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I wrote an overview of the problems I see with the POTS criteria, summarizing the studies posted in this thread. https://mecfsskeptic.com/the-problems-with-pots/ A brief summary of the arguments looks like this: A heart rate increase of 30 bpm (or 40 bpm in 12–19-year-olds) is far from...

Some studies point to this paper by David Streeten as the origin of the 30 bpm threshold for POTS. Unfortunately, I can't seem to find it online. Does anyone have access to it? Abnormal orthostatic changes in blood pressure and heart rate in subjects with intact sympathetic nervous function...

Some quotes from the article:

Abstract Although diagnostic criteria have been developed characterizing postural orthostatic tachycardia syndrome (POTS), no single set of criteria is universally accepted. Furthermore, there are gaps in the present criteria used to identify individuals who have this condition. The...

Interesting to see a ME/CFS study from Russia

Also notable in the POTS literature: not a single decent prevalence or epidemiological study. Almost all single-center observational studies which are probably affected by referral and selection bias. Also no prognosis studies, some say that half of the patients spontaneously recover within 3...

Does not look like a very useful design, at first glance.

Also from the WSJ article (which mentions Peter Rowe):

The following quote is taken form a 1999 article in the Wall Street Journal Some Doctors Operate on People Diagnosed With Chronic Fatigue - WSJ (available here: https://www.anapsid.org/cnd/diagnosis/chiari.html)

In 2000 The American Association of Neurological Surgeons published a statement about this: AANS - AANS Position Statement on the Use of Cervical Decompression for Chronic Fatigue Syndrome

This article in the The Massachusetts CFIDS/ME & FM Association Spring 2000 provides some background: https://massmecfs.org/more-resources-for-differential-diagnosis/172-cfidsfm-and-chiari-malformation-surgery "Dr. Michael J. Rosner, a primary proponent of the theory and the surgeon who has...

At the turn of the millennium neurosurgeon Michael J. Rosner argued that decompression of Craniovertebral Stenosis led to improvements in fibromyalgia and CFS patients. Success stories of brain surgery were shared online and in media reports but eventually it would lead to controversy and...

The senior author is David Robertson who sadly, passed away this year. His team has done the most interesting POTS studies from what I can tell. In Remembrance of Dr. David Robertson (1947-2024) - The American Autonomic Society