Structural and Functional Small Fiber Abnormalities in the Neuropathic Postural Tachycardia Syndrome
Open accessAbstract
OBJECTIVE: To define the neuropathology, clinical phenotype, autonomic physiology and differentiating features in individuals with neuropathic and non-neuropathic postural tachycardia syndrome (POTS). METHODS: Twenty-four subjects with POTS and 10 healthy control subjects had skin biopsy analysis of intra-epidermal nerve fiber density (IENFD), quantitative sensory testing (QST) and autonomic testing. Subjects completed quality of life, fatigue and disability questionnaires. Subjects were divided into neuropathic and non-neuropathic POTS, defined by abnormal IENFD and abnormal small fiber and sudomotor function. RESULTS: Nine of 24 subjects had neuropathic POTS and had significantly lower resting and tilted heart rates; reduced parasympathetic function; and lower phase 4 valsalva maneuver overshoot compared with those with non-neuropathic POTS (P<0.05). Neuropathic POTS subjects also had less anxiety and depression and greater overall self-perceived health-related quality of life scores than non-neuropathic POTS subjects. A sub-group of POTS patients (cholinergic POTS) had abnormal proximal sudomotor function and symptoms that suggest gastrointestinal and genitourinary parasympathetic nervous system dysfunction. CONCLUSIONS AND RELEVANCE: POTS subtypes may be distinguished using small fiber and autonomic structural and functional criteria. Patients with non-neuropathic POTS have greater anxiety, greater depression and lower health-related quality of life scores compared to those with neuropathic POTS. These findings suggest different pathophysiological processes underlie the postural tachycardia in neuropathic and non-neuropathic POTS patients. The findings have implications for the therapeutic interventions to treat this disorder.
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The presence of small fiber neuropathy could identify a clinical subgroup of POTS (neuropathic POTS).
“the presence of small fiber neuropathy could identify a clinical subgroup of POTS (a.k.a. “neuropathic” POTS) [29].”
In neuropathic POTS, the phase IV overshoot of the Valsalva maneuver is lower than in controls.
“In this category of POTS the phase IV overshoot of the Valsalva maneuver is lower than controls”
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“These POTS patients with sudomotor dysfunction bear some similarity to post-ganglionic cholinergic dysautonomia which is characterized by generalized, post-ganglionic parasympathetic nervous system impairment that includes gastrointestinal and bladder dysfunction, pupillomotor deficits, sudomotor dysfunction, xerophth…”
BackgroundThe value of autonomic testing in postural tachycardia syndrome
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Acute autonomic neuropathy. Two cases and a clinical review
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“These POTS patients with sudomotor dysfunction bear some similarity to post-ganglionic cholinergic dysautonomia which is characterized by generalized, post-ganglionic parasympathetic nervous system impairment that includes gastrointestinal and bladder dysfunction, pupillomotor deficits, sudomotor dysfunction, xerophth…”
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“The physiological factors that underlie this predisposition include decreased stroke volume [33,34], decreased total muscle sympathetic outflow [35] and differences in sympathetic burst discharge characteristics [36].”
BackgroundSelf-citation
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Research works printed but not linked: 1
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“symptoms and 10 = most severe symptoms) as previously described (Gibbons and Freeman, 2010; Gibbons et al., 2013).”
MethodSelf-citationPostural Orthostatic Tachycardia Syndrome
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Postural tachycardia syndrome – Diagnosis, physiology, and prognosis
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Postural Orthostatic Tachycardia Syndrome (POTS): A critical assessment
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Small-fiber neuropathy with cardiac denervation in postural tachycardia syndrome
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Evaluation of postural tachycardia syndrome (POTS)
Goodman, B. P. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.04.004 · Cited by 77 · see citing works
Raj, S. R., Bourne, K. M., Stiles, L. E., Miglis, M. G., Cortez, M. M., Miller, A. J., Freeman, R. L., Biaggioni, I., Rowe, P. C., Sheldon, R. S., et al. (2021) · Autonomic Neuroscience · doi:10.1016/j.autneu.2021.102836 · Cited by 63 · see citing works
“Prior studies have documented small fiber neuropathy in approximately half of POTS patients (Billig et al., 2020; Gibbons et al., 2013; Peltier et al., 2010), and there is some evidence that small fiber neuropathy in POTS may correlate to reduced cardiac innervation (Haensch et al., 2014).”
