Cognitive Dysfunction in Postural Tachycardia Syndrome

NCT ID: NCT01366963

Last Updated: 2016-08-17

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

60 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-03-31

Study Completion Date

2015-06-30

Brief Summary

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A common complaint among people with Postural Tachycardia Syndrome (POTS) is "brain fog" or difficulty concentrating. This is very poorly understood. To better understand this cognitive dysfunction, the investigators will test people with POTS and people without POTS using various neuropsychiatric instruments. The investigators hypothesis is that people with POTS will have greater abnormalities on neuropsychiatric testing than normal controls.

Detailed Description

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Postural Tachycardia Syndrome (POTS) is a disorder that affects an estimated 500,000 people in the United States alone and is an important source of disability in young adults. It shows a strong predilection for females. POTS is a form of orthostatic intolerance characterized by an excessive increase in heart rate (\>30 bpm) on assuming the upright position associated with orthostatic symptoms, but in the absence of orthostatic hypotension. Their symptoms of dizziness, nausea, tremor, chronic fatigue and exercise intolerance make even simple activities of daily living exhausting prospects.

Brain fog or cognitive dysfunction is a common and almost universal complaint among persons with POTS. There is a lack of pathophysiological understanding to this cognitive dysfunction and is also a major roadblock to the development of effective therapies for people with POTS.

The purpose of this study is to better define the cognitive dysfunction seen in patients with POTS. We will use a series of validated neuropsychological tools in order to characterize POTS cognitive dysfunction and compare this data to age and gender matched control subjects.

Specific Aims:

1. To assess whether POTS patients have more neuropsychological abnormalities than control subjects during seated assessments.
2. To assess whether POTS patients have more neuropsychological abnormalities than control subjects during assessments while standing.
3. To ascertain the phenomenology of any neuropsychological deficits distinguishing POTS patients from controls.

Conditions

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Postural Tachycardia Syndrome

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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Normal Controls / Healthy Volunteers

Age and gender matched individuals without postural orthostatic tachycardia syndrome

Seated Measurements

Intervention Type BEHAVIORAL

The following measurements will take place in a seated position:

Ruff 1 \& 7 (visual search and attention processes) Trails A \& B (Tests of scanning, mental flexibility and executive processes) Symbol Digit Modalities Test (SDMT)(attention and psychomotor speed) Stroop Test (naming response to certain stimuli) Verbal Fluency (COWA) Randt Wechsler Test of Adult Reading (WTAR)

Standing Measurements

Intervention Type BEHAVIORAL

The following will be measured in a standing position (at least 5 minutes)

Orthostatic Vital Signs Randt Paired Words Subtest Digits Forward and Backward Alternate COWA test

Self-Administered Surveys

Intervention Type BEHAVIORAL

Center for Epidemiologic Studies Depression Scale (CES-D) Cognitive-Somatic Anxiety Questionnaire (CSAQ) Subjective Neurocognitive Inventory (SNI)

Patients with Postural Tachycardia Syndrome (POTS)

Individuals with Postural Tachycardia Syndrome

Seated Measurements

Intervention Type BEHAVIORAL

The following measurements will take place in a seated position:

Ruff 1 \& 7 (visual search and attention processes) Trails A \& B (Tests of scanning, mental flexibility and executive processes) Symbol Digit Modalities Test (SDMT)(attention and psychomotor speed) Stroop Test (naming response to certain stimuli) Verbal Fluency (COWA) Randt Wechsler Test of Adult Reading (WTAR)

Standing Measurements

Intervention Type BEHAVIORAL

The following will be measured in a standing position (at least 5 minutes)

Orthostatic Vital Signs Randt Paired Words Subtest Digits Forward and Backward Alternate COWA test

Self-Administered Surveys

Intervention Type BEHAVIORAL

Center for Epidemiologic Studies Depression Scale (CES-D) Cognitive-Somatic Anxiety Questionnaire (CSAQ) Subjective Neurocognitive Inventory (SNI)

Interventions

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Seated Measurements

The following measurements will take place in a seated position:

Ruff 1 \& 7 (visual search and attention processes) Trails A \& B (Tests of scanning, mental flexibility and executive processes) Symbol Digit Modalities Test (SDMT)(attention and psychomotor speed) Stroop Test (naming response to certain stimuli) Verbal Fluency (COWA) Randt Wechsler Test of Adult Reading (WTAR)

Intervention Type BEHAVIORAL

Standing Measurements

The following will be measured in a standing position (at least 5 minutes)

Orthostatic Vital Signs Randt Paired Words Subtest Digits Forward and Backward Alternate COWA test

Intervention Type BEHAVIORAL

Self-Administered Surveys

Center for Epidemiologic Studies Depression Scale (CES-D) Cognitive-Somatic Anxiety Questionnaire (CSAQ) Subjective Neurocognitive Inventory (SNI)

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

All

* Ages between 18-60 years
* Male and female subjects are eligible
* Able and willing to provide informed consent



* Gender matched to POTS patients
* Age-matched to POTS patients (+/- 5 years of a POTS patient)
* Grossly matched in intelligence to POTS patients

Exclusion Criteria

ALL

* Inability to give or withdrawal of informed consent
* Pregnancy (determined by patient self report)
* Other factors which in the investigator's opinion would prevent the subject from completing the protocol.


