Cited by 381Hypothalamic control of reproductive hormonesNeuropeptides and Animal PhysiologyRegulation of Appetite and Obesity

The DOI matches its Crossref record; 203 of the 205 references it cites were found in a registry or an index; 5 of the 145 sources its claims cite were checked for support.

Modulation of body temperature and LH secretion by hypothalamic KNDy (kisspeptin, neurokinin B and dynorphin) neurons: A novel hypothesis on the mechanism of hot flushes

Open access
Rance, Naomi E., Dacks, Penny A., Mittelman-Smith, Melinda A., Romanovsky, Andrej A., Krajewski-Hall, Sally J.·2013·Frontiers in Neuroendocrinology

Abstract

Despite affecting millions of individuals, the etiology of hot flushes remains unknown. Here we review the physiology of hot flushes, CNS pathways regulating heat-dissipation effectors, and effects of estrogen on thermoregulation in animal models. Based on the marked changes in hypothalamic kisspeptin, neurokinin B and dynorphin (KNDy) neurons in postmenopausal women, we hypothesize that KNDy neurons play a role in the mechanism of flushes. In the rat, KNDy neurons project to preoptic thermoregulatory areas that express the neurokinin 3 receptor (NK3R), the primary receptor for NKB. Furthermore, activation of NK3R in the median preoptic nucleus, part of the heat-defense pathway, reduces body temperature. Finally, ablation of KNDy neurons reduces cutaneous vasodilatation and partially blocks the effects of estrogen on thermoregulation. These data suggest that arcuate KNDy neurons relay estrogen signals to preoptic structures regulating heat-dissipation effectors, supporting the hypothesis that KNDy neurons participate in the generation of flushes.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

This review proposes that hypothalamic KNDy (kisspeptin/neurokinin B/dynorphin) neurons relay estrogen-withdrawal signals to preoptic thermoregulatory pathways and thereby contribute to hot flushes. Evidence from postmenopausal women and rat models links KNDy/NK3R signaling to LH pulses, cutaneous vasodilatation, and body temperature control.

Key findings

  • In postmenopausal women, infundibular (arcuate) neurons expressing estrogen receptor, kisspeptin, and NKB are hypertrophied, with increased NKB and kisspeptin gene expression; dynorphin neurons are enlarged but dynorphin mRNA-expressing neuron number is reduced. Ovariectomy induces and estrogen reverses these changes in monkeys.
  • Rat KNDy neurons project to preoptic thermoregulatory areas, including the median preoptic nucleus (MnPO), which expresses NK3R. Microinfusion of the NK3R agonist senktide (90 pmol) into the MnPO reduced body temperature by about 1.5 °C.
  • KNDy neuron ablation with NK3-SAP destroyed nearly all arcuate kisspeptin- and NKB-immunoreactive neurons and reduced arcuate dynorphin neurons by 76%. Ablated rats did not show the post-ovariectomy LH increase, had lower tail skin temperatures, better defended core temperature against heat, and did not respond to estrogen with reduced core temperature.
  • Ovariectomized rats without estrogen showed a thermoneutral zone shifted to lower ambient temperatures, with the skin vasodilatation threshold 4 °C lower than in estrogen-treated rats. Estrogen reduced dark-phase tail skin temperature by >3 °C, and a small core temperature rise preceded 65%–76% of hot flushes in women.

Methods

  • Narrative review and hypothesis paper synthesizing human postmortem hypothalamic studies, ovariectomy/estrogen-replacement studies in monkeys and rats, and the authors’ rat thermoregulation experiments.
  • Data include postmortem hypothalamic tissue from premenopausal and postmenopausal women; ovariectomized monkeys and rats with estrogen replacement; rat tail skin and core temperature recordings; Fos immunocytochemistry; anterograde tract-tracing; NK3R agonist microinfusion; and NK3-SAP ablation.
  • Main analysis is qualitative integration of anatomic, neuroendocrine, and thermoregulatory findings to support a KNDy-neuron mechanism for hot flushes.

