Postural orthostatic tachycardia is not a useful diagnostic marker for chronic fatigue syndrome
Open accessAbstract
Background: Postural orthostatic tachycardia syndrome (POTS) is considered a diagnostic marker for chronic fatigue syndrome (CFS). Objectives: The aims of this study were to (i) compare POTS prevalence in a CFS cohort with fatigued patients not meeting CFS criteria, and (ii) assess activity, impairment and response to cognitive behavioural therapy (CBT) in CFS patients with POTS (POTS‐CFS) and without POTS (non‐POTS‐CFS). Methods: Prospective cohort study at the Radboud University Medical Centre in the Netherlands. Between June 2013 and December 2014, 863 consecutive patients with persistent fatigue were screened. Patients underwent an active standing test, filled out questionnaires and wore an activity‐sensing device for a period of 12 days. Results: A total of 419 patients with CFS and 341 non‐CFS fatigued patients were included in the study. POTS prevalence in adult patients with CFS was 5.7% vs. 6.9% in non‐CFS adults (P = 0.54). In adolescents, prevalence rates were 18.2% and 17.4%, respectively (P = 0.93). Adult patients with POTS‐CFS were younger (30 ± 12 vs. 40 ± 13 years, P = 0.001) and had a higher supine heart rate (71 ± 11 vs. 65 ± 9 beats per min, P = 0.009) compared with non‐POTS‐CFS patients. Severity and activity patterns did not differ between groups. In patients with CFS, criteria for Systemic Exertion Intolerance Disease (SEID) were met in 76% of adults and 67% of adolescents. In these patients with CFS fulfilling the SEID criteria, the prevalence of POTS was not different from that in the overall CFS population. POTS‐CFS adolescents had less clinically significant improvement after CBT than non‐POTS‐CFS adolescents (58% vs. 88%, P = 0.017). Conclusion: In adults with CFS, the prevalence of POTS was low, was not different from the rate in non‐CFS fatigued patients and was not related to disease severity or treatment outcome. In POTS‐CFS adolescents, CBT was less successful than in non‐POTS‐CFS patients. The evaluation of POTS appears to be of limited value for the diagnosis of CFS.
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Some further trials were not eligible for inclusion in the review because symptom burden was not measured.
“were not eligible for inclusion due to symptom burden not being measured”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Roerink et al., 2017
The available Abstract passage reports findings about POTS, chronic fatigue syndrome, and CBT outcomes, but does not discuss a review’s eligibility criteria. Searches for symptom burden not being measured and trials excluded from a review found no passage addressing the claim. (LLM, conf=0.72)
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Cites
Freeman, R., Wieling, W., Axelrod, F. B., Benditt, D. G., Benarroch, E., Biaggioni, I., Cheshire, W. P., Chelimsky, T., Cortelli, P., Gibbons, C. H., et al. (2011) · Clinical Autonomic Research · doi:10.1007/s10286-011-0119-5 · Cited by 1,697 · see citing works
Postural orthostatic tachycardia syndrome: the Mayo clinic experience
Thieben, M. J., Sandroni, P., Sletten, D. M., Benrud-Larson, L. M., Fealey, R. D., Vernino, S., Low, P. A., Lennon, V. A., & Shen, W.-K. (2007) · Mayo Clinic Proceedings · doi:10.1016/s0025-6196(11)61027-6 · Cited by 516 · see citing works
Postural Tachycardia Syndrome (POTS)
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Effects of volume loading and pressor agents in idiopathic orthostatic tachycardia
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Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome?
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Self-citationDeconditioning in patients with orthostatic intolerance
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Self-citationLong-term follow-up of patients with postural tachycardia syndrome
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Knoop, I., Picariello, F., Jenkinson, E., Gall, N., Chisari, C., & Moss-Morris, R. (2023) · Autonomic Neuroscience · doi:10.1016/j.autneu.2022.103052 · Cited by 21 · see citing works
“Some further trials (Taub et al., 2021; Batah and Baughan, 2022; Roerink et al., 2017) were not eligible for inclusion due to symptom burden not being measured, reemphasizing the urgent need for more standardized reporting of symptom response in POTS (Wells et al.”
Psychological and Psychiatric Support; When, Why and What to Do
Opie, M., Raj, V., & Arnold, A. C. (2021) · Postural Tachycardia Syndrome · doi:10.1007/978-3-030-54165-1_40 · Cited by 3 · see citing works
- Authors
- Roerink, M. E., Lenders, J. W. M., Schmits, I. C., Pistorius, A. M. A., Smit, J. W., Knoop, H., & van der Meer, J. W. M.
- Affiliations
- Radboud University Nijmegen (NL)
- Radboud University Medical Center (NL)
- Amsterdam UMC Location University of Amsterdam (NL)
- Department of Internal Medicine Radboud University Medical Centre Nijmegen the Netherlands
- Corresponding author
- Roerink, M. E.
- Venue
- Journal of Internal Medicine
- Publisher
- Wiley
- Published
- 2016-10-02
- Volume
- 281
- Issue
- 2
- Pages
- 179-188
- ISSN
- 0954-6820 (ISSN-L)
- 1365-2796
- OpenAlex
- W2528706699
- Cited by
- 19
- References
- 9
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 3 · 2021: 5 · 2020: 1 · 2019: 1 · 2018: 3
- FWCI
- 1.18
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Journal of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Fibromyalgia and Chronic Fatigue Syndrome Research
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, chronic fatigue syndrome, cognitive behavioral therapy, adolescents, activity patterns, heart rate, diagnostic biomarkers, persistent fatigue, treatment outcomes, disease severity, sex differences, age differences, comorbidities, anxiety
- MeSH terms
- Adolescent, Adult, Blood Pressure, Fatigue, Humans, Netherlands, Prospective Studies, Fatigue Syndrome, Chronic, Comorbidity, Cognitive Behavioral Therapy, Prevalence, Postural Orthostatic Tachycardia Syndrome
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