\- Overt cause for postural tachycardia (such as acute dehydration)


* Previously diagnosed with Axis I psychiatric disorder
* Previously diagnosed learning disorder
* Previously diagnosed attention deficit hyperactivity disorder (ADHD)
* Prior psychosis
* past or present substance abuse
* History of loss of consciousness
* History of seizures
Minimum Eligible Age

18 Years

Maximum Eligible Age

60 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Vanderbilt University

OTHER

Sponsor Role lead

Responsible Party

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Satish R. Raj

Assistant Professor of Medicine

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Satish Raj, MD, MSCI

Role: PRINCIPAL_INVESTIGATOR

Vanderbilt University

Locations

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Vanderbilt University

Nashville, Tennessee, United States

Site Status

Countries

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United States

References

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Raj V, Haman KL, Raj SR, Byrne D, Blakely RD, Biaggioni I, Robertson D, Shelton RC. Psychiatric profile and attention deficits in postural tachycardia syndrome. J Neurol Neurosurg Psychiatry. 2009 Mar;80(3):339-44. doi: 10.1136/jnnp.2008.144360. Epub 2008 Oct 31.

Reference Type BACKGROUND
PMID: 18977825 (View on PubMed)

Ruff RM, Niemann H, Allen CC, Farrow CE, Wylie T. The Ruff 2 and 7 Selective Attention Test: a neuropsychological application. Percept Mot Skills. 1992 Dec;75(3 Pt 2):1311-9. doi: 10.2466/pms.1992.75.3f.1311.

Reference Type BACKGROUND
PMID: 1484803 (View on PubMed)

Messinis L, Kosmidis MH, Tsakona I, Georgiou V, Aretouli E, Papathanasopoulos P. Ruff 2 and 7 Selective Attention Test: normative data, discriminant validity and test-retest reliability in Greek adults. Arch Clin Neuropsychol. 2007 Aug;22(6):773-85. doi: 10.1016/j.acn.2007.06.005. Epub 2007 Jul 20.

Reference Type BACKGROUND
PMID: 17640850 (View on PubMed)

Tombaugh TN. Trail Making Test A and B: normative data stratified by age and education. Arch Clin Neuropsychol. 2004 Mar;19(2):203-14. doi: 10.1016/S0887-6177(03)00039-8.

Reference Type BACKGROUND
PMID: 15010086 (View on PubMed)

Ruff RM, Light RH, Parker SB, Levin HS. Benton Controlled Oral Word Association Test: reliability and updated norms. Arch Clin Neuropsychol. 1996;11(4):329-38.

Reference Type BACKGROUND
PMID: 14588937 (View on PubMed)

Schwartz GE, Davidson RJ, Goleman DJ. Patterning of cognitive and somatic processes in the self-regulation of anxiety: effects of meditation versus exercise. Psychosom Med. 1978 Jun;40(4):321-8. doi: 10.1097/00006842-197806000-00004.

Reference Type BACKGROUND
PMID: 356080 (View on PubMed)

Moritz S, Kuelz AK, Jacobsen D, Kloss M, Fricke S. Severity of subjective cognitive impairment in patients with obsessive-compulsive disorder and depression. J Anxiety Disord. 2006;20(4):427-43. doi: 10.1016/j.janxdis.2005.04.001. Epub 2005 Jun 1.

Reference Type BACKGROUND
PMID: 15935611 (View on PubMed)

Lezak MD, Howieson DB, Oring DW, Annay HJ, Isher JS. Neuropsychological Assessment. New York:Oxford University Press;2004

Reference Type BACKGROUND

Smith A. Symbol Digit Modalitites Test.Los Angeles:Western Psychological Services; 1982.

Reference Type BACKGROUND

Wechsler D. The Wechsler Test of Adult Reading. San Antonio, Texas: PsychCorp;2001.

Reference Type BACKGROUND

Radloff LS. The CES-D Scale: A self-report depression scale for resarch in the general population. Applied Psychological Measurement 1077;1:385-401.

Reference Type BACKGROUND

Putzke JD, Williams MA, Daniel FJ, Bourge RC, Boll TJ. Self-report versus performance based activities of daily living capacity among heart transplanta candidates and their caregivers. Journal of Clinical Psychology in Medical Settings 2000;7:121-32.

Reference Type BACKGROUND

Other Identifiers

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101401

Identifier Type: -

Identifier Source: org_study_id

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