mango
Senior Member
- Messages
- 905
Quantitative assessment of autonomic symptom burden in Postural tachycardia syndrome (POTS)
Natalie A. Rea, Corey L. Campbell, Melissa M. Cortez
Journal of Neurological Sciences
DOI: http://dx.doi.org/10.1016/j.jns.2017.03.032
Published online: March 21, 2017 Accepted: March 20, 2017 Received in revised form: March 6, 2017 Received: December 5, 2016
Abstract
Highlights
Postural tachycardia syndrome (PoTS) is a poorly understood disorder characterized by excessive tachycardia in the upright position. In addition, patients with PoTS often complain of non-postural symptoms, including fatigue, gastrointestinal and vasomotor fluctuations.
The present study quantitatively assessed autonomic symptom burden in PoTS patients (n = 32) using the COMPASS-31, compared to that of autonomic failure/neuropathy (AF/N; n = 47) and asymptomatic, healthy controls (n = 32). Using AIC model selection and regression analysis, we found differences in the contribution of individual COMPASS-31 domains, depending on the autonomic disorder.
In PoTS, fatigue severity, orthostatic intolerance and pupillomotor symptom domains, contributed significantly to differences in COMPASS-31 scores compared to controls. In contrast, the secretomotor, gastrointestinal, bladder and vasomotor domains, contributed significantly to the AF/N model. Our results confirm an increase in autonomic symptoms across all functional domains in PoTS compared to controls, and with similar severity to AF/N, though with differing significant domain contributions.
Our findings provide additional support that PoTS is indeed a syndrome of autonomic dysfunction beyond orthostatic intolerance, but also indicates the likelihood of disease-specific contributions to symptom burden, highlighting the need for application of expanded physiological assessment beyond orthostatic challenge, as well as disease-specific symptom assessment tools for use in PoTS.
Keywords:
Postural tachycardia syndrome (PoTS), Autonomic symptoms, Fatigue, Pupils, Autonomic failure, Model selection
http://www.jns-journal.com/article/S0022-510X(17)30201-0/abstract
Natalie A. Rea, Corey L. Campbell, Melissa M. Cortez
Journal of Neurological Sciences
DOI: http://dx.doi.org/10.1016/j.jns.2017.03.032
Published online: March 21, 2017 Accepted: March 20, 2017 Received in revised form: March 6, 2017 Received: December 5, 2016
Abstract
Highlights
- Autonomic symptoms are significantly elevated in PoTS patients vs controls.
- Autonomic symptoms in PoTS are not limited to orthostatic intolerance.
- Model selection shows differing symptom contributions in PoTS vs autonomic failure.
- Differences in autonomic symptom domain scores highlight areas for further study.
Postural tachycardia syndrome (PoTS) is a poorly understood disorder characterized by excessive tachycardia in the upright position. In addition, patients with PoTS often complain of non-postural symptoms, including fatigue, gastrointestinal and vasomotor fluctuations.
The present study quantitatively assessed autonomic symptom burden in PoTS patients (n = 32) using the COMPASS-31, compared to that of autonomic failure/neuropathy (AF/N; n = 47) and asymptomatic, healthy controls (n = 32). Using AIC model selection and regression analysis, we found differences in the contribution of individual COMPASS-31 domains, depending on the autonomic disorder.
In PoTS, fatigue severity, orthostatic intolerance and pupillomotor symptom domains, contributed significantly to differences in COMPASS-31 scores compared to controls. In contrast, the secretomotor, gastrointestinal, bladder and vasomotor domains, contributed significantly to the AF/N model. Our results confirm an increase in autonomic symptoms across all functional domains in PoTS compared to controls, and with similar severity to AF/N, though with differing significant domain contributions.
Our findings provide additional support that PoTS is indeed a syndrome of autonomic dysfunction beyond orthostatic intolerance, but also indicates the likelihood of disease-specific contributions to symptom burden, highlighting the need for application of expanded physiological assessment beyond orthostatic challenge, as well as disease-specific symptom assessment tools for use in PoTS.
Keywords:
Postural tachycardia syndrome (PoTS), Autonomic symptoms, Fatigue, Pupils, Autonomic failure, Model selection
http://www.jns-journal.com/article/S0022-510X(17)30201-0/abstract