Abstract Details

Title Executive Functions Worsen during Orthostatic Challenge in Patients with Neurogenic Orthostatic Hypotension

Topic Autonomic Disorders

Presentation(s) P03 - (-)

Poster/Presentation
Number 035

Objective

Background BACKGROUND: Previous cross-sectional studies reported an association between NOH and cognitive decline. Although these studies did not measure blood pressure (BP) values and cognition concurrently, and performed cognitive assessment only while sitting. In a preliminary study based on ten patients with various causes of NOH we demonstrated that an asymptomatic decrease of 20 mmHg in systolic BP was associated with a significant worsening of global and executive cognitive performances.

Design/Methods DESIGN/METHODS: We enrolled 12 consecutive patients (10 males, 65±11 years old, range 35-76) with pure autonomic failure (n=11) or Dopamine beta-hydroxylase deficiency (n=1), normal brain MRI and normal sitting global cognitive evaluation. Patients, under continuos non-invasive monitoring of BP and heart rate (Task Force Monitor, CNSystem), underwent a neuropsychological assessment in two condition: while tilted to an angle able to cause a fall of at least 20 mmHg in SBP and during supine rest. The order of execution of the two evaluation was randomly assigned. Parallel forms of the tests were presented on each assessment and the sequence of presentation of the various test was randomized. Results were compared by using Wilcoxon signed-ranks test for related samples.

Results RESULTS: Compared to the supine position, during the orthostatic challenge patients scored significantly worse in the trail making test A (p=0,050) and B (p=0,041), visual search test (p=0,017), analogies test (p=0,003), immediate visual memory (p=0,023), span forward (p=0,011) and span backward test (p=0,020).

Conclusions CONCLUSIONS: This data demonstrate that NOH is associated with a significant worsening of executive functions like immediate and working memory, sustained attention, visual search and abstract thinking.

Authors/Disclosures
Pietro Guaraldi, MD, PhD (IRCCS Istituto Delle Scienze Neurologiche Di Bologna) PRESENTER	No disclosure on file
	No disclosure on file
Giovanna Calandra-Buonaura	No disclosure on file
	No disclosure on file
	No disclosure on file
Roberto Gallassi	No disclosure on file
Pietro Cortelli, MD, FAAN	Dr. Cortelli has nothing to disclose.
Laura J. Balcer, MD, MSCE, FAAN (NYU Grossman School of Medicine)	An immediate family member of Dr. Balcer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Children's Hospital of Philadelphia.

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