PURPOSE: Adolescents with postural tachycardia syndrome (POTS) often experience ill-defined cognitive impairment referred to by patients as "brain fog." The objective of this study was to evaluate the symptom of brain fog as a means of gaining further insight into its etiology and potential palliative interventions. METHODS: Eligible subjects who reported having been diagnosed with POTS were recruited from social media web sites. Subjects were asked to complete a 38-item questionnaire designed for this study, and the Wood mental fatigue inventory (WMFI). RESULTS: Responses were received from 138 subjects with POTS (88 % female), ranging in age from 14 to 29 years; 132 subjects reported brain fog. WMFI scores correlated with brain fog frequency and severity (P < 0.001). The top ranked descriptors of brain fog were "forgetful," "cloudy," and "difficulty focusing, thinking and communicating." The most frequently reported brain fog triggers were fatigue (91 %), lack of sleep (90 %), prolonged standing (87 %), dehydration (86 %), and feeling faint (85 %). Although aggravated by upright posture, brain fog was reported to persist after assuming a recumbent posture. The most frequently reported interventions for the treatment of brain fog were intravenous saline (77 %), stimulant medications (67 %), salt tablets (54 %), intra-muscular vitamin B-12 injections (48 %), and midodrine (45 %). CONCLUSIONS: Descriptors for "brain fog" are most consistent with it being a cognitive complaint. Factors other than upright posture may play a role in the persistence of this symptom. Subjects reported a number of therapeutic interventions for brain fog not typically used in the treatment of POTS that may warrant further investigation.
PURPOSE: Adolescents with postural tachycardia syndrome (POTS) often experience ill-defined cognitive impairment referred to by patients as "brain fog." The objective of this study was to evaluate the symptom of brain fog as a means of gaining further insight into its etiology and potential palliative interventions. METHODS: Eligible subjects who reported having been diagnosed with POTS were recruited from social media web sites. Subjects were asked to complete a 38-item questionnaire designed for this study, and the Wood mental fatigue inventory (WMFI). RESULTS: Responses were received from 138 subjects with POTS (88 % female), ranging in age from 14 to 29 years; 132 subjects reported brain fog. WMFI scores correlated with brain fog frequency and severity (P < 0.001). The top ranked descriptors of brain fog were "forgetful," "cloudy," and "difficulty focusing, thinking and communicating." The most frequently reported brain fog triggers were fatigue (91 %), lack of sleep (90 %), prolonged standing (87 %), dehydration (86 %), and feeling faint (85 %). Although aggravated by upright posture, brain fog was reported to persist after assuming a recumbent posture. The most frequently reported interventions for the treatment of brain fog were intravenous saline (77 %), stimulant medications (67 %), salt tablets (54 %), intra-muscular vitamin B-12 injections (48 %), and midodrine (45 %). CONCLUSIONS: Descriptors for "brain fog" are most consistent with it being a cognitive complaint. Factors other than upright posture may play a role in the persistence of this symptom. Subjects reported a number of therapeutic interventions for brain fog not typically used in the treatment of POTS that may warrant further investigation.
Authors: Walker B Plash; André Diedrich; Italo Biaggioni; Emily M Garland; Sachin Y Paranjape; Bonnie K Black; William D Dupont; Satish R Raj Journal: Clin Sci (Lond) Date: 2013-01 Impact factor: 6.124
Authors: Qi Fu; Tiffany B Vangundy; Shigeki Shibata; Richard J Auchus; Gordon H Williams; Benjamin D Levine Journal: Hypertension Date: 2011-06-20 Impact factor: 10.190
Authors: Kanika Bagai; Yanna Song; John F Ling; Beth Malow; Bonnie K Black; Italo Biaggioni; David Robertson; Satish R Raj Journal: J Clin Sleep Med Date: 2011-04-15 Impact factor: 4.062
Authors: Robert S Sheldon; Blair P Grubb; Brian Olshansky; Win-Kuang Shen; Hugh Calkins; Michele Brignole; Satish R Raj; Andrew D Krahn; Carlos A Morillo; Julian M Stewart; Richard Sutton; Paola Sandroni; Karen J Friday; Denise Tessariol Hachul; Mitchell I Cohen; Dennis H Lau; Kenneth A Mayuga; Jeffrey P Moak; Roopinder K Sandhu; Khalil Kanjwal Journal: Heart Rhythm Date: 2015-05-14 Impact factor: 6.343
Authors: Julian M Stewart; Jeffrey R Boris; Gisela Chelimsky; Phillip R Fischer; John E Fortunato; Blair P Grubb; Geoffrey L Heyer; Imad T Jarjour; Marvin S Medow; Mohammed T Numan; Paolo T Pianosi; Wolfgang Singer; Sally Tarbell; Thomas C Chelimsky Journal: Pediatrics Date: 2017-12-08 Impact factor: 7.124
Authors: Julian M Stewart; Andrew T Del Pozzi; Akash Pandey; Zachary R Messer; Courtney Terilli; Marvin S Medow Journal: Hypertension Date: 2014-12-15 Impact factor: 10.190
Authors: Rocío A Figueroa; Amy C Arnold; Victor C Nwazue; Luis E Okamoto; Sachin Y Paranjape; Bonnie K Black; Andre Diedrich; David Robertson; Italo Biaggioni; Satish R Raj; Alfredo Gamboa Journal: J Appl Physiol (1985) Date: 2014-07-24
Authors: Andrew T Del Pozzi; Akash Pandey; Marvin S Medow; Zachary R Messer; Julian M Stewart Journal: Am J Physiol Heart Circ Physiol Date: 2014-05-30 Impact factor: 4.733
Authors: Amy C Arnold; Kirsten Haman; Emily M Garland; Vidya Raj; William D Dupont; Italo Biaggioni; David Robertson; Satish R Raj Journal: Clin Sci (Lond) Date: 2015-01 Impact factor: 6.124