Neuroanatomical and Neuroendocrine Alterations in the Hypothalamic-Pituitary-Gonadal Axis Associated with Polycystic Ovary Syndrome in Nigerian Women: An Integrated Imaging and Histological Study

Polycystic ovary syndrome is the most common endocrine disorder affecting women of reproductive age in Nigeria, characterised by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Neuroanatomical and neuroendocrine dysregulation of the hypothalamic-pituitary-gonadal axis, including alterations in gonadotropin-releasing hormone pulsatility, kisspeptin neuron activity, and pituitary gonadotroph morphology, underlie the reproductive dysfunction in this condition. An integrated neuroanatomical and neuroendocrine investigation of this axis in Nigerian women with polycystic ovary syndrome has not been undertaken. This study aims to characterise hypothalamic-pituitary-gonadal axis neuroanatomy using structural and functional MRI of hypothalamic and pituitary volumes, combined with histological analysis of ovarian morphology and immunohistochemical characterisation of kisspeptin and neurokinin B expression in post-mortem brain tissue from female Wistar rat models with polycystic ovary syndrome induced by letrozole administration. Clinical participants will undergo three-dimensional hypothalamic and pituitary volumetric MRI, transvaginal ultrasonography of ovarian morphology, and hormonal profiling. Rat model specimens will provide kisspeptin neuron density and morphometric data from the arcuate and anteroventral periventricular nuclei. Integrated findings will constitute an original multimodal neuroanatomical characterisation of polycystic ovary syndrome-associated hypothalamic-pituitary-gonadal axis disruption with direct translational relevance to reproductive medicine in Nigeria.

Keywords: polycystic ovary syndrome, hypothalamic-pituitary-gonadal axis, kisspeptin, neuroanatomy, neuroendocrine