{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T19:33:46Z","timestamp":1790969626795,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T00:00:00Z","timestamp":1534118400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000968","name":"American Heart Association","doi-asserted-by":"publisher","award":["AHA12CRP94200029"],"award-info":[{"award-number":["AHA12CRP94200029"]}],"id":[{"id":"10.13039\/100000968","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008235","name":"School of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008235","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Chronic nausea in pediatrics is a debilitating condition with unclear etiology. We aimed to define hemodynamic and neurohumoral characteristics of chronic nausea associated with orthostatic intolerance in order to improve identification and elucidate mechanism.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children (10\u201018\u00a0years) meeting Rome III criteria for functional dyspepsia with nausea and symptoms of orthostatic intolerance (OI) completed a Nausea Profile Questionnaire followed by prolonged (45\u00a0minutes rather than the traditional 10\u00a0minutes) head\u2010upright tilt (HUT) (70\u00b0 tilt up) test. Circulating catecholamines, vasopressin, aldosterone, renin, and angiotensins were measured supine and after 15\u00a0minutes into HUT. Beat\u2010to\u2010beat heart rate and blood pressure were continuously recorded to calculate their variability and baroreflex sensitivity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Within 10 and 45\u00a0minutes of HUT, 46% and 85% of subjects, respectively, had an abnormal tilt test (orthostatic hypotension, postural orthostatic tachycardia, or syncope). At 15 and 45\u00a0minutes of HUT, nausea was elicited in 42% and 65% of subjects respectively. Higher Nausea Profile Questionnaire scores correlated with positive HUT testing at 10\u00a0minutes (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.004) and baroreflex sensitivity at 15\u00a0minutes (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.01). Plasma vasopressin rose 33\u2010fold in subjects with HUT\u2010induced nausea compared to twofold in those who did not experience HUT\u2010induced nausea (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>In children with chronic nausea and OI, longer duration HUT elicited higher frequency of abnormal tilt testing and orthostatic\u2010induced nausea. The Nausea Profile Questionnaire predicted the orthostatic response to tilt testing. Exaggerated vasopressin release differentiated patients with HUT\u2010induced nausea (vs those without nausea), suggesting a possible mechanism for chronic nausea in childhood.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13433","type":"journal-article","created":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T08:45:35Z","timestamp":1534149935000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Chronic nausea and orthostatic intolerance: Diagnostic utility of orthostatic challenge duration, Nausea Profile Questionnaire, and neurohumoral measures"],"prefix":"10.1111","volume":"30","author":[{"given":"Ashley L.","family":"Wagoner","sequence":"first","affiliation":[{"name":"Hypertension and Vascular Research Center Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally E.","family":"Tarbell","sequence":"additional","affiliation":[{"name":"Section of Pediatric Gastroenterology, Hepatology and Nutrition Ann &amp; Robert H. Lurie Children\u2019s Hospital of Chicago Chicago Illinois"},{"name":"Department of Psychiatry and Behavioral Sciences Ann &amp; Robert H. Lurie Children\u2019s Hospital of Chicago Chicago Illinois"},{"name":"Department of Psychiatry and Behavioral Sciences Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hossam A.","family":"Shaltout","sequence":"additional","affiliation":[{"name":"Hypertension and Vascular Research Center Wake Forest School of Medicine Winston\u2010Salem North Carolina"},{"name":"Department of Obstetrics and Gynecology Wake Forest School of Medicine Winston\u2010Salem North Carolina"},{"name":"Department of Surgery Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra I.","family":"Diz","sequence":"additional","affiliation":[{"name":"Hypertension and Vascular Research Center Wake Forest School of Medicine Winston\u2010Salem North Carolina"},{"name":"Department of Surgery Wake Forest School of Medicine Winston\u2010Salem North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debra E.","family":"Weese\u2010Mayer","sequence":"additional","affiliation":[{"name":"Center for Autonomic Medicine in Pediatrics Ann &amp; Robert H. Lurie Children\u2019s Hospital of Chicago Chicago Illinois"},{"name":"Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago Illinois"},{"name":"Stanley Manne Children\u2019s Research Institute Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3052-2913","authenticated-orcid":false,"given":"John E.","family":"Fortunato","sequence":"additional","affiliation":[{"name":"Hypertension and Vascular Research Center Wake Forest School of Medicine Winston\u2010Salem North Carolina"},{"name":"Section of Pediatric Gastroenterology, Hepatology and Nutrition Ann &amp; Robert H. Lurie Children\u2019s Hospital of Chicago Chicago Illinois"},{"name":"Center for Autonomic Medicine in Pediatrics Ann &amp; Robert H. Lurie Children\u2019s Hospital of Chicago Chicago Illinois"},{"name":"Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,13]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(96)70246-9"},{"key":"e_1_2_9_3_1","volume-title":"Rome III: Functional gastrointestinal disorders","author":"Drossman D","year":"2006"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2014.01.046"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3181de0639"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-011-0130-x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"crossref","first-page":"A513","DOI":"10.1161\/hyp.64.suppl_1.513","article-title":"Impaired hemodynamic response to head up tilt in adolescents presenting chronic nausea and orthostatic intolerance","volume":"64","author":"Shaltout H","year":"2014","journal-title":"Hypertension"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0000000000000305"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-014-3981-2"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPG.0b013e3182964203"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(95)00638-9"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-011-0119-5"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6882-11-132"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.explore.2012.02.001"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00583.2015"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20120276"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1673"},{"key":"e_1_2_9_18_1","first-page":"I\u2010217","article-title":"Vasopressin maintains blood pressure in diabetic orthostatic hypotension","volume":"11","author":"Ribeiro A","year":"1988","journal-title":"Hypertension"},{"key":"e_1_2_9_19_1","doi-asserted-by":"crossref","first-page":"A261","DOI":"10.1161\/hyp.62.suppl_1.A261","article-title":"Relationship of arginine vasopressin and blood pressure in patients with orthostatic intolerance","volume":"62","author":"Wagoner A","year":"2013","journal-title":"Hypertension"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spen.2013.01.002"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-014-3964-3"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2014.284240"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2006.07.020"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1023\/A:1005500403066"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2010.07.005"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.MPG.0000157914.40088.31"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.10.013"},{"key":"e_1_2_9_28_1","first-page":"G853","article-title":"Role of plasma vasopressin as a mediator of nausea and gastric slow wave dysrhythmias in motion sickness","volume":"272","author":"Kim M","year":"1997","journal-title":"Am J Physiol"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2982.1997.d01-44.x"},{"key":"e_1_2_9_30_1","volume-title":"Nausea: mechanisms and management","author":"Stern R","year":"2011"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhs073"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000267663.05398.40"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20050254"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00035.2011"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2015.00019"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-014-4007-9"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1152\/ajpendo.1993.265.4.E578"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2005.09.003"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pneurobio.2007.10.007"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2826.2003.01099.x"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/37.2.131"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-198007000-00004"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.34.4.505"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1042\/cs0670473"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fnmo.13433","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.13433","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,16]],"date-time":"2023-09-16T06:17:47Z","timestamp":1694845067000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.13433"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,13]]},"references-count":43,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1111\/nmo.13433"],"URL":"https:\/\/doi.org\/10.1111\/nmo.13433","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,13]]},"assertion":[{"value":"2018-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-06-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-08-13","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e13433"}}