Stellate ganglion blockade and verbal memory in midlife women: Evidence from a randomized trial.
OBJECTIVE
In a pilot randomized clinical trial of active stellate ganglion blockade (SGB) versus sham control, SGB significantly reduced the frequency of reported moderate to severe vasomotor symptoms (VMS) and the frequency of physiologic VMS measured using ambulatory skin conductance monitors. Here we examine secondary effects of SGB on verbal learning and memory.


METHODS
In a randomized, sham-controlled study, 36 women met eligibility criteria for cognitive assessments, of whom 17 were randomized to receive fluoroscopy-guided SGB and 19 to sham control.


METHODS
At baseline and three months post-treatment, women completed tests of verbal learning and memory (primary outcome) and other cognitive measures and also wore an ambulatory monitor for 24h to measure physiologic VMS and VMS reported in real time.


RESULTS
Verbal learning improved following active SGB (p<0.05) but not sham treatment; however, the interaction between group and time was not significant (p values 0.13-0.20). Two secondary cognitive measures improved only in the sham group. Improvements in physiologic VMS correlated significantly with improvements in verbal learning (r=0.51, p<0.05).


CONCLUSIONS
SGB might confer benefits to memory in relation to the magnitude of improvement in physiologic VMS. Broadly these findings suggest a possible link between physiologic VMS and memory problems in midlife women.
Department of Psychiatry, University of Illinois at Chicago, Neuropsychiatric Institute, MC 913, 912 S. Wood St., Chicago, IL, 60612, USA; Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison St., Chicago, IL, 60607, USA. Electronic address: pmaki@psych.uic.edu.
Pauline M
PM
Maki
Department of Psychiatry, University of Illinois at Chicago, Neuropsychiatric Institute, MC 913, 912 S. Wood St., Chicago, IL, 60612, USA. Electronic address: lrubin@psych.uic.edu.
Leah H
LH
Rubin
Graduate Program in Neuroscience, University of Illinois at Chicago, Psychiatric Institute MC 912, 1601W. Taylor St., Chicago, IL, 60612, USA. Electronic address: asavarese@psych.uic.edu.
Antonia
A
Savarese
Department of Psychology, University of Illinois at Chicago, 1007 W. Harrison St., Chicago, IL, 60607, USA. Electronic address: ldrogos@gmail.com.
Lauren
L
Drogos
Department of Obstetrics and Gynecology, Prentice Women's Hospital, 250 E. Superior Street, Room 05-2174, Chicago, IL, 60611 USA. Electronic address: Lee.Shulman@nm.org.
Lee P
LP
Shulman
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Suite 5-704 Chicago, IL, 60611 USA. Electronic address: s-banuvar@northwestern.edu.
Suzanne
S
Banuvar
Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 East Huron Street, Suite 5-704 Chicago, IL, 60611 USA. Electronic address: d-walega@northwestern.edu.
David R
DR
Walega
D001340:Autonomic Nerve Block; D005260:Female; D019584:Hot Flashes / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008568:Memory; D008875:Middle Aged; D012879:Skin Physiological Phenomena; D013233:Stellate Ganglion; D014706:Verbal Learning
Hot flash; Memory; Menopause; Stellate ganglion blockade; Vasomotor symptoms