title: Menopausal hot flashes and the default mode network.
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.
  
  
  METHODS
  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.
  
  
  METHODS
  University medical center.
  
  
  METHODS
  Twenty midlife women aged 40-60 years who had their uterus and both ovaries and were not taking hormone therapy (HT).
  
  
  METHODS
  None.
  
  
  METHODS
  The DMN functional connectivity.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address: thurstonrc@upmc.edu.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
authors.affiliation: Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Maki
authors.affiliation: Department of Neurology, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Derby
authors.affiliation: Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Ervin
authors.initials: E
authors.lastname: Sejdić
authors.affiliation: Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Aizenstein
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D001931:Brain Mapping; D005260:Female; D006624:Hippocampus; D019584:Hot Flashes / Q000503:physiopathology*; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology*; D012146:Rest; D012890:Sleep
keywords: Hot flashes; brain; default mode network; hippocampus; vasomotor symptoms