{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:55:00Z","timestamp":1787018100020,"version":"build-2736575974"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2020,12,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The physiology underlying \"brain fog\" in the absence of orthostatic stress in postural tachycardia syndrome (POTS) remains poorly understood.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      We evaluated cognitive and hemodynamic responses (cardiovascular and cerebral: heart rate, blood pressure, end\u2010tidal carbon dioxide, and cerebral blood flow velocity (CBFv) in the middle cerebral artery at baseline, after initial cognitive testing, and after (30\u2010minutes duration) prolonged cognitive stress test (PCST) whilst seated; as well as after 5\u2010minute standing in consecutively enrolled participants with POTS (n=22) and healthy controls (n=18). Symptom severity was quantified with orthostatic hypotensive questionnaire at baseline and end of study. Subjects in POTS and control groups were frequency age\u2010 and sex\u2010matched (29\u00b111 versus 28\u00b113\u00a0years; 86 versus 72% women, respectively; both\n                      <jats:italic>P<\/jats:italic>\n                      \u22650.4). The CBFv decreased in both groups (condition,\n                      <jats:italic>P<\/jats:italic>\n                      =0.04) following PCST, but a greater reduction in CBFv was observed in the POTS versus control group (\u22127.8% versus \u22121.8%; interaction,\n                      <jats:italic>P<\/jats:italic>\n                      =0.038). Notably, the reduced CBFv following PCST in the POTS group was similar to that seen during orthostatic stress (60.0\u00b114.9 versus 60.4\u00b114.8\u00a0cm\/s). Further, PCST resulted in greater slowing in psychomotor speed (6.1% versus 1.4%, interaction,\n                      <jats:italic>P<\/jats:italic>\n                      =0.027) and a greater increase in symptom scores at study completion (interaction,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001) in the patients with POTS, including increased difficulty with concentration. All other physiologic responses (blood pressure and end\u2010tidal carbon dioxide) did not differ between groups after PCST (all\n                      <jats:italic>P<\/jats:italic>\n                      &gt;0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Reduced CBFv and cognitive dysfunction were evident in patients with POTS following prolonged cognitive stress even in the absence of orthostatic stress.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.120.017861","type":"journal-article","created":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T05:01:16Z","timestamp":1607144476000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":27,"title":["Cerebral Blood Flow and Cognitive Performance in Postural Tachycardia Syndrome: Insights from Sustained Cognitive Stress Test"],"prefix":"10.1161","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6847-0143","authenticated-orcid":false,"given":"Rachel","family":"Wells","sequence":"first","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"},{"name":"Department of Medicine Royal Adelaide Hospital Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1564-439X","authenticated-orcid":false,"given":"Varun","family":"Malik","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"},{"name":"Department of Cardiology Royal Adelaide Hospital Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony G.","family":"Brooks","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4893-0824","authenticated-orcid":false,"given":"Dominik","family":"Linz","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"},{"name":"Department of Cardiology Royal Adelaide Hospital Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian D.","family":"Elliott","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3803-8429","authenticated-orcid":false,"given":"Prashanthan","family":"Sanders","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"},{"name":"Department of Cardiology Royal Adelaide Hospital Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7086-5865","authenticated-orcid":false,"given":"Amanda","family":"Page","sequence":"additional","affiliation":[{"name":"Centre for Nutrition and Gastrointestinal Diseases The University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias","family":"Baumert","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"},{"name":"School of Electrical and Electronic Engineering The University of Adelaide Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7753-1318","authenticated-orcid":false,"given":"Dennis H.","family":"Lau","sequence":"additional","affiliation":[{"name":"Centre for Heart Rhythm Disorders The University of Adelaide Adelaide Australia"},{"name":"Department of Cardiology Royal Adelaide Hospital Adelaide Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.11.059"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.08.013"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00735.2002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.02.043"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2147\/VHRM.S127393"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2018.01.025"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2015.03.029"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cjca.2019.12.024"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2018.07.001"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.013006"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2014.00230"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.114.04576"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-0620-8_34"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1042\/CS20140251"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.npp.1301005"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-011-0146-2"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21649"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2012.10.013"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.008854"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.2001.280.5.H2162"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1042\/CS20110241"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpheart.00994.2011"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2018.03.004"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/joa3.12325"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-013-0212-z"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.5.939"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2019.10.016"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1227\/00006123-199305000-00006"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jneumeth.2017.04.013"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.120.017861","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T07:02:55Z","timestamp":1715583775000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.120.017861"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,15]]},"references-count":29,"journal-issue":{"issue":"24","published-print":{"date-parts":[[2020,12,15]]}},"alternative-id":["10.1161\/JAHA.120.017861"],"URL":"https:\/\/doi.org\/10.1161\/jaha.120.017861","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,15]]},"assertion":[{"value":"2020-06-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-10-02","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e017861"}}