Self-citationCelletti, C., Camerota, F., Castori, M., Censi, F., Gioffrè, L., Calcagnini, G., & Strano, S. (2017) · BioMed Research International · doi:10.1155/2017/9161865 · Cited by 62 · see citing works
Gastrointestinal symptoms in postural tachycardia syndrome: a systematic review
Mehr, S. E., Barbul, A., & Shibao, C. A. (2018) · Clinical Autonomic Research · doi:10.1007/s10286-018-0519-x · Cited by 55 · see citing works
Is postural orthostatic tachycardia syndrome (POTS) a central nervous system disorder?
Blitshteyn, S. (2021) · Journal of Neurology · doi:10.1007/s00415-021-10502-z · Cited by 46 · see citing works
COVID-19 Induced Postural Orthostatic Tachycardia Syndrome (POTS): A Review
Mallick, D. C., Goyal, L., Chourasia, P. K., Zapata, M. R., Yashi, K., & Surani, S. (2023) · Cureus · doi:10.7759/cureus.36955 · Cited by 58 · see citing works
“Up to 43% to 63% of POTS patients with GI symptoms have abnormal sudomotor testing [23-27].”
BackgroundGibbons, C. H. (2014) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/01.con.0000455874.68556.02 · Cited by 52 · see citing works
“A recent study detected evidence of a small fiber neuropathy in a subset of patients diagnosed with postural orthostatic tachycardia syndrome (POTS).(32) Nine of 24 patients with POTS had biopsy-confirmed evidence of a small fiber neuropathy.”
BackgroundSelf-citationVagal and Sympathetic Function in Neuropathic Postural Tachycardia Syndrome
Jacob, G., Diedrich, L., Sato, K., Brychta, R. J., Raj, S. R., Robertson, D., Biaggioni, I., & Diedrich, A. (2019) · Hypertension · doi:10.1161/hypertensionaha.118.11803 · Cited by 51 · see citing works
Quantitative assessment of autonomic symptom burden in Postural tachycardia syndrome (POTS)
Rea, N. A., Campbell, C. L., & Cortez, M. M. (2017) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2017.03.032 · Cited by 52 · see citing works
“The most widely reported subgroups include neuropathic (41-43), hyperadrenergic (44, 45), and volume dysregulation (45)”
Treatment-Induced Neuropathy of Diabetes
Gibbons, C. H. (2017) · Current Diabetes Reports · doi:10.1007/s11892-017-0960-6 · Cited by 47 · see citing works
Self-citationChronic Fatigue Syndrome and Cardiovascular Disease
Natelson, B. H., Brunjes, D. L., & MANCINI, D. M. (2021) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2021.06.045 · Cited by 46 · see citing works
Gibbons, C. H., Silva, G., & Freeman, R. L. (2021) · Heart Rhythm · doi:10.1016/j.hrthm.2021.01.017 · Cited by 44 · see citing works
“The chronic nature of the disease and the severity of symptoms result in diminished quality of life across multiple domains.(3,4) A number of pharmacological treatment options for POTS exist including b-blockade, blood volume expansion, and induced hypertension, but there are no studies of pharmacotherapeutic interven…”
BackgroundSelf-citationAutonomic Dysfunction in Cardiology: Pathophysiology, Investigation, and Management
Arnold, A. C., Ng, J., Lei, L. Y., & Raj, S. R. (2017) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2017.09.008 · Cited by 40 · see citing works
“Second, ~50% of patients have a neuropathic subtype associated with asymptomatic small fiber neuropathy affecting sympathetic innervation of the lower limbs.(49) Third, up to 50% of patients have a hyperadrenergic phenotype characterized by tachycardia, SBP increase >10 mmHg, plasma norepinephrine >600 pg/mL, and symp…”
Joseph, P., Pari, R., Miller, S., Warren, A., Stovall, M. C., Squires, J., Chang, C.-J., Xiao, W., Waxman, A. B., & Systrom, D. M. (2022) · CHEST Journal · doi:10.1016/j.chest.2022.04.146 · Cited by 44 · see citing works
Postural Orthostatic Tachycardia Syndrome (POTS): An Update for Clinical Practice.
