Mental clouding is an almost universal complaint among patients with postural tachycardia syndrome (POTS) but remains poorly understood. Thus, we have determined whether POTS patients exhibit deficits during neuropsychological testing relative to healthy subjects. A comprehensive battery of validated neuropsychological tests was administered to 28 female POTS patients and 24 healthy subjects in a semi-recumbent position. Healthy subjects were matched to POTS patients on age and gender. Selective attention, a primary outcome measure, and cognitive processing speed were reduced in POTS patients compared with healthy subjects (Ruff 2&7 Speed t-score: 40±9 compared with 49±8; P=0.009; Symbol Digit Modalities Test t-score: 45±12 compared with 51±8; P=0.011). Measures of executive function were also lower in POTS patients (Trails B t-score: 46±8 compared with 52±8; P=0.007; Stroop Word Color t-score: 45±10 compared with 56±8; P=0.001), suggesting difficulties in tracking and mental flexibility. Measures of sustained attention, psychomotor speed, memory function or verbal fluency were not significantly different between groups. The present study provides evidence for deficits in selective attention and cognitive processing in patients with POTS, in the seated position when orthostatic stress is minimized. In contrast, other measures of cognitive function, including memory assessments, were not impaired in these patients, suggesting selectivity in these deficits. These findings provide new insight into the profile of cognitive dysfunction in POTS and provide the basis for further studies to identify clinical strategies to better manage the mental clouding associated with this condition.
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January 2015
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Research Article|
August 27 2014
Cognitive dysfunction in postural tachycardia syndrome
Amy C. Arnold;
Amy C. Arnold
*Division of Clinical Pharmacology and Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
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Kirsten Haman;
Kirsten Haman
†Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
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Emily M. Garland;
Emily M. Garland
*Division of Clinical Pharmacology and Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
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Vidya Raj;
Vidya Raj
†Department of Psychiatry, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
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William D. Dupont;
William D. Dupont
‡Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
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Italo Biaggioni;
Italo Biaggioni
*Division of Clinical Pharmacology and Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
§Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
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David Robertson;
David Robertson
*Division of Clinical Pharmacology and Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
§Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
∥Department of Neurology, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
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Satish R. Raj
*Division of Clinical Pharmacology and Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
§Department of Pharmacology, Vanderbilt University School of Medicine, Nashville, TN 37232, U.S.A.
Correspondence: Dr Satish R. Raj (email [email protected]).
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Publisher: Portland Press Ltd
Received:
April 18 2014
Revision Received:
May 28 2014
Accepted:
July 08 2014
Accepted Manuscript online:
July 08 2014
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© The Authors Journal compilation © 2015 Biochemical Society
2015
Clin Sci (Lond) (2015) 128 (1): 39–45.
Article history
Received:
April 18 2014
Revision Received:
May 28 2014
Accepted:
July 08 2014
Accepted Manuscript online:
July 08 2014
Citation
Amy C. Arnold, Kirsten Haman, Emily M. Garland, Vidya Raj, William D. Dupont, Italo Biaggioni, David Robertson, Satish R. Raj; Cognitive dysfunction in postural tachycardia syndrome. Clin Sci (Lond) 1 January 2015; 128 (1): 39–45. doi: https://doi.org/10.1042/CS20140251
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