- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04137757
fMRI in Postural Tachycardia Syndrome (POTS)
May 2, 2024 updated by: Amy Arnold, Milton S. Hershey Medical Center
Neural Correlates of Cognitive Dysfunction in Postural Tachycardia Syndrome
Postural tachycardia syndrome (POTS) is one of the most common forms of chronic orthostatic intolerance in the United States.
This is a disabling disorder characterized by an excessive increase in heart rate upon standing that is accompanied by symptoms such as dizziness and fatigue.
One of the most under appreciated and bothersome symptoms of POTS is impaired cognition or "brain fog," which occurs to a level that interferes with daily activities such as work and education.
Despite this high impact, the reasons why POTS patients have problems with cognition are not well understood.
This project will test the overall hypothesis that "brain fog" in POTS is related to increased activation of cognitive brain regions during mental tasks when compared with healthy subjects, and that this activation is exacerbated by in the presence of orthostatic stress.
Study Overview
Status
Recruiting
Conditions
Intervention / Treatment
Detailed Description
A randomized, double blind, crossover study will be conducted to determine if there are differences in resting brain structure and blood oxygen perfusion in postural tachycardia syndrome (POTS) compared with healthy subjects, and to identify the pattern of brain activation produced by cognitive testing under resting conditions and in the presence of a physical challenge mimicking orthostatic stress (lower body negative pressure, LBNP).
This is an outpatient study that requires a screening visit in the Clinical Research Center within the Penn State Hershey Medical Center, and if eligible, two study visits in the Penn State Center for Nuclear Magnetic Resonance Imaging involving blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI) and a cognitive test while lying in a magnetic resonance imaging (MRI) scanner with the lower body placed in the LBNP chamber.
The LBNP chamber applies suction to the lower body to pool blood in the legs and physiologically mimic what happens when standing up.
Blood pressure, heart rate, and oxygen saturation will be measured throughout the study.
A scan will be performed while at rest to look at the structure and blood oxygen perfusion in the brain.
The LBNP or sham pressure will then be initiated, with the order determined randomly and the other stress applied at the second study visit.
Once the appropriate level of pressure is achieved, brain oxygen perfusion will be measured and subjects will be asked to complete one test of cognitive function.
At the end of the cognitive test, brain oxygen levels will be measured and the testing will end.
The time inside the MRI scanner at each study visit will be approximately 45 minutes.
Study Type
Interventional
Enrollment (Estimated)
55
Phase
- Not Applicable
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Aimee J Cauffman, RN
- Phone Number: 717-531-1617
- Email: acauffman@pennstatehealth.psu.edu
Study Contact Backup
- Name: Amy C Arnold, Ph.D.
- Phone Number: 717-531-3674
- Email: aca17@psu.edu
Study Locations
-
-
Pennsylvania
-
Hershey, Pennsylvania, United States, 17033
- Recruiting
- Penn State Milton S. Hershey Medical Center
-
Contact:
- Aimee Cauffman, RN
- Phone Number: 717-531-1617
- Email: acauffman@pennstatehealth.psu.edu
-
Contact:
- Amy Arnold, PhD
- Phone Number: 717-531-3674
- Email: aca17@psu.edu
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
16 years to 58 years (Adult)
Accepts Healthy Volunteers
Yes
Description
Inclusion Criteria:
- Men and women of all races
- Age 18-60
- Healthy volunteers or previously diagnosed with POTS by current consensus criteria (rise in heart rate of at least 30 beats/minute within 10 minutes of standing; absence of orthostatic hypotension defined as a drop in blood pressure greater than 20/10 mmHg within 3 minutes of standing; and presence of daily orthostatic symptoms for at least 6 months such as lightheadedness, dizziness, nausea, and palpitations).