Sebastian, S. A., Co, E. L., Panthangi, V., Jain, E., Ishak, A., Shah, Y., Vasavada, A., & Padda, I. (2022) · Current problems in cardiology · doi:10.1016/j.cpcardiol.2022.101384 · Cited by 33 · see citing works
Clinical challenges in the diagnosis and management of postural tachycardia syndrome
Jones, P., Shaw, B., & Raj, S. (2016) · Practical Neurology · doi:10.1136/practneurol-2016-001405 · Cited by 34 · see citing works
Defining Cardiac Dysautonomia – Different Types, Overlap Syndromes; Case-based Presentations
Lakkireddy, D. (2020) · Journal of Atrial Fibrillation · doi:10.4022/jafib.2403 · Cited by 33 · see citing works
Case-Control Study of Individuals With Small Fiber Neuropathy After COVID-19
McAlpine, L. S., Zubair, A. S., Joseph, P., & Spudich, S. (2024) · Neurology Neuroimmunology & Neuroinflammation · doi:10.1212/nxi.0000000000200244 · Cited by 31 · see citing works
Skin biopsy reveals generalized small fibre neuropathy in hypermobile Ehlers–Danlos syndromes
Igharo, D., Thiel, J. C., Rolke, R., Akkaya, M., Weis, J., Katona, I., Schulz, J. B., & Maier, A. (2022) · European Journal of Neurology · doi:10.1111/ene.15649 · Cited by 32 · see citing works
“Particularly in neuropathic PoTS, SFN is considered to play an active role in the underlying pathophysiology [42, 43].”
BackgroundResultThe role of autonomic testing in syncope
Jones, P. K., & Gibbons, C. H. (2014) · Autonomic Neuroscience · doi:10.1016/j.autneu.2014.05.011 · Cited by 28 · see citing works
Self-citationManagement of headache and chronic pain in POTS
Cook, G. A., & Sandroni, P. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.06.004 · Cited by 28 · see citing works
Billig, S. C. I., Schauermann, J. C., Rolke, R., Katona, I., Schulz, J. B., & Maier, A. (2019) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000000770 · Cited by 21 · see citing works
Evaluating and managing postural tachycardia syndrome
Lei, L. Y., Chew, D. S., Sheldon, R. S., & Raj, S. R. (2019) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.86a.18002 · Cited by 26 · see citing works
“17,23 A compensatory increase in sympathetic tone results in tachycardia to maintain cardiac output and blood pressure.”
BackgroundPostural orthostatic tachycardia syndrome and migraine: A narrative review
Mueller, B. R., & Robinson‐Papp, J. (2022) · Headache The Journal of Head and Face Pain · doi:10.1111/head.14365 · Cited by 23 · see citing works
Post-COVID postural orthostatic tachycardia syndrome (POTS): a new phenomenon
Cantrell, C., Reid, C., Walker, C. S., Tidd, S. J. S., Zhang, R., & Wilson, R. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1297964 · Cited by 23 · see citing works
Quantitative Sensory Testing in Pain Management
Roldan, C. J., & Abdi, S. (2015) · Pain Management · doi:10.2217/pmt.15.37 · Cited by 21 · see citing works
Dysautonomia following Lyme disease: a key component of post-treatment Lyme disease syndrome?
Adler, B. L., Chung, T., Rowe, P. C., & Aucott, J. N. (2024) · Frontiers in Neurology · doi:10.3389/fneur.2024.1344862 · Cited by 21 · see citing works
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Moon, J., Lee, H. S., Byun, J.-I., Sunwoo, J.-S., Shin, J.-W., Lim, J.-A., Kim, T.-J., Shin, Y.-W., Lee, K.-J., Jeon, D., et al. (2016) · Journal of the American Society of Hypertension · doi:10.1016/j.jash.2016.01.011 · Cited by 17 · see citing works
Symptom presentation by phenotype of postural orthostatic tachycardia syndrome
Angeli, A. M., Salonen, B. R., Ganesh, R., Hurt, R. T., Abdalrhim, A. D., Mueller, M., Volcheck, M. M., & Aakre, C. A. (2024) · Scientific Reports · doi:10.1038/s41598-023-50886-8 · Cited by 18 · see citing works
Chelimsky, G. G., & Chelimsky, T. C. (2018) · Autonomic Neuroscience · doi:10.1016/j.autneu.2018.09.003 · Cited by 14 · see citing works
A novel method to quantify cutaneous vascular innervation
Sohn, E., Suh, B. C., Wang, N., Freeman, R. L., & Gibbons, C. H. (2020) · Muscle & Nerve · doi:10.1002/mus.26889 · Cited by 13 · see citing works
“Autonomic symptoms were scored on an 11 point scale (where 0 = no symptoms and 10 = most severe symptoms) as previously described.(25,26) A symptom was considered present if score was >2/10 as previously described.”
