Abstract Details

Title Effect of headache on quantitative symptom scores in children and young adults with postural orthostatic tachycardia syndrome

Topic Neuromuscular and Clinical Neurophysiology (EMG)

Presentation(s) P9 - Poster Session 9 (5:30 PM-6:30 PM)

Poster/Presentation
Number 4-004

Objective To evaluate whether patients with postural orthostatic tachycardia syndrome (POTS) with history of headache have a greater disease burden than those without headaches.

Background Headache is a common and often debilitating symptom in patients with POTS. Given absence of disease-specific outcomes and the multi-dimensional nature of symptom burden, assessment of POTS often includes symptom-specific questionnaires to assess the scope and severity of accompanying symptoms.

Design/Methods A retrospective chart review was done of patients < 20 years old seen at the University of Utah Autonomic Clinic and clinically diagnosed with POTS; patients were subdivided on the basis of headache history (inclusive of undiagnosed recurrent headache, migraine, and positional/orthostatic headache). Results of the Fatigue Severity Scale (FSS), Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-9), and Composite Autonomic Symptom Score (COMPASS-31) assessments performed at the time of initial evaluation were recorded. Statistical comparisons were made using unpaired t-test; p-values <0.05 were considered significant.

Results 58 patients aged 9-20 years were included (from 2015-2021), with a median age of 17.9 years. Of these, 44 (76%) had a documented history of recurrent headaches. The most notable difference was in GAD-7 scores, where the average score was 3.6 points higher in patients with headache (11.5 vs 7.9, p = 0.04). For all other symptom scales, including all subdomains of the COMPASS-31, scores were higher in patients with a documented history of headache; however, these differences were not statistically significant.

Conclusions The presence of headache is associated with higher scores on GAD-7 assessment in patients with POTS. Patients with headache also demonstrated higher average scores on FSS, PHQ-9, and COMPASS-31 assessments, however these were not statistically significant. This finding highlights the relationship between recurrent headache and anxiety symptoms and may also suggest a negative impact of headache on symptom severity across multiple domains in patients with POTS.

Authors/Disclosures
Luke Heyliger, MD (University of Utah) PRESENTER	Dr. Heyliger has nothing to disclose.
Christopher Taylor, NP (Imaging & Neurosciences)	Mr. Taylor has nothing to disclose.
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.

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