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. 2015 Jun;103(6):1572-8.e1.
doi: 10.1016/j.fertnstert.2015.03.008. Epub 2015 Apr 22.

Menopausal hot flashes and the default mode network

Rebecca C Thurston  1 , Pauline M Maki  2 , Carol A Derby  3 , Ervin Sejdić  4 , Howard J Aizenstein  5
Affiliations

Menopausal hot flashes and the default mode network

Rebecca C Thurston et al. Fertil Steril. 2015 Jun.

Abstract

Objective: To test whether more physiologically assessed hot flashes were associated with more connectivity in the default mode network (DMN), the network of brain regions active during rest. We particularly focus on DMN networks supporting the hippocampus as this region is rich in estrogen (E) receptors (ER) and has previously been linked to hot flashes.

Design: Women underwent 24 hours of physiologic and diary hot flash monitoring, functional magnetic resonance imaging (MRI), 72 hours of sleep actigraphy monitoring, a blood draw, questionnaires, and physical measures.

Setting: University medical center.

Patient(s): Twenty midlife women aged 40-60 years who had their uterus and both ovaries and were not taking hormone therapy (HT).

Intervention(s): None.

Main outcome measure(s): The DMN functional connectivity.

Result(s): Controlling for age, race, and education, more physiologically-monitored hot flashes were associated with greater DMN connectivity (beta, B [SE] = 0.004 [0.002]), particularly hippocampal DMN connectivity (B [SE] = 0.005 [0.002]). Findings were most pronounced for sleep physiologic hot flashes (with hippocampal DMN, B [SE] = 0.02 [0.007]). Associations also persisted controlling for sleep, depressive symptoms, and serum E2 concentrations.

Conclusion(s): More physiologically-monitored hot flashes were associated with more DMN connectivity, particularly networks supporting the hippocampus. Findings were most pronounced for sleep hot flashes. Findings underscore the importance of continued investigation of the central nervous system in efforts to understand this classic menopausal phenomenon.

Keywords: Hot flashes; brain; default mode network; hippocampus; vasomotor symptoms.

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Figures

Figure 1
Figure 1
Scatterplot of relation between sleep physiologic hot flashes and hippocampal DMN Note: Values of horizontal axis represent mean of the normalized correlations between the hippocampus and all the other nodes of the DMN
See this image and copyright information in PMC

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