January 16, 2020
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Hot flashes associated with altered brain function during memory tests

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Pauline Maki

A higher number of physiologically measured hot flashes among a small cohort of postmenopausal women was associated with worse performance on verbal and logical memory tests, according to findings published in Menopause.

“Hot flushes have been considered a bothersome but benign symptom of menopause,” Pauline Maki, PhD, senior director of research at the Center for Research on Women and Gender and professor of psychiatry and psychology at the University of Illinois at Chicago, told Healio. “Contrary to that idea, this work suggests an association between objectively measured hot flushes, memory difficulties and alterations in memory circuits in the brain.”

Maki and colleagues analyzed data from 14 postmenopausal women (mean age 54 years; 64% black) with moderate to severe vasomotor symptoms (> 35 per week) and not taking hormone therapy, recruited from a pool of women screened for entry into a randomized clinical trial comparing therapies for menopausal symptoms. Participants completed functional MRI assessments during word encoding and recognition tests, as well as 24-hour physiologic vasomotor symptom monitoring, symptom questionnaires and two verbal memory tests.

Within the cohort, women subjectively reported an average of 18.76 vasomotor symptoms per day. Monitors recorded an average of 19.07 physiologic vasomotor symptoms per day.

brain 
A higher number of physiologically measured hot flashes among a small cohort of postmenopausal women was associated with worse performance on verbal and logical memory tests.
Source: Shutterstock

In regression analyses, a higher number of physiologic vasomotor symptoms — but not reported vasomotor symptoms — was associated with worse verbal memory on immediate logical memory tests (r = –0.53; P < .05) and delayed logical memory tests (r = –0.72; P < .01).

On functional MRI assessments, a higher number of physiologic vasomotor symptoms, but not subjective vasomotor symptoms, was associated with greater activation in the left orbitofrontal cortex, left medial and superior frontal gyrus, right superior frontal gyrus, and right parahippocampal gyrus during the encoding task (P < .005).

During the recognition task, physiologic vasomotor symptoms were associated with greater activation in the left medial and superior frontal gyrus, left parahippocampal gyrus and hippocampus, right medial and superior frontal gyrus, right parahippocampal gyrus and hippocampus (P < .005), and with decreased activation in the ventral medial prefrontal cortex (P < .005). Associations persisted after adjustment for symptoms and hormone levels.

“Critically, subjective vasomotor symptoms did not predict brain activation patterns,” the researchers wrote.

“Longitudinal studies indicate that memory performance declines during the menopausal transition and likely returns to baseline in the postmenopause,” Maki said. “This work suggests that some of that decline might be related to hot flushes and their effects on memory circuits in the brain.”

Maki and colleagues are conducting research to see whether treating vasomotor symptoms leads to improvements in memory and a change in the memory circuits, she said.

“If that works, then we will have identified a modifiable risk factor for memory problems during the menopausal transition,” Maki said. – by Regina Schaffer

For more information:

Pauline Maki, PhD, can be reached at the University of Illinois at Chicago, 912 S. Wood St., Chicago, IL 60612; email: pmaki1@uic.edu.

Disclosures: Maki reports she has received speaking fees from Mylan. Please see the study for all other authors’ relevant financial disclosures.