PCOS could lead to decreased alertness and longer reaction times: study

The Hindu

27-05-2025

A recent study revealed that hormonal imbalance associated with Polycystic Ovarian Syndrome (PCOS) could lead to decreased alertness and longer reaction times, likely to compromise attention-based tasks in affected women. The task-based tests suggest that PCOS impacts women's focused and divided attention, decreasing the speed of response by about 56% and accuracy by about 10%.
The study explores the effect of PCOS on attention, as attention is the 'precursor for all vital cognitive processing—receiving, understanding, and making sense of the information' and divided attention helps to 'handle and respond to multiple tasks'. The study authored by Maitreyi Redkar and Azizuddin Khan at the Indian Institute of Technology Bombay (IIT Bombay) assessed the impact of PCOS on focused and divided attention.
The findings highlight that decreased accuracy in divided attention tasks may influence working memory, which hinders holding the information temporarily, making daily activities such as keeping track of directions challenging. 'Despite the variability in PCOS symptoms and their severity, the impairments in the core cognitive abilities of attention and processing speed seem to be prevalent across women,' adds Prof. Khan.
Inferences of the study
101 women with PCOS and 72 healthy women participated in the study and underwent the attention tasks. Before the test, the hormonal levels of all the women were assessed before the study.
Women with PCOS showed over a 50% slower response and made about 10% more errors than the healthy ones in the focused attention test. Similarly, PCOS women performed about 20% slowly, with 3% extra errors in the divided attention task, as per the study.
Among the two types of attention, PCOS women performed poorer in focused attention. Along with elevated androgen levels, the participants with PCOS had insulin resistance that is linked to attention. The study also pointed out that insulin resistance causes poor glucose metabolism and affects brain cell (neuron) activity, leading to poor performance in focused attention tasks. Mental fatigue linked to PCOS, such as anxiety and frustration, makes divided attention tasks more challenging.
How was the study conducted?
For conducting the study, the researchers used two tests- the Flanker Task and the Posner Cueing Task- While the Flanker Task assesses the participant's ability to avoid distracting stimuli while focusing only on the important information, the Posner Cueing task evaluates how quickly the participants focus on the correct spot and how efficiently they shift their focus from the wrong one.
The test included a task, focusing on the centre of the screen (central fixation point) with two boxes on either side. The participants will receive a cue, such as an arrow or a flash, followed by a target stimulus in one of the boxes. The participants should quickly press the corresponding arrow key.
'In this task, the participants are instructed to focus on a target stimulus (usually an arrow or a letter) that appears in the middle of a row while ignoring the distracting stimulus on either side (the 'flankers'). For example, if the participant is shown '→→→→→', the middle arrow is easy to identify. However, if they are shown'←←→←←', the surrounding arrows point the other way, making it harder to concentrate and respond accurately,' adds Prof. Khan.
The task-based tests drew inferences that women with PCOS are slower to react and more easily distracted than their healthy counterparts. 'The cognitive experiments are specifically designed to capture the subtle millisecond-level differences in how individuals respond to critical stimuli. These minute delays reveal significant impairments in attention, which may impact our real-life functioning,' said Prof. Khan.
The findings emphasise the need to understand PCOS as a complex medical condition that not only affects physical health but also cognitive health.