author":"Whittaker","year":"2022","journal-title":"Front Neurosci"},{"key":"2026070806144102800_bib39","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1111\/jog.14543","article-title":"Arterial stiffness measured by cardio-ankle vascular index is greater in non-obese young women with polycystic ovarian syndrome","volume":"47","author":"Kilic","year":"2021","journal-title":"J Obstet Gynaecol Res"},{"key":"2026070806144102800_bib40","doi-asserted-by":"crossref","first-page":"655","DOI":"10.3109\/09513590.2016.1149812","article-title":"Cerebral white matter lesions and silent cerebral infarcts in postmenopausal women with polycystic ovary syndrome","volume":"32","author":"Guoqing","year":"2016","journal-title":"Gynecol Endocrinol"},{"key":"2026070806144102800_bib41","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1016\/S1474-4422(19)30079-1","article-title":"Small vessel disease: mechanisms and clinical implications","volume":"18","author":"Wardlaw","year":"2019","journal-title":"Lancet Neurol"},{"key":"2026070806144102800_bib42","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1177\/0271678X241230741","article-title":"Cerebral arterial stiffness is linked to white matter hyperintensities and perivascular spaces in older adults \u2013 a 4D flow MRI study","volume":"44","author":"Bj\u00f6rnfot","year":"2024","journal-title":"J Cereb Blood Flow Metab"},{"key":"2026070806144102800_bib43","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.neubiorev.2020.11.007","article-title":"White matter hyperintensities and risks of cognitive impairment and dementia: a systematic review and meta-analysis of 36 prospective studies","volume":"120","author":"Hu","year":"2021","journal-title":"Neurosci Biobehav Rev"},{"key":"2026070806144102800_bib44","doi-asserted-by":"crossref","first-page":"1585","DOI":"10.1210\/clinem\/dgab134","article-title":"Incidence and predictors of hypertension in a cohort of Australian women with and without polycystic ovary syndrome","volume":"106","author":"Joham","year":"2021","journal-title":"J Clin Endocrinol Metab"},{"key":"2026070806144102800_bib45","doi-asserted-by":"crossref","DOI":"10.1016\/j.molmet.2021.101236","article-title":"Insulin\u2019s actions on vascular tissues: physiological effects and pathophysiological contributions to vascular complications of diabetes","volume":"52","author":"Fu","year":"2021","journal-title":"Mol Metab"},{"key":"2026070806144102800_bib46","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1093\/brain\/awad308","article-title":"White matter tracts and executive functions: a review of causal and correlation evidence","volume":"147","author":"Ribeiro","year":"2024","journal-title":"Brain"},{"key":"2026070806144102800_bib47","doi-asserted-by":"crossref","first-page":"2093","DOI":"10.1152\/jn.00221.2016","article-title":"White matter and cognition: making the connection","volume":"116","author":"Filley","year":"2016","journal-title":"J Neurophysiol"},{"key":"2026070806144102800_bib48","doi-asserted-by":"crossref","first-page":"137","DOI":"10.2337\/dc12-0493","article-title":"Microstructural white matter abnormalities and cognitive functioning in type 2 diabetes","volume":"36","author":"Reijmer","year":"2013","journal-title":"Diabetes Care"},{"key":"2026070806144102800_bib49","doi-asserted-by":"crossref","first-page":"1714","DOI":"10.1016\/j.neuroimage.2003.07.005","article-title":"Diffusion tensor imaging detects and differentiates axon and myelin degeneration in mouse optic nerve after retinal ischemia","volume":"20","author":"Song","year":"2003","journal-title":"Neuroimage"},{"key":"2026070806144102800_bib50","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1016\/j.fertnstert.2016.01.034","article-title":"Does polycystic ovary syndrome affect cognition? A functional magnetic resonance imaging study exploring working memory","volume":"105","author":"Soleman","year":"2016","journal-title":"Fertil Steril"},{"key":"2026070806144102800_bib51","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1177\/09727531221115318","article-title":"EEG-ERP correlates of cognitive dysfunction in polycystic ovarian syndrome","volume":"29","author":"Showkath","year":"2022","journal-title":"Ann Neurosci"},{"key":"2026070806144102800_bib52","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1097\/RLI.0000000000001015","article-title":"Advancements in diffusion MRI tractography for neurosurgery","volume":"59","author":"Kamagata","year":"2024","journal-title":"Investig Radiol"},{"key":"2026070806144102800_bib53","doi-asserted-by":"crossref","DOI":"10.1016\/j.jneumeth.2020.108990","article-title":"Towards in vivo g-ratio mapping using MRI: unifying myelin and diffusion imaging","volume":"348","author":"Mohammadi","year":"2021","journal-title":"J Neurosci Methods"},{"key":"2026070806144102800_bib54","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1159\/000546487","article-title":"Mendelian randomization analyses reveal causal relationships between brain structural connectivity and risk of polycystic ovary syndrome","volume":"91","author":"Niu","year":"2026","journal-title":"Gynecol Obstet Invest"},{"key":"2026070806144102800_bib55","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1016\/j.neubiorev.2013.07.001","article-title":"A revised limbic system model for memory, emotion and behaviour","volume":"37","author":"Catani","year":"2013","journal-title":"Neurosci Biobehav Rev"}],"container-title":["Journal of Endocrinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/joe.bioscientifica.com\/view\/journals\/joe\/269\/2\/JOE-25-0421.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/joe.bioscientifica.com\/downloadpdf\/journals\/joe\/269\/2\/JOE-25-0421.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/joe\/article-pdf\/doi\/10.1530\/JOE-25-0421\/507461\/joe-25-0421.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/journals.bioscientifica.com\/joe\/article-pdf\/doi\/10.1530\/JOE-25-0421\/507461\/joe-25-0421.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T10:14:53Z","timestamp":1783505693000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.bioscientifica.com\/joe\/article\/269\/2\/e250421\/75715\/Advanced-neuroimaging-in-PCOS-state-of-the-art"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,28]]},"references-count":55,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,5,1]]}},"URL":"https:\/\/doi.org\/10.1530\/joe-25-0421","relation":{},"ISSN":["1479-6805","0022-0795"],"issn-type":[{"value":"1479-6805","type":"electronic"},{"value":"0022-0795","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,28]]},"article-number":"e250421"}}