Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction
Abstract Cognitive dysfunction is frequently reported in individuals with postural orthostatic tachycardia syndrome (POTS), possibly resulting from reduced cerebral blood flow (CBF). We used brain SPECT, an accessible imaging modality that has not been systematically evaluated in this patient group....
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Nature Portfolio
2025-01-01
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| Online Access: | https://doi.org/10.1038/s41598-025-87748-4 |
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| author | Marie-Claire Seeley Howard O’Brien Gemma Wilson Clair Coat Tess Smith Kevin Hickson Reynold Casse Amanda J. Page Celine Gallagher Dennis H. Lau |
| author_facet | Marie-Claire Seeley Howard O’Brien Gemma Wilson Clair Coat Tess Smith Kevin Hickson Reynold Casse Amanda J. Page Celine Gallagher Dennis H. Lau |
| author_sort | Marie-Claire Seeley |
| collection | DOAJ |
| description | Abstract Cognitive dysfunction is frequently reported in individuals with postural orthostatic tachycardia syndrome (POTS), possibly resulting from reduced cerebral blood flow (CBF). We used brain SPECT, an accessible imaging modality that has not been systematically evaluated in this patient group. Retrospective review of participants from our registry was undertaken to identify those who had a brain SPECT performed for investigation of cognitive dysfunction. Abnormal CBF was taken as z-score > 2 standard deviations of healthy control reference values. Patient reported outcome measures (PROMs) such as autonomic, gastric and quality of life symptom scores were analyzed. From a total of 56 participants (mean 34.8 ± 10.7 years, 88% females), PROMs indicate: moderate to severe autonomic dysfunction in 75%; at least mild to moderate gastroparesis in 23%; low global health rating and utility scores. Abnormal CBF was seen in 61% but did not differ by POTS triggers. The regions with the lowest mean z-scores were the lateral prefrontal and sensorimotor cortices. Hierarchal regression analyses found number of brain regions with abnormal CBF, autonomic and gastric symptoms to account for 51% of variances in health utility. Cerebral hypoperfusion is prevalent in those with POTS and cognitive dysfunction even whilst supine, contributing to reduced quality of life. |
| format | Article |
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| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Nature Portfolio |
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| spelling | doaj-art-70cd001c670040b0adcbc4225f14270b2025-02-02T12:22:39ZengNature PortfolioScientific Reports2045-23222025-01-011511910.1038/s41598-025-87748-4Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunctionMarie-Claire Seeley0Howard O’Brien1Gemma Wilson2Clair Coat3Tess Smith4Kevin Hickson5Reynold Casse6Amanda J. Page7Celine Gallagher8Dennis H. Lau9Australian Dysautonomia and Arrhythmia Research CollaborativeAustralian Dysautonomia and Arrhythmia Research CollaborativeAustralian Dysautonomia and Arrhythmia Research CollaborativeThe Queen Elizabeth HospitalThe Queen Elizabeth HospitalThe Queen Elizabeth HospitalThe Queen Elizabeth HospitalFaculty of Health and Medical Science, The University of AdelaideAustralian Dysautonomia and Arrhythmia Research CollaborativeAustralian Dysautonomia and Arrhythmia Research CollaborativeAbstract Cognitive dysfunction is frequently reported in individuals with postural orthostatic tachycardia syndrome (POTS), possibly resulting from reduced cerebral blood flow (CBF). We used brain SPECT, an accessible imaging modality that has not been systematically evaluated in this patient group. Retrospective review of participants from our registry was undertaken to identify those who had a brain SPECT performed for investigation of cognitive dysfunction. Abnormal CBF was taken as z-score > 2 standard deviations of healthy control reference values. Patient reported outcome measures (PROMs) such as autonomic, gastric and quality of life symptom scores were analyzed. From a total of 56 participants (mean 34.8 ± 10.7 years, 88% females), PROMs indicate: moderate to severe autonomic dysfunction in 75%; at least mild to moderate gastroparesis in 23%; low global health rating and utility scores. Abnormal CBF was seen in 61% but did not differ by POTS triggers. The regions with the lowest mean z-scores were the lateral prefrontal and sensorimotor cortices. Hierarchal regression analyses found number of brain regions with abnormal CBF, autonomic and gastric symptoms to account for 51% of variances in health utility. Cerebral hypoperfusion is prevalent in those with POTS and cognitive dysfunction even whilst supine, contributing to reduced quality of life.https://doi.org/10.1038/s41598-025-87748-4Postural orthostatic tachycardia syndromeCerebral blood flowBrain SPECTOrthostatic intolerancePost-acute sequelae of COVID-19 |
| spellingShingle | Marie-Claire Seeley Howard O’Brien Gemma Wilson Clair Coat Tess Smith Kevin Hickson Reynold Casse Amanda J. Page Celine Gallagher Dennis H. Lau Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction Scientific Reports Postural orthostatic tachycardia syndrome Cerebral blood flow Brain SPECT Orthostatic intolerance Post-acute sequelae of COVID-19 |
| title | Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction |
| title_full | Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction |
| title_fullStr | Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction |
| title_full_unstemmed | Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction |
| title_short | Novel brain SPECT imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction |
| title_sort | novel brain spect imaging unravels abnormal cerebral perfusion in patients with postural orthostatic tachycardia syndrome and cognitive dysfunction |
| topic | Postural orthostatic tachycardia syndrome Cerebral blood flow Brain SPECT Orthostatic intolerance Post-acute sequelae of COVID-19 |
| url | https://doi.org/10.1038/s41598-025-87748-4 |
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