Brain fog in neuropathic postural tachycardia syndrome may be associated with autonomic hyperarousal and improves after water drinking.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_1ED1FCDC6149
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Brain fog in neuropathic postural tachycardia syndrome may be associated with autonomic hyperarousal and improves after water drinking.
Journal
Frontiers in neuroscience
Author(s)
Rodriguez B., Hochstrasser A., Eugster P.J., Grouzmann E., Müri R.M., Z'Graggen W.J.
ISSN
1662-4548 (Print)
ISSN-L
1662-453X
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
16
Pages
968725
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Brain fog is a common and highly disturbing symptom for patients with neuropathic postural tachycardia syndrome (POTS). Cognitive deficits have been measured exclusively in the upright body position and mainly comprised impairments of higher cognitive functions. The cause of brain fog is still unclear today. This study aimed to investigate whether increased autonomic activation might be an underlying mechanism for the occurrence of brain fog in neuropathic POTS. We therefore investigated cognitive function in patients with neuropathic POTS and a healthy control group depending on body position and in relation to catecholamine release as a sensitive indicator of acute stress. The second aim was to test the effect of water intake on cardiovascular regulation, orthostatic symptoms, cognitive function and catecholamine release.
Thirteen patients with neuropathic POTS and 15 healthy control subjects were included. All participants completed a total of four rounds of cognitive testing: two before and two after the intake of 500 ml still water, each first in the supine position and then during head-up tilt. At the end of each cognitive test, a blood sample was collected for determination of plasma catecholamines. After each head-up tilt phase participants were asked to rate their current symptoms on a visual analogue scale.
Working memory performance in the upright body position was impaired in patients, which was associated with self-reported symptom severity. Patients had elevated plasma norepinephrine independent of body position and water intake that increased excessively in the upright body position. The excessive increase of plasma norepinephrine was related to heart rate and symptom severity. Water intake in patients decreased norepinephrine concentrations and heart rate, and improved symptoms as well as cognitive performance.
Brain fog and symptom severity in neuropathic POTS are paralleled by an excessive norepinephrine secretion. Bolus water drinking down-regulates norepinephrine secretion and improves general symptom severity including brain fog.
Keywords
General Neuroscience, autonomic dysfunction, autonomic neuropathy, cognition, dysautonomia, neuropsychology, stress
Pubmed
Web of science
Open Access
Yes
Create date
08/08/2022 8:23
Last modification date
30/08/2022 6:41
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