Advertisement

Attention and executive function are impaired during active standing in postural tachycardia syndrome

      Abstract

      Postural tachycardia syndrome (POTS) is a chronic form of orthostatic intolerance associated with cognitive dysfunction. We hypothesized executive function and attention is impaired in POTS during active standing. Eighty-seven POTS participants and 39 healthy controls of similar age, sex, and education level completed executive function (Stroop word-color) and attention (CogState Identification) tests in supine and standing postures in a cross-sectional study. POTS participants had lower executive function (t-score: 48 ± 11 vs. 55 ± 10 control; p = 0.009) and worse attention (reaction speed: 2.78 ± 0.11 vs. 2.69 ± 0.06 control; p < 0.001) during standing. These data provide new evidence that active standing impairs attention and executive functioning in POTS.

      Keywords

      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 Autonomic Neuroscience: Basic and Clinical
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Anderson J.W.
        • Lambert E.A.
        • Sari C.I.
        • Dawood T.
        • Esler M.D.
        • Vaddadi G.
        • Lambert G.W.
        Cognitive function, health-related quality of life, and symptoms of depression and anxiety sensitivity are impaired in patients with the postural orthostatic tachycardia syndrome (POTS).
        Front. Physiol. 2014; 5: 230
        • Arnold A.C.
        • Haman K.
        • Garland E.M.
        • Raj V.
        • Dupont W.D.
        • Biaggioni I.
        • Robertson D.
        • Raj S.R.
        Cognitive dysfunction in postural tachycardia syndrome.
        Clin. Sci. (Lond.). 2015; 128: 39-45
        • Arnold A.C.
        • Ng J.
        • Raj S.R.
        Postural tachycardia syndrome - diagnosis, physiology, and prognosis.
        Auton. Neurosci. 2018; 215: 3-11
        • Boris J.R.
        • Bernadzikowski T.
        Demographics of a large paediatric Postural Orthostatic Tachycardia Syndrome Program.
        Cardiol. Young. 2018; 28: 668-674
        • Jensen A.R.
        • Rohwer Jr., W.D.
        The Stroop color-word test: a review.
        Acta Psychol. 1966; 25: 36-93
        • Karas B.
        • Grubb B.P.
        • Boehm K.
        • Kip K.
        The postural orthostatic tachycardia syndrome: a potentially treatable cause of chronic fatigue, exercise intolerance, and cognitive impairment in adolescents.
        Pacing Clin. Electrophysiol. 2000; 23: 344-351
        • Maruff P.
        • Thomas E.
        • Cysique L.
        • Brew B.
        • Collie A.
        • Snyder P.
        • Pietrzak R.H.
        Validity of the CogState brief battery: relationship to standardized tests and sensitivity to cognitive impairment in mild traumatic brain injury, schizophrenia, and AIDS dementia complex.
        Arch. Clin. Neuropsychol. 2009; 24: 165-178
        • McDonald C.
        • Koshi S.
        • Busner L.
        • Kavi L.
        • Newton J.L.
        Postural tachycardia syndrome is associated with significant symptoms and functional impairment predominantly affecting young women: a UK perspective.
        BMJ Open. 2014; 4e004127
        • Ocon A.J.
        • Messer Z.R.
        • Medow M.S.
        • Stewart J.M.
        Increasing orthostatic stress impairs neurocognitive functioning in chronic fatigue syndrome with postural tachycardia syndrome.
        Clin. Sci. (Lond.). 2012; 122: 227-238
        • Plash W.B.
        • Diedrich A.
        • Biaggioni I.
        • Garland E.M.
        • Paranjape S.Y.
        • Black B.K.
        • Dupont W.D.
        • Raj S.R.
        Diagnosing postural tachycardia syndrome: comparison of tilt testing compared with standing haemodynamics.
        Clin. Sci. (Lond.). 2013; 124: 109-114
        • Raj V.
        • Opie M.
        • Arnold A.C.
        Cognitive and psychological issues in postural tachycardia syndrome.
        Auton. Neurosci. 2018; 215: 46-55
        • Ross A.J.
        • Medow M.S.
        • Rowe P.C.
        • Stewart J.M.
        What is brain fog? An evaluation of the symptom in postural tachycardia syndrome.
        Clin. Auton. Res. 2013; 23: 305-311
        • Rowell L.B.
        Orthostasis in Human Circulation: Regulation During Physical Stress.
        Oxford University Press, New York, USA1986: 150
        • Shaw B.H.
        • Stiles L.E.
        • Bourne K.
        • Green E.A.
        • Shibao C.A.
        • Okamoto L.E.
        • Garland E.M.
        • Gamboa A.
        • Diedrich A.
        • Raj V.
        • Sheldon R.S.
        • Biaggioni I.
        • Robertson D.
        • Raj S.R.
        The face of postural tachycardia syndrome - insights from a large cross-sectional online community-based survey.
        J. Intern. Med. 2019; 286: 438-448
        • Sheldon R.S.
        • Grubb 2nd, B.P.
        • Olshansky B.
        • Shen W.K.
        • Calkins H.
        • Brignole M.
        • Raj S.R.
        • Krahn A.D.
        • Morillo C.A.
        • Stewart J.M.
        • Sutton R.
        • Sandroni P.
        • Friday K.J.
        • Hachul D.T.
        • Cohen M.I.
        • Lau D.H.
        • Mayuga K.A.
        • Moak J.P.
        • Sandhu R.K.
        • Kanjwal K.
        2015 heart rhythm society expert consensus statement on the diagnosis and treatment of postural tachycardia syndrome, inappropriate sinus tachycardia, and vasovagal syncope.
        Heart Rhythm. 2015; 12: e41-e63
        • Stewart J.M.
        • Medow M.S.
        • Messer Z.R.
        • Baugham I.L.
        • Terilli C.
        • Ocon A.J.
        Postural neurocognitive and neuronal activated cerebral blood flow deficits in young chronic fatigue syndrome patients with postural tachycardia syndrome.
        Am. J. Physiol. Heart Circ. Physiol. 2012; 302: H1185-H1194
        • Stewart J.M.
        • Del Pozzi A.T.
        • Pandey A.
        • Messer Z.R.
        • Terilli C.
        • Medow M.S.
        Oscillatory cerebral blood flow is associated with impaired neurocognition and functional hyperemia in postural tachycardia syndrome during graded tilt.
        Hypertension. 2015; 65: 636-643
        • Tsai Owens M.
        • Fischer P.
        • Kirsch A.
        • Harbeck-Weber C.
        • Sim L.
        • Zaccariello M.
        • Homan K.
        Neurocognitive difficulties among youth with POTS within an intensive pain rehabilitation program.
        J. Pediatr. Psychol. 2019; 44: 567-575