PCOS Likely To Compromise Attention-Based Tasks In Affected Women: IIT Bombay Study
Polycystic Ovary Syndrome or PCOS is a well-known endocrine disorder in women, with symptoms like irregular or absent periods, polycystic ovaries, and increased levels of male hormone (androgen). An earlier research study underlines that Indian women with PCOS show an increased level of anxiety and depression. For example, they avoid social events due to the fear of being judged for their weight gain or feel hopeless due to constantly battling irregular periods.
The effect of PCOS on attention is less explored. Attention is the precursor for all vital cognitive processing—receiving, understanding, and making sense of the information. Attention is also a complex process that involves focusing on relevant information and filtering out irrelevant stimuli (focused attention). Divided attention helps us handle and respond to multiple tasks simultaneously.
In their recent study, Maitreyi Redkar and Prof Azizuddin Khan from the Psychophysiology Laboratory, Department of Humanities and Social Sciences at the Indian Institute of Technology Bombay (IIT Bombay) assessed the impact of PCOS on focused and divided attention. Two groups of participants, 101 women with PCOS and 72 healthy women, underwent the attention tasks. Their hormonal levels were assessed before the study. The task-based tests showed 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. In the specific context of focused attention, it is not just about concentrating on the task at hand to respond at the right time, but also inhibiting irrelevant distractors,” remarks Prof. Khan, who led the study.
Researchers used two task-based tests, the Flanker Task and the Posner Cueing Task, to test PCOS and healthy individuals for accuracy and response time (speed). The Flanker Task assesses the participant’s ability to avoid distracting stimuli while focusing only on the important information. “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 stimuli 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 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 assesses their divided attention. Participants were asked to focus on the centre of the screen (central fixation point) with two boxes on either side. They 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. Their reaction times would be quicker if the cue and target appeared on the same box. This task evaluates the speed and accuracy of the participants by studying how quickly they shift their focus between the cue and the target.
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. Among the two types of attention, PCOS women performed poorer in focused attention. The hormonal imbalance associated with PCOS could lead to decreased alertness and longer reaction times. Along with elevated androgen levels, the participants with PCOS had insulin resistance that is linked to attention. Insulin resistance causes poor glucose metabolism and affects brain cell (neuron) activity, leading to poor performance in focused attention tasks.
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Mental fatigue linked to PCOS, such as anxiety and frustration, makes divided attention tasks more challenging. The finding of the study highlights that decreased accuracy in divided attention tasks may influence working memory, which hinders holding the information temporarily. This makes daily activities such as keeping track of directions while driving or remembering a phone number to dial more challenging.
“PCOS is a heterogeneous condition, which means that its symptoms and severity vary depending on the hormonal profile, metabolic health, mental health and socio-environmental conditions of the individual. 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.
While the challenges of low accuracy and slow response time seem daunting, there is a light at the end of the tunnel. Playing brain games focusing on attention and memory can improve response time (speed) and accuracy. Relaxation and stress reduction techniques may reduce stress and anxiety and improve focus and speed.
“Increasing physical activity levels, maintaining a nutritious diet, and reducing weight are beneficial not just for PCOS symptoms but also for cognitive health. Even improving sleep hygiene contributes significantly to improving attentional accuracy and reaction time,” suggests Prof. Khan.
The findings emphasise the need to understand PCOS as a complex medical condition that not only affects physical but also cognitive health. A comprehensive intervention that addresses diverse aspects, including supportive care, will help the well-being of women with PCOS.
