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Increasing orthostatic stress impairs neurocognitive functioning in CFS
Friday 10 February 2012
[Note: in this article, the authors propose further work to determine whether orthostatic stress has a similar cognitive effect on ME/CFS patients who are orthostatically tolerant.]
CFS (chronic fatigue syndrome) is commonly co-morbid with POTS (postural tachycardia syndrome). Individuals with CFS/POTS experience unrelenting fatigue, tachycardia during orthostatic stress and ill-defined neurocognitive impairment, often described as 'mental fog'.
We hypothesized that orthostatic stress causes neurocognitive impairment in CFS/POTS related to decreased CBFV (cerebral blood flow velocity).
A total of 16 CFS/POTS and 20 control subjects underwent graded tilt table testing (at 0, 15, 30, 45, 60 and 75 degrees) with continuous cardiovascular, cerebrovascular, and respiratory monitoring and neurocognitive testing using an n-back task at each angle.
The n-back task tests working memory, concentration, attention and information processing. The n-back task imposes increasing cognitive challenge with escalating (0-, 1-, 2-, 3- and 4-back) difficulty levels.
Subject dropout due to orthostatic presyncope [faintness] at each angle was similar between groups.
Thus we conclude that increasing orthostatic stress combined with a cognitive challenge impairs the neurocognitive abilities of working memory, accuracy and information processing in CFS/POTS, but that this is not related to changes in cerebral blood flow velocity.
Individuals with CFS/POTS should be aware that orthostatic stress may impair their neurocognitive abilities.
Source: Clinical Science (London), Mar 2012; 122(5):227-38. Ocon AJ, Messer ZR, Medow MS, Stewart JM. Department of Physiology, New York Medical College, Valhalla, New York, USA. [Email: email@example.com]
The above originally appeared here.
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