Department of Psychiatry, Cardiac Sciences, and Family Medicine, University of Calgary, 1213 4th Street SW, Calgary, Alberta T2R 0X7, Canada.
Department of Psychological Medicine, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, United Kingdom.
Auton Neurosci. 2018 Dec;215:46-55. doi: 10.1016/j.autneu.2018.03.004. Epub 2018 Mar 27.
Postural tachycardia syndrome (POTS) is one of the most common forms of chronic orthostatic intolerance. In addition to orthostatic symptoms, many POTS patients report incapacitating cognitive dysfunction or "brain fog" even while lying down or seated. Consistent with these subjective reports, there is accruing objective evidence of specific cognitive difficulties in POTS, with studies showing mild to moderate cognitive impairment using standardized neuropsychological assessment batteries. The precise profile of cognitive dysfunction in POTS patients has been shown to vary among these studies potentially due to the neuropsychological tests used, postural position, comorbidities and length of illness, inclusion of adolescent versus adult patients, and sites of recruitment. The extent of the impact that this cognitive challenge has in patients justifies ongoing investigation and research into lifestyle and pharmacological treatments. Psychologically, patients face challenges congruent with many chronic illnesses, perhaps especially early in adjusting to the condition. POTS patients often exhibit mild to moderate depression symptoms as well as symptoms of anxiety disorders. Since even low levels of anxiety can exacerbate symptoms, and a high number of patients experience sub-clinical low mood and sleep disturbances, there is a likely role for psychotherapy in helping control adjustment-related issues, and possibly aberrant physiology, in POTS.
体位性心动过速综合征（POTS）是慢性直立不耐受最常见的形式之一。除直立症状外，许多 POTS 患者即使躺着或坐着也会报告使人无力的认知功能障碍或“脑雾”。这些主观报告与客观证据一致，表明 POTS 患者存在特定的认知困难，研究使用标准化神经心理学评估工具显示存在轻度至中度认知障碍。在这些研究中，POTS 患者认知功能障碍的具体特征可能因使用的神经心理学测试、体位、合并症和疾病持续时间、青少年与成年患者的纳入以及招募地点而异。认知挑战对患者的影响程度证明有必要对生活方式和药物治疗进行持续调查和研究。从心理上讲，患者面临着与许多慢性疾病相一致的挑战，也许在适应病情的早期更是如此。POTS 患者常表现出轻度至中度抑郁症状以及焦虑障碍症状。由于即使是低水平的焦虑也会加重症状，并且许多患者都经历亚临床情绪低落和睡眠障碍，因此心理治疗在帮助控制与适应相关的问题，以及可能的异常生理方面，在 POTS 中可能发挥作用。
