Quantitative assessment of autonomic symptom burden in Postural tachycardia syndrome (POTS)
Abstract
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 sy…
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People with POTS reported more orthostatic symptoms than healthy controls.
“Medium-high quality studies found that people with POTS reported more orthostatic symptoms (mean ± SD OGS score 10.54 ± 3.83 out of 20 = 52.7 %; OHQ 6.16 ± 1.78 out of 10 = 61.6 %; OIQ 16.4 ± 3.2 out of 40 = 41 %) than healthy controls (Rea et al., 2017”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Rea et al., 2017
Wider autonomic symptom burden was comparable in people with POTS and people with autonomic failure.
“and comparable to people with autonomic failure (Rea et al., 2017”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Rea et al., 2017
Orthostatic intolerance symptoms contributed most to differences between POTS and other groups, followed by light sensitivity, pupillomotor function, vasomotor domains and fatigue.
“Orthostatic intolerance symptoms contributed most to differences between POTS and other groups, followed by light sensitivity (Cortez et al., 2020”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Rea et al., 2017
People with POTS had a higher heart rate increment on head-up tilt (HUT) than healthy controls, people with CFS, chronic migraine, and autonomic failure/neuropathy.
“People with POTS had a higher heart rate increment on head-up tilt (HUT) than healthy controls, people with CFS”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Rea et al., 2017
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- Authors
- Rea, N. A., Campbell, C. L., & Cortez, M. M.
- Affiliations
- University of Utah (US)
- Colorado State University (US)
- Corresponding author
- Rea, Natalie A.
- Campbell, Corey L.
- Cortez, Melissa M.
- Venue
- Journal of the Neurological Sciences
- Publisher
- Elsevier BV
- Published
- 2017-06
- Volume
- 377
- Pages
- 35-41
- ISSN
- 0022-510X (ISSN-L)
- OpenAlex
- W2601173973
- Cited by
- 52
- References
- 16
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 9 · 2023: 5 · 2022: 9 · 2021: 5 · 2020: 5 · 2019: 4 · 2018: 8
- FWCI
- 4.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the Neurological Sciences (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Minority Health and Health Disparities (L32 MD009927)
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, autonomic dysfunction, COMPASS-31, autonomic failure, orthostatic intolerance, fatigue, gastrointestinal symptoms, vasomotor symptoms, symptom assessment
- MeSH terms
- Adolescent, Adult, Autonomic Nervous System, Child, Fatigue, Female, Heart Rate, Humans, Male, Middle Aged, Pupil Disorders, Severity of Illness Index, Case-Control Studies, Orthostatic Intolerance, Postural Orthostatic Tachycardia Syndrome, Young Adult
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