Abstract Details

Title Cognitive Performance in Postural Orthostatic Tachycardia Syndrome

Topic Autonomic Disorders

Presentation(s) S33 - Autonomic Disorders (11:39 AM-11:51 AM)

Poster/Presentation
Number 003

Objective To assess objective cognitive measures in postural orthostatic tachycardia syndrome (POTS) patients with self-reported mental health correlates.

Background Patients with POTS frequently report cognitive symptoms. Few studies have investigated specific domains of cognitive performance in POTS.

Design/Methods As part of a prospective NIH-funded multimodality phenotyping project, POTS patients (and age/sex-matched controls) underwent an in-person cognitive battery consisting of the Montreal Cognitive Assessment [MoCA], digit span (attention/working memory), Trails A (processing speed) and B (executive function), Controlled Oral Word Association Test [COWAT] (verbal fluency) and Dot-Counting Task [DCT] (validity). Raw values were converted to standardized scores (1-19) as reported in the Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) and Heaton norms, with higher values indicating better performance. Participants also reported their psychiatric diagnoses and completed validated health measures and the POTS Symptom Score (MAPS).

Results 101 POTS patients and 18 controls were included. Mean age was 27.6 years (SD: 7.2) and mostly White (97.0%), non-Hispanic (93.1%), and female (91.1%). Anxiety (49.5%), depression (30.7%), and ADHD (22.8%) were commonly reported conditions with POTS. On the MoCA, 30.7% scored below the normal cognition cutoff (<26/30) versus 11.8% of controls (p=0.19). POTS patients performed worse on Trails A (WAIS-IV score: 10.1 vs 12.3, p=0.003), COWAT (9.0 vs 10.8, p=0.03), and digit span (9.7 vs 11.2, p=0.043) compared to controls. After removing 13 POTS patients with poor validity on DCT, 25.7% still scored below the normal MOCA cutoff, and the statistically significant differences in Trails A and COWAT performance persisted. Worse MAPS was significantly but not meaningfully associated with worse performance on Trails A (r2 = 0.04, p=0.04). Self-reported anxiety, depression, and ADHD were unassociated.

Conclusions Cognitive complaints (“brain fog”) are common in POTS. Having POTS itself, irrespective of comorbid psychiatric conditions or magnitude of symptom awareness, may adversely impact cognitive performance.

Authors/Disclosures
Victor Liaw, MD (UTSW) PRESENTER	Dr. Liaw has nothing to disclose.
Caitlin Reese, PhD	Dr. Reese has nothing to disclose.
Eric T. Hedge, PhD	Dr. Hedge has nothing to disclose.
Amanda Lee	Ms. Lee has nothing to disclose.
Steve Hopkins	Steve Hopkins has nothing to disclose.
Erika Ivey, MS	Miss Ivey has nothing to disclose.
Shannon Grappe, NP	Ms. Grappe has nothing to disclose.
Denis J. Wakeham, PhD	The institution of Dr. Wakeham has received research support from Bank of America Fichtenbaum Charitable Trust. The institution of Dr. Wakeham has received research support from Wilderness Medical Society.
Amber Salter, PhD (UT Southwestern Medical Center)	Dr. Salter has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gryphon Bio. Dr. Salter has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Abata Therapeutics. Dr. Salter has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Sora Neuroscience. Dr. Salter has stock in Owl Therapeutics. The institution of Dr. Salter has received research support from National Multiple Sclerosis Society. The institution of Dr. Salter has received research support from Department of Defense Congressionally Directed Medical Research Program. The institution of Dr. Salter has received research support from Consortium of Multiple Sclerosis Centers.
Meredith A. Bryarly, MD (UT Southwestern)	The institution of Dr. Bryarly has received research support from Theravance.
Benjamin D. Levine, MD	Dr. Levine has nothing to disclose.
Steven Vernino, MD, PhD, FAAN (UT Southwestern Medical Center)	Dr. Vernino has received personal compensation in the range of $500-$4,999 for serving as a Consultant for antag. Dr. Vernino has received personal compensation in the range of $500-$4,999 for serving as a Consultant for CSL Behring. Dr. Vernino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for argenx. Dr. Vernino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kyverna. Dr. Vernino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Autonomic Neuroscience (Elsevier). The institution of Dr. Vernino has received research support from Takeda. The institution of Dr. Vernino has received research support from NIH/NHLBI. The institution of Dr. Vernino has received research support from Lundbeck. The institution of Dr. Vernino has received research support from Regeneron.

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