Brain tissue changes, network dysfunction, and cerebral hemodynamic deficits in postural orthostatic tachycardia syndrome
Authors' conclusion
Patients with POTS show evidence of brain tissue structural changes, impaired central neural responses, and reduced cerebral blood flow in autonomic regulatory sites during cardiovascular reflex testing. These findings indicate that central autonomic control deficits may help explain cardiovascular dysreflexia in POTS.
Study context
- Population
- Individuals with postural orthostatic syndrome (POTS) and age- and sex-matched healthy controlsparticipants enrolled
- Participants
- 38 individuals
- Comparison
- Patients with POTS compared with controls
- POTSn = 18
- Controlsn = 20
- Outcome
- Age, sex, body mass index
Methodological detailsage- and sex-matched healthy controls, magnetic resonance imaging (MRI) with autonomic reflex challenges
- Age- and sex-matched healthy controls
- MRI with autonomic reflex challenges
Main finding
As reported in the abstract
- No significant differences
- P > .05
Observational data: associations, not effects.
Further findings
| Outcome | POTS | Controls | P value |
|---|---|---|---|
| Montreal Cognitive Assessment test | 28 ± 1 | 29 ± 1 | P = 0.2 |
| Trail Making Test Part BExecutive function was slowed in POTS | 44 ± 12 | 67 ± 34 | P = 0.008 |
Anxiety and depression symptoms
- Higher anxiety and depression symptoms in POTS
Brain tissue structural changes and cerebral blood flow
- Brain tissue structural changes in POTS
- P < 0.005
- Reduced cerebral blood flow in POTS compared with controls
- P < 0.005
Neural responses during passive leg raise, mental arithmetic, and isometric handgrip reflex challenges
- Impaired neural responses in POTS
- P < 0.005
- Preserved peripheral reflex function
- P > 0.05
Original publication
Brain tissue changes, network dysfunction, and cerebral hemodynamic deficits in postural orthostatic tachycardia syndrome. Heart Rhythm. Published 23 February 2026. doi:10.
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