Limitations

  • Stated: whether rats actually experience hot flushes after estrogen withdrawal is unknown; rats cannot report flush onset, so studies rely on objective measures such as tail skin temperature.
  • Stated: normal female rats show wide tail skin temperature fluctuations, and objective measures in women may reflect physiological events other than flushes; concordance between self-reported flushes and skin conductance can be limited.
  • Evident: the central hypothesis is largely indirect and not directly tested in humans; much of the causal evidence comes from rat models, and the review notes that roles for other KNDy peptides, substance P, or GnRH neurons remain to be explored.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.yfrne.2013.07.003

Cites

203 of 203 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

80 Not checked yet · 18 Own interpretation · 6 No basis given · 5 Own result · 3 Partly supported · 2 Supported so far · accuracy not yet measured

Verify all 140 references — free account
  • It may state two separate claims as one. 30
  • Probably not a substantial claim. 21
47 of 47
  • The paper relies on this without support.

    There was virtually no information on the role of KNDy neurons in thermoregulation in any species before the authors' studies.

    “There was, however virtually no information on the role of KNDy neurons in thermoregulation in any species.”
  • The paper relies on this without support.

    Findings about KNDy neurons and thermoregulation in the rat are relevant to the mechanism of hot flushes in women.

    “To address this issue, we established methods in our laboratory to examine how estrogen modulates thermoregulation and related neural pathways in the rat (Dacks et al., 2011b; Dacks and Rance, 2010; Williams et al., 2010).”
  • The paper relies on this without support.

    Hot flushes are a manifestation of a central (hypothalamic) disorder of thermoregulation.

    “One of the most prominent symptoms of menopause is the hot flush, a manifestation of a central (hypothalamic) disorder of thermoregulation.”
  • The paper relies on this without support.

    Cutaneous vasodilatation is a cardinal sign of a hot flush.

    “Because cutaneous vasodilatation is a cardinal sign of a hot flush, these data support the hypothesis that KNDy neurons could play a role in the generation of flushes.”
4 of 4

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Show all 205 references

Research works printed but not linked: 1

  1. Wiley, 2005

Cited by

Sorted by citations

See all 381

Metadata

Authors
Rance, N. E., Dacks, P. A., Mittelman-Smith, M. A., Romanovsky, A. A., & Krajewski-Hall, S. J.
Affiliations
  • University of Arizona (US)
  • Alzheimer's Drug Discovery Foundation (US)
  • St. Joseph's Hospital and Medical Center (US)
Corresponding author
Rance, Naomi E.
Venue
Frontiers in Neuroendocrinology
Publisher
Elsevier BV
Published
2013-08
Volume
34
Issue
3
Pages
211-227
ISSN
0091-3022 (ISSN-L)
OpenAlex
W2061642929
Cited by
380
References
205
Citations by year
2026: 45 · 2025: 52 · 2024: 46 · 2023: 41 · 2022: 28 · 2021: 35 · 2020: 22 · 2019: 24 · 2018: 28 · 2017: 27 · 2016: 10 · 2015: 15 · 2014: 7
FWCI
1.70
Type
journal article
Language
en
Open access
Locations
  • Frontiers in Neuroendocrinology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute of Neurological Disorders and Stroke (R01 NS41233)
  • National Institute on Aging (R01 AG032315)
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuropeptides and Animal Physiology
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Regulation of Appetite and Obesity
Keywords
hot flashes, KNDy neurons, kisspeptin, neurokinin B, dynorphin, hypothalamus, thermoregulation, estrogen, postmenopausal women, neurokinin-3 receptor, median preoptic nucleus, cutaneous vasodilation, luteinizing hormone secretion, arcuate nucleus
MeSH terms
Animals, Body Temperature Regulation, Dynorphins, Estradiol, Female, Humans, Hypothalamus, Luteinizing Hormone, Models, Biological, Neurons, Ovariectomy, Preoptic Area, Skin, Tail, Vasodilation, Neurokinin B, Signal Transduction, Postmenopause, Receptors, Neurokinin-3, Hot Flashes, Estrous Cycle, Rats, Kisspeptins

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

A language model drew the claims from the paper on 2026-10-10, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).

A second model labelled each claim on 2026-10-10 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).

Cited sources are checked with a language model’s help (gpt-6-sol).

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review