Cardio-oncology & otherCase-control study

Brain tissue changes, network dysfunction, and cerebral hemodynamic deficits in postural orthostatic tachycardia syndrome

Heart RhythmPublished

  • Case-control study
  • age- and sex-matched healthy controls
  • Magnetic resonance imaging (MRI) with autonomic reflex challenges

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 · patients with POTS 18 · controls 20
Participants
38 individuals
Comparison
patients with POTS compared with controls
  • POTSn = 18
  • controlsn = 20

Main finding

As reported in the abstract

Age, sex, body mass index

No significant differences

P > .05

Observational data: associations, not effects.

Further findings

OutcomePOTScontrolsP value
Montreal Cognitive Assessment test28 ± 129 ± 1P = 0.2
Trail Making Test Part B · executive function was slowed in POTS44 ± 1267 ± 34P = 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:10.1016/j.hrthm.2026.02.020

Summarised from the published abstract; every number is checked against it