Cognitive Dysfunction in Postural Tachycardia Syndrome
Condition: Postural Tachycardia Syndrome
MeSH terms: Postural Orthostatic Tachycardia Syndrome; Tachycardia; Syndrome; Cognitive Dysfunction
Study type: Observational

Summary: 
      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.
    

Detailed description: 
      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.
    

Intervention name(s): Seated Measurements; Standing Measurements; Self-Administered Surveys
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The following measurements will take place in a seated position:
Ruff 1 & 7 (visual search and attention processes) Trails A & B (Tests of scanning, mental flexibility and executive processes) Symbol Digit Modalities Test (SDMT)(attention and psychomotor speed) Stroop Test (naming response to certain stimuli) Verbal Fluency (COWA) Randt Wechsler Test of Adult Reading (WTAR); The following will be measured in a standing position (at least 5 minutes)
Orthostatic Vital Signs Randt Paired Words Subtest Digits Forward and Backward Alternate COWA test; Center for Epidemiologic Studies Depression Scale (CES-D) Cognitive-Somatic Anxiety Questionnaire (CSAQ) Subjective Neurocognitive Inventory (SNI)
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Patients having been diagnosed with postural tachycardia syndrome and age & gender matched
        normal controls
      
Keywords: postural tachycardia syndrome; brain fog; cognitive dysfunction