PMID- 37703657
OWN - NLM
STAT- Publisher
LR  - 20231006
IS  - 1873-5150 (Electronic)
IS  - 0887-8994 (Linking)
VI  - 148
DP  - 2023 Nov
TI  - Neurocognitive Profiles in Adolescents With Postural Tachycardia Syndrome and 
      Perceived Brain Fog: A Preliminary Report.
PG  - 128-132
LID - S0887-8994(23)00269-2 [pii]
LID - 10.1016/j.pediatrneurol.2023.08.011 [doi]
AB  - BACKGROUND: Postural tachycardia syndrome (POTS) is associated with complaints of 
      cognitive and emotional difficulties that may contribute to severe functional 
      disability. For high-achieving adolescents, these symptoms can result in 
      decreased participation in school and extracurricular activities. There are very 
      limited data comparing subjective symptom reports to neurocognitive profiles in 
      adolescents presenting with POTS, "brain fog," and cognitive difficulties. 
      METHODS: A review of medical records and neuropsychological data was conducted 
      for six adolescents diagnosed with POTS at a pediatric neurology clinic. All 
      patients had frequent symptoms of orthostatic intolerance for more than 
      three months. There was heart rate increase of >/=40 beats per minute (bpm) within 
      10 minutes of active standing or head-up tilt test in five patients and 36 bpm in 
      one patient, who was diagnosed with probable POTS. All were referred for 
      neuropsychological evaluations due to reported debilitating cognitive problems 
      and an inability to function in a regular academic setting. Patients underwent a 
      six-hour neuropsychological evaluation utilizing standardized measures of 
      cognitive and emotional functioning. Clinically reported symptoms included 
      fatigue, poor concentration, and memory impairment as well as "brain fog." 
      RESULTS: Subjective complaints differed from patients' performance on 
      standardized neuropsychological measures. Patients performed in the average to 
      superior range across measures of general intelligence, verbal and working 
      memory, processing speed, and sustained attention. CONCLUSIONS: Further research 
      is needed to elucidate the basis for perceived "brain fog" and cognitive 
      impairment in POTS, such as better understanding of patient and parental 
      perceptions of initial medical symptoms and diagnosis as well as symptom 
      amplification due to biopsychosocial processes.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Koch, Sarah A
AU  - Koch SA
AD  - Pediatric Neuropsychology Program, Department of Neurology, Indiana University 
      School of Medicine, Indianapolis, Indiana. Electronic address: kochsa@iu.edu.
FAU - Jarjour, Imad T
AU  - Jarjour IT
AD  - Section of Child Neurology, Department of Pediatrics, Baylor College of Medicine, 
      Texas Children's Hospital, Houston, Texas. Electronic address: jarjour@bcm.edu.
FAU - Evankovich, Karen D
AU  - Evankovich KD
AD  - Section of Child Neurology, Department of Pediatrics, Baylor College of Medicine, 
      Texas Children's Hospital, Houston, Texas; Sections of Psychology, Department of 
      Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, 
      Texas. Electronic address: kdevanko@texaschildrens.org.
LA  - eng
PT  - Journal Article
DEP - 20230817
PL  - United States
TA  - Pediatr Neurol
JT  - Pediatric neurology
JID - 8508183
SB  - IM
OTO - NOTNLM
OT  - Autonomic function tests
OT  - Brain fog
OT  - Neurocognitive
OT  - Orthostatic intolerance
OT  - POTS
OT  - Pediatric
COIS- Declaration of competing interest None.
EDAT- 2023/09/14 00:41
MHDA- 2023/09/14 00:41
CRDT- 2023/09/13 18:04
PHST- 2022/10/21 00:00 [received]
PHST- 2023/07/17 00:00 [revised]
PHST- 2023/08/10 00:00 [accepted]
PHST- 2023/09/14 00:41 [pubmed]
PHST- 2023/09/14 00:41 [medline]
PHST- 2023/09/13 18:04 [entrez]
AID - S0887-8994(23)00269-2 [pii]
AID - 10.1016/j.pediatrneurol.2023.08.011 [doi]
PST - ppublish
SO  - Pediatr Neurol. 2023 Nov;148:128-132. doi: 10.1016/j.pediatrneurol.2023.08.011. 
      Epub 2023 Aug 17.