{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T23:44:53Z","timestamp":1793231093104,"version":"4.5.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Autonomic disorders, especially those characterized by orthostatic intolerance such as Postural Tachycardia Syndrome (POTS), remain diagnostically and therapeutically challenging due to their complex pathophysiology and limited access to specialized care. This paper proposes a conceptual framework for applying digital twin technology to POTS and other autonomic disorders. A digital autonomic twin\u2014a dynamic, virtual replica of a patient\u2019s autonomic system\u2014offers a transformative approach to understanding, predicting, and managing these conditions. A dynamic digital twin framework integrates mechanistic and AI-based modeling utilizing continuous physiological, clinical, genetic, and patient-reported data to enhance individualized diagnosis, disease monitoring, and treatment. This system can simulate autonomic responses, predict disease trajectories, and personalize interventions. Digital twins provide real-time physiological modeling, adaptive treatment simulations, lifestyle intervention tracking, and integration of environmental and biometric data. Key components include wearable devices, electronic health records, AI-driven simulations, and clinician interfaces. However, challenges such as data volume, model transparency, and ethical considerations must be addressed. In conclusion, digital twin technology has the potential to revolutionize the management of POTS and related autonomic disorders, transitioning to personalized, predictive, adaptive medicine by providing a continuously updated and tailored approach to neurological care.<\/jats:p>","DOI":"10.3389\/fneur.2025.1678955","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T04:20:29Z","timestamp":1760070029000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Digital twin framework for postural tachycardia syndrome and autonomic disorders"],"prefix":"10.3389","volume":"16","author":[{"given":"Peter","family":"Novak","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,10]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"102828","DOI":"10.1016\/j.autneu.2021.102828","article-title":"Postural orthostatic tachycardia syndrome (POTS): state of the science and clinical care from a 2019 National Institutes of Health expert consensus meeting - part 1","volume":"235","author":"Vernino","year":"2021","journal-title":"Auton Neurosci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"133","DOI":"10.1038\/s41579-022-00846-2","article-title":"Long COVID: major findings, mechanisms and recommendations","volume":"21","author":"Davis","year":"2023","journal-title":"Nat Rev Microbiol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1016\/j.amjmed.2018.09.027","article-title":"Autonomic disorders","volume":"132","author":"Novak","year":"2019","journal-title":"Am J Med"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.tcm.2025.07.001","article-title":"The evidence for treatments for postural orthostatic tachycardia syndrome: a systematic review of randomized trials","volume":"2025","author":"Kwok","year":"2025","journal-title":"Trends Cardiovasc Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1016\/j.pcad.2020.03.010","article-title":"Postural orthostatic tachycardia syndrome (POTS): a critical assessment","volume":"63","author":"Olshansky","year":"2020","journal-title":"Prog Cardiovasc Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"711","DOI":"10.3390\/diagnostics14070711","article-title":"Long COVID: long-term impact of SARS-CoV2","volume":"14","author":"Makhluf","year":"2024","journal-title":"Diagnostics (Basel)"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1007\/s12026-025-09661-2","article-title":"Dysautonomia: a common comorbidity of systemic disease","volume":"73","author":"Blitshteyn","year":"2025","journal-title":"Immunol Res"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1476918","DOI":"10.3389\/fneur.2024.1476918","article-title":"Orthostatic intolerance with tachycardia (postural tachycardia syndrome) and without (hypocapnic cerebral hypoperfusion) represent a spectrum of the same disorder","volume":"15","author":"Novak","year":"2024","journal-title":"Front Neurol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3390\/asi4020036","article-title":"Digital twin: origin to future","volume":"4","author":"Singh","year":"2021","journal-title":"Appl Syst Innov"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"e031981","DOI":"10.1161\/JAHA.123.031981","article-title":"Building digital twins for cardiovascular health: from principles to clinical impact","volume":"13","author":"Sel","year":"2024","journal-title":"J Am Heart Assoc"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"100383","DOI":"10.1016\/j.jii.2022.100383","article-title":"Digital twins: state of the art theory and practice, challenges, and open research questions","volume":"30","author":"Sharma","year":"2022","journal-title":"J Ind Inf Integr"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1255","DOI":"10.3390\/jpm12081255","article-title":"Digital twins in healthcare: is it the beginning of a new era of evidence-based medicine? 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