Is Postural Orthostatic Tachycardia Syndrome (POTS) a Central Nervous System Disorder?

Overview

Journal J Neurol

Specialty Neurology

Date 2021 Mar 7

PMID 33677650

Citations 17

Authors

Svetlana Blitshteyn

Affiliations

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Abstract

Postural orthostatic tachycardia syndrome (POTS), a disorder of the autonomic nervous system characterized by a rise in heart rate of at least 30 bpm from supine to standing position, has been traditionally viewed as a dysfunction of the peripheral nervous system. However, recent studies and evidence from overlapping conditions suggest that in addition to being considered a disorder of the peripheral nervous system, POTS should be viewed also as a central nervous system (CNS) disorder given (1) significant CNS symptom burden in patients with POTS; (2) structural and functional differences found on neuroimaging in patients with POTS and other forms of orthostatic intolerance; (3) evidence of cerebral hypoperfusion and possible alteration in cerebrospinal fluid volume, and (4) positive response to medications targeting the CNS and non-pharmacologic CNS therapies. This review outlines existing evidence of POTS as a CNS disorder and proposes a hypothetical model combining key mechanisms in the pathophysiology of POTS. Redefining POTS as a CNS disorder can lead to new possibilities in pharmacotherapy and non-pharmacologic therapeutic interventions in patents affected by this disabling syndrome.

Citing Articles

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Neuroinflammation at the Dorsolateral Inferior Medulla: A Possible Central Nervous System Localization for POTS and Long COVID.

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Exercise in Postural Orthostatic Tachycardia Syndrome: Focus on Individualized Exercise Approach.

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The relationship between cardiovagal baroreflex and cerebral autoregulation in postural orthostatic tachycardia disorder using advanced cross-correlation function.

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