Cognitive Dysfunction in Postural Tachycardia Syndrome
| Status: | Completed |
|---|---|
| Conditions: | Cognitive Studies, Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases, Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - 60 |
| Updated: | 2/7/2015 |
| Start Date: | March 2011 |
| End Date: | March 2015 |
| Contact: | Satish Raj, MD, MSCI |
| Email: | adcresearch@vanderbilt.edu |
| Phone: | 615-322-2931 |
Origins of Cognitive Dysfunction in Postural Tachycardia Syndrome (POTS)
A common complaint among people with Postural Tachycardia Syndrome (POTS) is "brain fog" or
difficulty concentrating. This is very poorly understood. To better understand this
cognitive dysfunction, the investigators will test people with POTS and people without POTS
using various neuropsychiatric instruments. The investigators hypothesis is that people
with POTS will have greater abnormalities on neuropsychiatric testing than normal controls.
difficulty concentrating. This is very poorly understood. To better understand this
cognitive dysfunction, the investigators will test people with POTS and people without POTS
using various neuropsychiatric instruments. The investigators hypothesis is that people
with POTS will have greater abnormalities on neuropsychiatric testing than normal controls.
Postural Tachycardia Syndrome (POTS) is a disorder that affects an estimated 500,000 people
in the United States alone and is an important source of disability in young adults. It
shows a strong predilection for females. POTS is a form of orthostatic intolerance
characterized by an excessive increase in heart rate (>30 bpm) on assuming the upright
position associated with orthostatic symptoms, but in the absence of orthostatic
hypotension. Their symptoms of dizziness, nausea, tremor, chronic fatigue and exercise
intolerance make even simple activities of daily living exhausting prospects.
Brain fog or cognitive dysfunction is a common and almost universal complaint among persons
with POTS. There is a lack of pathophysiological understanding to this cognitive
dysfunction and is also a major roadblock to the development of effective therapies for
people with POTS.
The purpose of this study is to better define the cognitive dysfunction seen in patients
with POTS. We will use a series of validated neuropsychological tools in order to
characterize POTS cognitive dysfunction and compare this data to age and gender matched
control subjects.
Specific Aims:
1. To assess whether POTS patients have more neuropsychological abnormalities than control
subjects during seated assessments.
2. To assess whether POTS patients have more neuropsychological abnormalities than control
subjects during assessments while standing.
3. To ascertain the phenomenology of any neuropsychological deficits distinguishing POTS
patients from controls.
in the United States alone and is an important source of disability in young adults. It
shows a strong predilection for females. POTS is a form of orthostatic intolerance
characterized by an excessive increase in heart rate (>30 bpm) on assuming the upright
position associated with orthostatic symptoms, but in the absence of orthostatic
hypotension. Their symptoms of dizziness, nausea, tremor, chronic fatigue and exercise
intolerance make even simple activities of daily living exhausting prospects.
Brain fog or cognitive dysfunction is a common and almost universal complaint among persons
with POTS. There is a lack of pathophysiological understanding to this cognitive
dysfunction and is also a major roadblock to the development of effective therapies for
people with POTS.
The purpose of this study is to better define the cognitive dysfunction seen in patients
with POTS. We will use a series of validated neuropsychological tools in order to
characterize POTS cognitive dysfunction and compare this data to age and gender matched
control subjects.
Specific Aims:
1. To assess whether POTS patients have more neuropsychological abnormalities than control
subjects during seated assessments.
2. To assess whether POTS patients have more neuropsychological abnormalities than control
subjects during assessments while standing.
3. To ascertain the phenomenology of any neuropsychological deficits distinguishing POTS
patients from controls.
Inclusion Criteria:
All
- Ages between 18-60 years
- Male and female subjects are eligible
- Able and willing to provide informed consent
POTS - additional inclusion criteria - Diagnosed with postural tachycardia syndrome by
Vanderbilt Autonomic Dysfunction Center (increase in heart rate greater than or equal to
30 beats per minute with position change from supine to standing (10 minutes; chronic
symptoms consistent with POTS that are worse when upright and get better with recumbence.)
Control subjects - additional inclusion criteria
- Gender matched to POTS patients
- Age-matched to POTS patients (+/- 5 years of a POTS patient)
- Grossly matched in intelligence to POTS patients
Exclusion Criteria:
ALL
- Inability to give or withdrawal of informed consent
- Pregnancy (determined by patient self report)
- Other factors which in the investigator's opinion would prevent the subject from
completing the protocol.
POTS - additional exclusion criteria
- Overt cause for postural tachycardia (such as acute dehydration)
Normal Controls - additional exclusion criteria
- Previously diagnosed with Axis I psychiatric disorder
- Previously diagnosed learning disorder
- Previously diagnosed attention deficit hyperactivity disorder (ADHD)
- Prior psychosis
- past or present substance abuse
- History of loss of consciousness
- History of seizures
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