MethodSelf-citationPostural orthostatic tachycardia syndrome: pathophysiology, management, and experimental therapies
Narasimhan, B., Aggarwal, D., Satish, P., Kantharia, B. K., & Aronow, W. S. (2022) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2022.2121697 · Cited by 12 · see citing works
“have lower resting heart rates, lower anxiety, and greater overall health-related quality of life [14].”
BackgroundLoughnan, A., Gall, N. P., & James, S. (2020) · Autonomic Neuroscience · doi:10.1016/j.autneu.2020.102762 · Cited by 11 · see citing works
Pitarokoili, K., Maier, A., Rubio, E. D. M., Hahn, K., Wallukat, G., Athanasopoulos, D., Grüter, T., Motte, J., Fisse, A. L., & Gold, R. (2021) · Journal of Translational Autoimmunity · doi:10.1016/j.jtauto.2021.100112 · Cited by 11 · see citing works
Recognizing postural orthostatic tachycardia syndrome
Pavlik, D., Agnew, D. M., Stiles, L. E., & Ditoro, R. (2016) · JAAPA · doi:10.1097/01.jaa.0000481398.76099.09 · Cited by 11 · see citing works
Intraepidermal nerve fiber analysis using immunofluorescence with and without confocal microscopy
Provitera, V., Nolano, M., Stancanelli, A., Caporaso, G., Vitale, D. F., & Santoro, L. (2014) · Muscle & Nerve · doi:10.1002/mus.24338 · Cited by 11 · see citing works
“Consequently, most of the studies that aim to demonstrate impairment of epidermal innervation in SFN are based on evaluation of IENF linear density.(10,11) Accepted counting rules(12) state that all fibers that cross the BM are eligible to be counted.”
BackgroundExploring quality of life in postural orthostatic tachycardia syndrome: A conceptual analysis
Frye, W. S., & Greenberg, B. A. (2024) · Autonomic Neuroscience · doi:10.1016/j.autneu.2024.103157 · Cited by 11 · see citing works
Mountford, R., Adler, B. L., Andersson, D. A., Bashford-Rogers, R. J. M., Berwick, R., Bevan, S., Caro, X., Chung, T., Clark, J. D., Dawes, J. M., et al. (2024) · PAIN Reports · doi:10.1097/pr9.0000000000001167 · Cited by 10 · see citing works
Cutaneous alpha‐synuclein deposition in postural tachycardia patients
Levine, T. D., Bellaire, B., Gibbons, C., & Freeman, R. (2021) · Annals of Clinical and Translational Neurology · doi:10.1002/acn3.51347 · Cited by 11 · see citing works
“denervation,(24) impaired distal sudomotor function,(25,26) lower norepinephrine spillover in the legs than the arms,(27) quantitative sensory test results,(28) and the association with denervation on skin biopsy.(7,29) Estimates suggest that in tertiary referral center studies, a neuropathic etiology may underlie POT…”
BackgroundSelf-citationTufvesson, H., Hamrefors, V., Fedorowski, A., Hansson, M., & Ohlsson, B. (2024) · Frontiers in Physiology · doi:10.3389/fphys.2024.1342351 · Cited by 9 · see citing works
Zhang, R., Mayuga, K., Shields, R., Cantrell, C., & Wilson, R. G. (2022) · Cureus · doi:10.7759/cureus.31021 · Cited by 10 · see citing works
“Previous studies have shown that IENFD and cardiovagal function are correlated in patients with POTS, concluding that neuropathic POTS is associated with reduced heart rate variability compared to nonneuropathic POTS [8].”
BackgroundResultInfluentialVascular dysfunction of postural tachycardia syndrome in children
Bai, W., Chen, S., Jin, H., & Du, J. (2018) · World Journal of Pediatrics · doi:10.1007/s12519-017-0104-8 · Cited by 9 · see citing works
Skin sympathetic nerve activity in patients with chronic orthostatic intolerance
Lee, A. J., Liu, X., Rosenberg, C., Borle, S., Hwang, D., Chen, L. S., Li, X., Merz, C. N. B., & Chen, P. (2022) · Heart Rhythm · doi:10.1016/j.hrthm.2022.03.015 · Cited by 9 · see citing works
Postural Tachycardia Syndrome: Diagnosis and Management in Adolescents and Young Adults
Heyer, G. L. (2017) · Pediatric Annals · doi:10.3928/19382359-20170322-01 · Cited by 9 · see citing works
Diabetic small fiber neuropathy: clinical and electrophysiological study
Alkotami, A. S., Elkholy, S. H., Elshamy, A. M., El-Seidy, E. A. S., & Fadel, W. A. (2024) · The Egyptian Journal of Neurology Psychiatry and Neurosurgery · doi:10.1186/s41983-024-00923-8 · Cited by 6 · see citing works
Go, S., Yamanaka, G., Kasuga, A., Kanou, K., Takamatsu, T., Takeshita, M., Morishita, N., Morıchı, S., Ishida, Y., Oana, S., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9124125 · Cited by 6 · see citing works
“reported cholinergic POTS patients had abnormal proximal sudomotor function and symptoms suggesting gastrointestinal and genitourinary parasympathetic nervous system dysfunction [29].”
