- •In a randomized, sham-controlled trial of stellate ganglion blockade, decreases in vasomotor symptoms related to increases in verbal memory.
- •Stellate ganglion blockade may confer secondary benefits to memory.
- •Broadly the findings suggest a possible link between physiologic vasomotor symptoms and memory problems in midlife women.
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.
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.
Main outcome measures
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 24 h to measure physiologic VMS and VMS reported in real time.
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).
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.
Abbreviations:SGB (Stellate Ganglion Blockade), CES-D (Center for Epidemiological Studies − Depression Scale), CVLT (California Verbal Learning Test), VMS (vasomotor symptoms)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Maturitas
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Stellate ganglion block for the management of hot flashes and sleep disturbances in breast cancer survivors: an uncontrolled experimental study with 24 weeks of follow-up.Ann. Oncol. 2012; 23: 1449-1454
- Pilot evaluation of a stellate ganglion block for the treatment of hot flashes.Support. Care Cancer. 2011; 19: 941-947
- Effects of stellate-ganglion block on hot flushes and night awakenings in survivors of breast cancer: a pilot study.Lancet Oncol. 2008; 9: 523-532
- Stellate-ganglion block as a treatment for severe postmenopausal flushing.Climacteric. 2013; 16: 41-47
- Effects of stellate ganglion block on vasomotor symptoms: findings from a randomized controlled clinical trial in postmenopausal women.Menopause. 2014; 21: 807-814
- Nonhormonal management of menopause-associated vasomotor symptoms position statement of The North American Menopause Society.Menopause. 2015;
- Symptoms during the menopausal transition and early postmenopause and their relation to endocrine levels over time: observations from the Seattle Midlife Women's Health Study.J. Womens Health (Larchmt.). 2007; 16: 667-677
- Relation of demographic and lifestyle factors to symptoms in a multi-racial/ethnic population of women 40–55 years of age.Am. J. Epidemiol. 2000; 152: 463-473
- Objective cognitive performance is related to subjective memory complaints in midlife women with moderate to severe vasomotor symptoms.Menopause. 2013; 20: 1236-1242
- Menopause effects on verbal memory: findings from a longitudinal community cohort.J. Clin. Endocrinol. Metab. 2013; 98: 3829-3838
- Cognition in perimenopause: the effect of transition stage.Menopause. 2013; 20: 511-517
- Effects of the menopause transition and hormone use on cognitive performance in midlife women.Neurology. 2009; 72: 1850-1857
- Objective hot flashes are negatively related to verbal memory performance in midlife women.Menopause. 2008; 15: 848-856
- Menopausal hot flashes and white matter hyperintensities.Menopause. 2015;
- Menopausal hot flashes and the default mode network.Fertil. Steril. 2015; 103 (e1): 1572-1578
- The clinical importance of white matter hyperintensities on brain magnetic resonance imaging: systematic review and meta-analysis.BMJ. 2010; 341: c3666
- Emotional antecedents of hot flashes during daily life.Psychosom. Med. 2005; 67: 137-146
- Methodologic lessons learned from hot flash studies.J. Clin. Oncol. 2001; 19: 4280-4290
- The CES-D Scale: a self-report depression scale for research in the general population.Appl. Psychol. Meas. 1977; 1: 385-401
- The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.Psychiatry Res. 1989; 28: 193-213
- Ober BA California Verbal Learning Test − Research Edition.The Psychological Corporation, New York1987
- Manual for the Wechsler Memory Scale- Revised.Psychological Corporation, San Antonio, TX1987
- The Revised Visual Retention Test: Clinical and Experimental Applications.3rd edition. Psychological Corporation, New York1963
- Wechsler Adult Intelligence Scale—Revised.Psychological Corporation, New York1981
- Development and psychometric properties of the Brief Test of Attention.Clin. Neuropsychol. 1996; 10: 80-89
- Differential behavioral effects in frontal lobe disease.Neuropsychologia. 1968; 6: 53-60
- Prevalence, frequency and problem rating of hot flushes persist in older postmenopausal women: impact of age, body mass index, hysterectomy, hormone therapy use, lifestyle and mood in a cross-sectional cohort study of 10,418 British women aged 54–65.BJOG. 2012; 119: 40-50
- Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women.Psychoneuroendocrinology. 1988; 13: 345-357
- Are vasomotor symptoms associated with sleep characteristics among symptomatic midlife women? Comparisons of self-report and objective measures.Menopause. 2012; 19: 742-748
- Association between hot flashes, sleep complaints, and psychological functioning among healthy menopausal women.Int. J. Behav. Med. 2006; 13: 163-172
- Sleep, fatigue, and depressive symptoms in breast cancer survivors and matched healthy women experiencing hot flashes.Oncol. Nurs. Forum. 2004; 31: 591-5598
- Self-reported sleep in postmenopausal women.Menopause. 2004; 11: 198-207
- Self-reported and measured sleep duration: how similar are they.Epidemiology. 2008; 19: 838-845
- Stellate ganglion block improves refractory post-traumatic stress disorder and associated memory dysfunction: a case report and systematic literature review.Mil. Med. 2013; 178: e260-4
- Pituitary hormones during the menopausal hot flash.Obstet. Gynecol. 1984; 64: 752-756
- Increased urinary cortisol levels during the menopausal transition.Menopause. 2006; 13: 212-221
- Increase in urinary cortisol excretion and memory declines: MacArthur studies of successful aging.J. Clin. Endocrinol. Metab. 1997; 82: 2458-2465
- Higher basal cortisol predicts verbal memory loss in postmenopausal women: Rancho Bernardo Study.J. Am. Geriatr. Soc. 2000; 48: 1655-1658
- A unifying theory linking the prolonged efficacy of the stellate ganglion block for the treatment of chronic regional pain syndrome (CRPS), hot flashes, and posttraumatic stress disorder (PTSD).Med. Hypotheses. 2009; 72: 657-661
- Beck Vigue SG. Stellate ganglion block may relieve hot flashes by interrupting the sympathetic nervous system.Med. Hypotheses. 2007; 69: 758-763
- Effects of estrogen on memory function in surgically menopausal women.Psychoneuroendocrinology. 1992; 17: 485-495
- Add-back estrogen reverses cognitive deficits induced by a gonadotropin-releasing hormone agonist in women with leiomyomata uteri.J. Clin. Endocrinol. Metab. 1996; 81: 2545-2549
- Effects of hormone therapy on cognition and mood in recently postmenopausal women: findings from the randomized, controlled KEEPS-Cognitive and affective study.PLoS Med. 2015; 12: e1001833
Published online: July 16, 2016
Accepted: July 14, 2016
Received in revised form: July 11, 2016
Received: May 19, 2016
© 2016 Elsevier Ireland Ltd. All rights reserved.