CFS (chronic fatigue syndrome) is commonly co-morbid with POTS (postural tachycardia syndrome). Individuals with CFS/POTS experience unrelenting fatigue, tachycardia during orthostatic stress and ill-defined neurocognitive impairment, often described as ‘mental fog’. We hypothesized that orthostatic stress causes neurocognitive impairment in CFS/POTS related to decreased CBFV (cerebral blood flow velocity). A total of 16 CFS/POTS and 20 control subjects underwent graded tilt table testing (at 0, 15, 30, 45, 60 and 75°) with continuous cardiovascular, cerebrovascular, and respiratory monitoring and neurocognitive testing using an n-back task at each angle. The n-back task tests working memory, concentration, attention and information processing. The n-back task imposes increasing cognitive challenge with escalating (0-, 1-, 2-, 3- and 4-back) difficulty levels. Subject dropout due to orthostatic presyncope at each angle was similar between groups. There were no n-back accuracy or RT (reaction time) differences between groups while supine. CFS/POTS subjects responded less correctly during the n-back task test and had greater nRT (normalized RT) at 45, 60 and 75°. Furthermore, at 75° CFS/POTS subjects responded less correctly and had greater nRT than controls during the 2-, 3- and 4-back tests. Changes in CBFV were not different between the groups and were not associated with n-back task test scores. Thus we conclude that increasing orthostatic stress combined with a cognitive challenge impairs the neurocognitive abilities of working memory, accuracy and information processing in CFS/POTS, but that this is not related to changes in CBFV. Individuals with CFS/POTS should be aware that orthostatic stress may impair their neurocognitive abilities.
Skip Nav Destination
Article navigation
Research Article|
November 08 2011
Increasing orthostatic stress impairs neurocognitive functioning in chronic fatigue syndrome with postural tachycardia syndrome
Anthony J. Ocon;
*Department of Physiology, New York Medical College, Valhalla, NY, U.S.A.
Correspondence: Dr Anthony J. Ocon (email [email protected]).
Search for other works by this author on:
Zachary R. Messer;
Zachary R. Messer
†Department of Pediatrics, New York Medical College, Valhalla, NY, U.S.A.
Search for other works by this author on:
Marvin S. Medow;
Marvin S. Medow
*Department of Physiology, New York Medical College, Valhalla, NY, U.S.A.
†Department of Pediatrics, New York Medical College, Valhalla, NY, U.S.A.
Search for other works by this author on:
Julian M. Stewart
Julian M. Stewart
*Department of Physiology, New York Medical College, Valhalla, NY, U.S.A.
†Department of Pediatrics, New York Medical College, Valhalla, NY, U.S.A.
‡Department of Medicine, New York Medical College, Valhalla, NY, U.S.A.
Search for other works by this author on:
Publisher: Portland Press Ltd
Received:
May 09 2011
Revision Received:
August 08 2011
Accepted:
September 15 2011
Accepted Manuscript online:
September 15 2011
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2012 Biochemical Society
2012
Clin Sci (Lond) (2012) 122 (5): 227–238.
Article history
Received:
May 09 2011
Revision Received:
August 08 2011
Accepted:
September 15 2011
Accepted Manuscript online:
September 15 2011
Citation
Anthony J. Ocon, Zachary R. Messer, Marvin S. Medow, Julian M. Stewart; Increasing orthostatic stress impairs neurocognitive functioning in chronic fatigue syndrome with postural tachycardia syndrome. Clin Sci (Lond) 1 March 2012; 122 (5): 227–238. doi: https://doi.org/10.1042/CS20110241
Download citation file:
Sign in
Don't already have an account? Register
Sign in to your personal account
You could not be signed in. Please check your email address / username and password and try again.
Could not validate captcha. Please try again.
Biochemical Society Member Sign in
Sign InSign in via your Institution
Sign in via your InstitutionGet Access To This Article
Open Access for all
We offer compliant routes for all authors from 2025. With library support, there will be no author nor reader charges in 5 journals. Check here |
![]() |