Research: orthostatic stress impairs neurocognitive functioning, Clinical Science, 15 September 2011

September 18, 2011


Clin Sci (Lond). 2011 Sep 15. [Epub ahead of print]

Increasing orthostatic stress impairs neurocognitive functioning in Chronic Fatigue Syndrome with Postural Tachycardia Syndrome.

Ocon AJ, Messer Z, Medow M, Stewart J.
(MEA editorial note – academic affiliations not given)

Abstract

Chronic Fatigue Syndrome (CFS) is commonly co-morbid with Postural Tachycardia Syndrome (POTS). 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 cerebral blood flow velocity (CBFV). 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 a N-back task at each angle. The N-back task tests working memory, concentration, attention, and information processing. The N-back 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 reaction time differences between groups while supine. CFS/POTS subjects responded less correctly during the N-back and had greater normalized reaction time at 45, 60, and 75°. Further, at 75° CFS/POTS subjects responded less correctly and had greater normalized reaction time 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 scores. Thus, we concluded 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.

PMID: 21919887 [PubMed – as supplied by publisher]

3 thoughts on “Research: orthostatic stress impairs neurocognitive functioning, Clinical Science, 15 September 2011”

  1. “..be aware that orthostatic stress may impair…”

    I’ve known it for donkey’s years. What’s the treatment?

    I suppose it’s easier to keep repeating the obvious and well known facts instead of looking for cures.

  2. “Individuals with POTS SHOULD be AWARE that orthostatic stress
    may impair their neurocognitive abilities”

    I had the tilt table test 15yrs ago and you WILL be AWARE if you
    have pots.(In fact everything have gone to pot.)

  3. I wondered why i couldn’t think straight when i stood up? I have been trying to explain this to my Doctor for years, I too had a tilt table test that showed i had POTS as well as ME. I think it is good that now it is in writing I wonder if anyone will listen though?

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