BackgroundUtility of salivary gland biopsy in diagnosing Sjogren's syndrome in a POTS patient population.
Pasadyn, S. R., Warren, C., & Wilson, R. G. (2020) · Autonomic Neuroscience: Basic & Clinical · doi:10.1016/j.autneu.2020.102694 · Cited by 5 · see citing works
Mitra, K., Kunte, S. A., Taube, S., Tian, W. M., Richardson, E. S., Frazier‐Mills, C. G., & Fudim, M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13237304 · Cited by 5 · see citing works
“Patients with POTS typically have underlying hypovolemia, deconditioning, neuroendocrine dysfunction, and neuropathy [6,8–10].”
The genetic landscape of pediatric postural orthostatic tachycardia syndrome
Qu, H., Qu, J., Chang, X., Williams, N., Mentch, F. D., Snyder, J., Lemma, M., Nguyen, K., Behr, M. A., March, M., et al. (2025) · Clinical Autonomic Research · doi:10.1007/s10286-025-01110-2 · Cited by 5 · see citing works
“Additionally, there is increasing evidence to suggest that a significant number of patients with POTS experience small fiber neuropathy (SFN), an autoimmune disorder that specifically targets and damages the small fibers responsible for conducting autonomic and pain signals [33, 36].”
Pathophysiology and Classification of PoTS
Lloyd, M., & Raj, S. (2020) · Postural Tachycardia Syndrome · doi:10.1007/978-3-030-54165-1_5 · Cited by 4 · see citing works
Leys, F., Verginer, M., Kirchler, E., Marino, L., Goebel, G., Campese, N., Eschlböck, S., Duerr, S., Broessner, G., Djamshidian, A., et al. (2025) · Journal of Neurology · doi:10.1007/s00415-025-13518-x · Cited by 4 · see citing works
“QSART revealed a diffuse pattern of postganglionic, sympathetic-cholinergic sudomotor dysfunction, and the patient was therefore diagnosed with neuropathic POTS [42–44].”
Mueller, B. R. (2023) · Current Pain and Headache Reports · doi:10.1007/s11916-023-01173-8 · Cited by 4 · see citing works
“In individuals with neuropathic POTS, patchy absence of sweating and a decrease in intraepidermal nerve fiber density (IENFD) suggests a small fiber neuropathy that affects sympathetic efferents [38, 39].”
BackgroundKnoop, I., Jones, A. S. K., Gall, N. P., Norton, S., Pascoe, W., & Moss-Morris, R. E. (2024) · Psychosomatic Medicine · doi:10.1097/psy.0000000000001346 · Cited by 4 · see citing works
“Up to 45% of people with POTS are thought to have SFN (10,11), although it often remains undiagnosed (12).”
Dizziness in postural tachycardia syndrome and its link to vestibular migraine
Sekhon, R., Gall, N. P., Ainsworth, C., & Murdin, L. J. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1583348 · Cited by 3 · see citing works
Awareness of postural orthostatic tachycardia syndrome is required in adolescent syncope
Kim, D. H., Park, J. Y., Kim, S. Y., Lee, N. M., Yi, D. Y., Yun, S. W., Lim, I. S., & Chae, S. A. (2022) · Medicine · doi:10.1097/md.0000000000031513 · Cited by 3 · see citing works
Herrera, A., & Behm, J. (2021) · Occupational Therapy In Health Care · doi:10.1080/07380577.2021.1967548 · Cited by 3 · see citing works
“POTS is also frequently associated with symptoms of anxiety (Gibbons et al., 2013; Kanjwal et al., 2011) and, in some cases, is mistaken for generalized anxiety disorder (Masuki et al., 2007).”
