Preprint Feasibility and Preliminary Outcomes of a Brain/Body Intervention for ... (POTS): Pilot Trial of POts Reprocessing Therapy (PORT) 2026 Crouch et al

[Andy]

Full title: Feasibility and Preliminary Outcomes of a Brain/Body Intervention for Postural Tachycardia Syndrome (POTS): Pilot Trial of POts Reprocessing Therapy (PORT).

Purpose​

Postural tachycardia syndrome (POTS) is a chronic autonomic disorder characterized by orthostatic intolerance and frequently accompanied by a broad constellation of debilitating symptoms. Emerging evidence suggests that dysregulation within central–autonomic regulatory networks may contribute to symptom persistence. We developed POts Reprocessing Therapy (PORT), a neuroplasticity-informed behavioral intervention adapted from Pain Reprocessing Therapy. This pilot study evaluated the feasibility, acceptability, and preliminary clinical outcomes of PORT for individuals with POTS.

Methods​

We conducted a non-randomized, two-arm, open-label pilot feasibility trial. Adults with clinically significant POTS symptoms (Malmö POTS Symptom Score ≥ 42) received eight weekly PORT sessions (n = 14). A comparison group of adults with POTS receiving community care while awaiting entry to an autonomic clinic served as controls (n = 15). Self-report measures were collected at baseline and 8-week follow-up, including POTS symptom severity (Malmö), symptom catastrophizing, anxiety, depression, pain, fatigue, and quality of life. Feasibility and acceptability were assessed via recruitment, retention, and treatment satisfaction.

Results​

PORT demonstrated strong feasibility and acceptability, with 83% retention and strong satisfaction ratings among completers. Participants receiving PORT reported greater symptom improvement compared with community care controls. Mixed ANOVA analyses revealed significant group × time interactions for POTS symptoms (ηp² = 0.283), anxiety (ηp² = 0.363), symptom catastrophizing (ηp² = 0.193), and depression (ηp² = 0.186), reflecting moderate-to-large effect sizes.

Conclusion​

This pilot study suggests that PORT is a feasible and acceptable intervention and may be associated with improvements in POTS symptom burden and related psychological processes. Findings provide preliminary support for targeting central–autonomic processes through neuroplasticity-based interventions and warrant larger randomized controlled trials to evaluate efficacy and underlying mechanisms.

Preprint

 

[Utsikt]

In collaboration with multidisciplinary experts and patients with lived experience, we developed an adapted version of PRT for POTS, called POts Reprocessing Therapy (PORT) [28].

Competing Interests: Y.K.A discloses financial relationships with Lin Health and the Pain Reprocessing Therapy Center. The other authors have no relevant financial or non-financial interests to disclose.

Hmm..

 

[rvallee]

Intervention content includes psychoeducation to reframe POTS symptoms as protective but no longer adaptive “false alarm” signals from the nervous system, mindfulness meditation and somatic inquiry, and graded exposure to symptoms (e.g., with imagined or actual standing) paired with cognitive and somatic regulation strategies. There is also a focus on addressing emotional, coping, and interpersonal factors conceptualized to be contributing to or maintaining symptoms.

Same old generic crap as always.

Findings provide preliminary support for targeting central–autonomic processes through neuroplasticity-based interventions and warrant larger randomized controlled trials to evaluate efficacy and underlying mechanisms.

They've already sold the chickens that would hatch from the eggs of chickens that haven't even walked a single step.