Cognitive functioning in POTS among different body positions: a prospective pilot study (POTSKog study), 2023, Maier et al

Full title:
Cognitive functioning in postural orthostatic tachycardia syndrome among different body positions: a prospective pilot study (POTSKog study)

Abstract

Purpose
Approximately 96% of patients with postural orthostatic tachycardia syndrome (PoTS) report cognitive complaints. We investigated whether cognitive function is impaired during sitting and active standing in 30 patients with PoTS compared with 30 healthy controls (HCs) and whether it will improve with the counter manoeuvre of leg crossing.

Methods
In this prospective pilot study, patients with PoTS were compared to HCs matched for age, sex, and educational level. Baseline data included norepinephrine plasma levels, autonomic testing and baseline cognitive function in a seated position [the Montreal Cognitive Assessment, the Leistungsprüfsystem (LPS) subtests 1 and 2, and the Test of Attentional Performance (TAP)]. Cognitive functioning was examined in a randomized order in supine, upright and upright legs crossed position. The primary outcomes were the cognitive test scores between HCs and patients with PoTS at baseline testing, and among the different body positions.

Results
Patients with PoTS had impaired attention (TAP median reaction time) in the seated position and impaired executive functioning (Stroop) while standing compared with HC. Stroop was influenced by position (supine versus upright versus upright legs crossed) only in the PoTS group. Leg crossing did not result in an improvement in executive function. In patients with PoTS, there was a negative correlation of Stroop with norepinephrine plasma levels while standing.

Conclusion
Compared with HCs, PoTS participants showed impaired cognitive attention and executive function in the upright position that did not improve in the legs crossed position. Data provide further evidence for orthostatic cognitive deterioration in patients with PoTS.

Open access: https://link.springer.com/article/10.1007/s10286-023-00950-0

 

And nobody was surprised.

 

Third party corroboration seems to be the only way to get the stamp of approval in many, many areas of life.

It would be quite the departure from the norm if millions of people with the same condition were actually taken at their word.

 

Good to see sensible comments in the last paragraph of the discussion about the problems of interpreting scores on anxiety and depression questionnaires without considering that patients are actually describing POTs symptoms.

 

This is one of the things i find hardest to bear. I dont understand why i cant simply be taken at my word, i was really distressed the other day because it feels like no medic ever takes me at my word for anything, i always have to have a carer corroborate it, it really pisses me off. I have done nothing to lose their trust what the hell is it with doctors that they cant simply believe the person, take them as trustworthy unless they prove otherwise?!