Cognitive function, health-related quality of life, and symptoms of depression and anxiety sensitivity are impaired in patients with the postural orthostatic tachycardia syndrome (POTS)
Open accessAbstract
The Postural Orthostatic Tachycardia Syndrome (POTS) is a condition in which heart rate increases abnormally when the individual assumes an upright position. In addition to the marked tachycardia, presyncope, and syncope, patients with POTS often complain of light-headedness, fatigue, and difficulty in concentrating. The present study assessed individuals with POTS for psychiatric comorbidity, anxiety sensitivity and health related quality of life and examined general cognitive ability. Data was obtained from patients with POTS (n = 15, 12 female, aged 30 ± 3 years) and age matched healthy subjects (n = 30, 21 female, aged 32 ± 2 years). Patients with POTS commonly presented with symptoms of depression, elevated anxiety and increased anxiety sensitivity, particularly with regards to cardiac symptoms, and had a poorer health related quality of life in both the physical and mental health domains. While patients with POTS performed worse in tests of current intellectual functioning (verbal and non-verbal IQ) and in measures of focused attention (digits forward) and short term memory (digits back), test results were influenced largely by years of education and the underlying level of depression and anxiety. Acute changes in cognitive performance in response to head up tilt were evident in the POTS patients. From results obtained, it was concluded that participants with POTS have an increased prevalence of depression and higher levels of anxiety. These underlying symptoms impact on cognition in patients with POTS, particularly in the cognitive domains of attention and short-term memory. Our results indicate that psychological interventions may aid in recovery and facilitate uptake and adherence of other treatment modalities in patients with POTS.
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Cerebral blood flow reductions, orthostatic symptoms, and cognitive impairment can occur during and after upright as well as seated positions in people with POTS.
“cerebral blood flow reductions, orthostatic symptoms and cognitive impairment can occur during and after upright as well as seated positions in people with POTS”
From Self-reported symptom burden in postural orthostatic tachycardia syndrome (POTS): A narrative review of observational and interventional studies (2023) · cites this paper as Anderson et al., 2014
The Results (Cognitive function in response to head up tilt; page not specified) show impaired attention during 60° head-up tilt in patients with POTS. The Discussion reports reduced cerebral blood flow during head-up tilt, citing earlier research. The paper does not establish that these effects occur after upright positioning or while seated; its comparison position was semi-recumbent. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAntidepressant use is likely high in POTS patients, given the high incidence of polypharmacy and the perception of increased depression in this population.
“Given the high incidence of polypharmacy in POTS patients (10), coupled with the perception of increased depression in POTS patients (74), antidepressant use is likely high in this patient population.”
From Postural orthostatic tachycardia syndrome: mechanisms and new therapies (2020) · cites this paper as [74]
Other studies have suggested that patients with POTS may have increased prevalence of depression and anxiety.
“However, other studies have also suggested that patients with POTS may have increased prevalence of depression and anxiety 30.”
From The face of postural tachycardia syndrome – insights from a large cross‐sectional online community‐based survey (2019) · cites this paper as [30]
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- Authors
- Anderson, J. W., Lambert, E. A., Sari, C. I., Dawood, T., Esler, M. D., Vaddadi, G., & Lambert, G. W.
- Affiliations
- Baker Heart and Diabetes Institute (AU)
- Corresponding author
- Lambert, Gavin W.
- Venue
- Frontiers in Physiology
- Publisher
- Frontiers Media SA
- Published
- 2014-06-25
- Volume
- 5
- Pages
- 230-230
- ISSN
- 1664-042X (ISSN-L)
- PMC
- PMC4070177
- OpenAlex
- W1977600357
- Cited by
- 96
- References
- 53
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 10 · 2023: 8 · 2022: 13 · 2021: 8 · 2020: 10 · 2019: 6 · 2018: 6 · 2017: 8 · 2016: 6 · 2015: 6
- FWCI
- 6.62
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Frontiers in Physiology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (cc-by)
- Funders
- State Government of Victoria
- Medical Research Council
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Keywords
- postural orthostatic tachycardia syndrome, cognitive function, health-related quality of life, depression, anxiety, anxiety sensitivity, attention, short-term memory, head-up tilt, psychiatric comorbidity, autonomic dysfunction
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