title: Menopausal hot flashes and white matter hyperintensities.
abstract: OBJECTIVE
  Hot flashes are classic symptoms of menopause. Emerging data link hot flashes to cardiovascular disease (CVD) risk, yet whether hot flashes are related to brain health is poorly understood. We examined the relationship between hot flashes (measured via physiologic monitor and self-report) and white matter hyperintensities (WMH) among midlife women.
  
  
  METHODS
  Twenty midlife women (aged 40-60 y) without clinical CVD, with an intact uterus and ovaries, and not taking hormone therapy were recruited. Women underwent 24 hours of ambulatory physiologic and diary hot flash monitoring to quantify hot flashes; magnetic resonance imaging to assess WMH burden; 72 hours of actigraphy to quantify sleep; and a blood draw, questionnaires, and physical measures to quantify demographics and CVD risk factors. Tests of a priori hypotheses regarding relationships between physiologically monitored and self-reported wake and sleep hot flashes and WMH were conducted in linear regression models.
  
  
  RESULTS
  More physiologically monitored hot flashes during sleep were associated with greater WMH, controlling for age, race, and body mass index (β [SE] = 0.0002 [0.0001], P = 0.03]. Findings persisted after controlling for sleep characteristics and additional CVD risk factors. No relationships were observed for self-reported hot flashes.
  
  
  CONCLUSIONS
  More physiologically monitored hot flashes during sleep are associated with greater WMH burden among midlife women without clinical CVD. Results suggest that the relationship between hot flashes and CVD risk observed in the periphery may extend to the brain. Future work should consider the unique role of sleep hot flashes in brain health.
authors.affiliation: 1Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 2Department of Neurology, Albert Einstein College of Medicine, Bronx, NY 3Department of Electrical and Computer Engineering, University of Pittsburgh, Pittsburgh, PA 4Department of Psychiatry, University of Illinois at Chicago, Chicago, IL.
authors.forename: Rebecca C
authors.initials: RC
authors.lastname: Thurston
authors.forename: Howard J
authors.initials: HJ
authors.lastname: Aizenstein
authors.forename: Carol A
authors.initials: CA
authors.lastname: Derby
authors.forename: Ervin
authors.initials: E
authors.lastname: Sejdić
authors.forename: Pauline M
authors.initials: PM
authors.lastname: Maki
mesh_terms: D056044:Actigraphy; D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology; D005260:Female; D019584:Hot Flashes / Q000150:complications / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008593:Menopause / Q000502:physiology*; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000379:methods; D012307:Risk Factors; D057566:Self Report; D012890:Sleep; D066127:White Matter / Q000473:pathology*