BackgroundCook, G. A., Kissel, J. T., & Dimachkie, M. M. (2025) · Neurologic Clinics · doi:10.1016/j.ncl.2025.05.013 · Cited by 2 · see citing works
Bourne, K. M., Gamboa, A., Black, B., Hall, J., Biaggioni, I., Shibao, C. A., Diedrich, A., Peltier, A., Jacob, G., Okamoto, L. E., et al. (2026) · Journal of Internal Medicine · doi:10.1111/joim.70104 · Cited by 2 · see citing works
Wolff, D. T., & Walker, S. J. (2022) · Frontiers in Pain Research · doi:10.3389/fpain.2021.810809 · Cited by 2 · see citing works
“These include some forms of POTS (41), complex chronic pelvic pain (CPP) (42), and chronic fatigue syndrome (CFS) (43) indicating a pathophysiologic link between these syndromes.”
BackgroundImbalance in Cardiac Autonomic Nervous System Mediates Fatigue
Vinik, A. I., Vinik, E. J., Lai, Y.-C., Morrison, S., Colberg, S. R., Neumann, S. A., Edwards, J., Gerwe, S., CASELLINI, C. M., & Parson, H. K. (2022) · Medical Research Archives · doi:10.18103/mra.v10i2.2659 · Cited by 2 · see citing works
Zirpoli, G., Farhad, K., Klein, M., Downs, S., Klein, M. M., & Oaklander, A. L. (2023) · Muscle & Nerve · doi:10.1002/mus.28013 · Cited by 2 · see citing works
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Waheed, W., & Holmes, G. L. (2024) · Pediatric Neurology · doi:10.1016/j.pediatrneurol.2024.09.025 · Cited by 2 · see citing works
Cantrell, C., Rilinger, R. G., Tidd, S. J. S., & Wilson, R. (2025) · Cureus · doi:10.7759/cureus.82781 · Cited by 1 · see citing works
“The laboratory then assesses intraepidermal NFD, and an abnormal classification is assigned if the NFD is less than the fifth percentile [20].”
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Varma-Doyle, A. V., & Robbins, N. M. (2025) · Seminars in Neurology · doi:10.1055/a-2764-3644 · Cited by 1 · see citing works
Differential Diagnosis of Vasovagal Syncope: Postural Orthostatic Tachycardia
Garland, E. M., & Raj, S. R. (2014) · Springer eBooks · doi:10.1007/978-3-319-09102-0_14 · Cited by 1 · see citing works
Small Fiber Neuropathy after COVID-19: A Key to Long COVIDPreprint
McAlpine, L. S., Zubair, A. S., Joseph, P., & Spudich, S. (2023) · medRxiv · doi:10.1101/2023.11.07.23297764 · Cited by 1 · see citing works
OBSOLETE: Sinus Tachycardias: Inappropriate Sinus Tachycardia and Postural Tachycardia Syndrome
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Neurological Red Flags in Common Neurological Conditions Associated with PoTS
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Clinical and autonomic characteristics in patients with postural tachycardia syndrome
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“사지의 혈관에 있는 교감 신경의 부분적인 차단이 이런 증상을 나타나게 한다[19,23].”
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Sinus Tachycardias: Inappropriate Sinus Tachycardia and Postural Orthostatic Tachycardia Syndrome
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Self-citationImmunotherapy considerations for distal sensory-predominant and small-fiber peripheral neuropathies
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- Authors
- Gibbons, C. H., Bonyhay, I., Benson, A., Wang, N., & Freeman, R.
- Affiliations
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Freeman, Roy
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2013-12-27
- Volume
- 8
- Issue
- 12
- Pages
- e84716
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC3874039
- OpenAlex
- W2130193631
- Cited by
- 99
- References
- 49
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 15 · 2023: 4 · 2022: 13 · 2021: 8 · 2020: 11 · 2019: 5 · 2018: 6 · 2017: 11 · 2016: 3 · 2015: 2 · 2014: 6
- FWCI
- 3.61
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL059459)
- National Institute of Neurological Disorders and Stroke (K23NS050209)
- 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, small fiber neuropathy, autonomic dysfunction, parasympathetic function, sudomotor function, quantitative sensory testing, quality of life, anxiety and depression, heart rate, Valsalva maneuver
- MeSH terms
- Adult, Autonomic Nervous System Diseases, Epidermis, Female, Humans, Male, Nerve Fibers, Postural Orthostatic Tachycardia Syndrome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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