Abstract Details

Title Multi-sensory gain abnormalities in postural tachycardia syndrome exceed those of migraine

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P3 - Poster Session 3 (5:30 PM-6:30 PM)

Poster/Presentation
Number 7-055

Objective

We hypothesized that POTS patients would show features of central sensitization, including allodynia and photophobia, with potential amplification of these features compared to migraine alone.

Background Up to 90% of postural tachycardia syndrome (POTS) patients report headaches. Migraine headache is a highly comorbid primary headache disorder in POTS. Given this observation, it is possible that the two disorders pathophysiologically interact, potentially revealing underappreciated aspects of disease expression and treatment opportunities.

Design/Methods

80 participants were evaluated (30 chronic migraine, CM); 20 POTS with and without migraine; 30 non-headache controls, NH) using a structured migraine diagnosis questionnaire, MIDAS/HIT-6, allodynia/photophobia scores, and COMPASS-31. Sensory testing included mechanical pain thresholds by VonFrey Hair testing and quantitative light sensitivity thresholds. Statistical evaluation was performed using Kruskall-Wallis rank sum test, and post-hoc pair-wise comparisons with Wilcoxon rank sum test.

Results 70% of POTS subjects had migraine headache phenotype, though a minority of these were CM (30%). Photophobia and allodynia symptom scores were significantly higher among CM and POTS groups compared to controls. COMPASS-31 scores were significantly higher in POTS compared to CM, and both groupings were significantly higher compared to NH. Photophobia thresholds were significantly lower in POTS compared to CM; both were significantly different compared to NH. Mechanical pain thresholds were significantly lower in CM and POTS compared to NH, though the patterns differed (CM showed reduced periorbital+forearm pain thresholds, while POTS showed reduced forearm thresholds).

Conclusions

We found that POTS subjects had significantly lower light sensitivity thresholds compared to CM and NH, with a tendency towards expression of reduced mechanical pain thresholds and allodynia in the forearm (rather than periorbital) region. To our knowledge, this is the first report of sensory testing in POTS patients, and reveals an important aspect of their disease burden as well as potential insight into underlying mechanisms of central sensitization in POTS.

Authors/Disclosures
PRESENTER	No disclosure on file
K.C. Brennan, MD, FAAN (University of Utah, Dept of Neurology)	Dr. Brennan has received personal compensation in the range of $500-$4,999 for serving as a Consultant for AbbVie/Allergan. The institution of Dr. Brennan has received research support from NIH.
Melissa M. Cortez, DO (University of Utah Neurology)	The institution of Dr. Cortez has received research support from NIH NINDS. The institution of Dr. Cortez has received research support from Dysautonomia International. Dr. Cortez has received personal compensation in the range of $500-$4,999 for serving as a Content Expert, Reviewer, DSMB with NIH RECOVER project.

��ɫ��

��ɫ��