- Capable of giving informed consent
- Fluent in written and spoken English
Exclusion Criteria:
- Age <18 years or >60 years
- Pregnant or breastfeeding women
- Left handedness
- Require glasses for vision correction (contact lenses are okay)
- Current smokers
- Alcohol or drug abuse
- Recreational drug use (e.g. cannabis, heroin, cocaine)
- Other potential causes for tachycardia (e.g. prolonged bed rest, dehydration)
- Taking selective norepinephrine reuptake inhibitors or stimulant medications within the past 3 months as these may alter cognition
- Unable to tolerate an MRI scanner (e.g. claustrophobia, implanted metal)
- Unable to give or withdraw informed consent
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Basic Science
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Lower Body Negative Pressure (LBNP)
Participants complete mental tasks and imaging while undergoing lower body negative pressure (LBNP).
|
Lower body negative pressure will be applied.
|
Sham Comparator: Sham Pressure
Participants complete mental tasks and imaging with pressure noise but no pressure.
|
Noise will be turned on but no pressure will be applied.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cognitive Brain Region Activation
Time Frame: 60 minutes
|
The change in activation of cognitive brain regions measured by blood oxygen dependent functional magnetic resonance imaging following cognitive tasks and orthostatic stress.
|
60 minutes
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Brain Oxygen Perfusion
Time Frame: 60 minutes
|
The change in brain oxygen perfusion measured by arterial spin labeling magnetic resonance imaging following cognitive tasks and orthostatic stress.
|
60 minutes
|
Blood Pressure
Time Frame: 60 minutes
|
The change in blood pressure following cognitive tasks and orthostatic stress.
|
60 minutes
|
Heart Rate
Time Frame: 60 minutes
|
The change in heart rate following cognitive tasks and orthostatic stress.
|
60 minutes
|
Stroop Word-Color Score
Time Frame: 10 minutes
|
The change in the Stroop word-color test score following orthostatic stress and sham stress.
This test measure executive function.
The scores are T-scores normalized to population averages based on age and education level from 0 to 100.
A higher score indicates better executive function.
|
10 minutes
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Investigators
- Principal Investigator: Amy C Arnold, Ph.D., Milton S. Hershey Medical Center
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
February 18, 2022
Primary Completion (Estimated)
December 1, 2024
Study Completion (Estimated)
December 1, 2024
Study Registration Dates
First Submitted
October 22, 2019
First Submitted That Met QC Criteria
October 22, 2019
First Posted (Actual)
October 24, 2019
Study Record Updates
Last Update Posted (Actual)
May 3, 2024
Last Update Submitted That Met QC Criteria
May 2, 2024
Last Verified
May 1, 2024
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Study00012860
- UL1TR002014 (U.S. NIH Grant/Contract)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Postural Tachycardia Syndrome
-
Vanderbilt University Medical CenterNational Heart, Lung, and Blood Institute (NHLBI)RecruitingPostural Tachycardia Syndrome (POTS)United States
-
Vanderbilt University Medical CenterNational Heart, Lung, and Blood Institute (NHLBI); National Institutes of Health...CompletedPostural Tachycardia Syndrome (POTS)United States
-
Mayo ClinicNot yet recruitingPostural Tachycardia Syndrome | Postural Orthostatic Tachycardia Syndrome | Autonomic Dysfunction | POTS - Postural Orthostatic Tachycardia SyndromeUnited States
-
argenxIqvia Pty LtdRecruitingPost-COVID Postural Orthostatic Tachycardia Syndrome Postural Orthostatic Tachycardia SyndromeUnited States
-
AtriCure, Inc.RecruitingPostural Tachycardia Syndrome | Inappropriate Sinus TachycardiaBelgium
-
University of CalgaryDysautonomia InternationalRecruiting
-
University of CalgaryCompleted
-
University of CalgaryRecruiting
-
Mayo ClinicNational Institute of Neurological Disorders and Stroke (NINDS)RecruitingPostural Tachycardia SyndromeUnited States
-
Insel Gruppe AG, University Hospital BernActive, not recruiting
Clinical Trials on Lower Body Negative Pressure
-
University of British ColumbiaRecruitingHeart Failure With Preserved Ejection FractionCanada
-
Yale UniversityRecruitingHypovolemia | Hemodynamic InstabilityUnited States
-
University of Texas Southwestern Medical CenterCompletedSpace Flight Associated Neuro-ocular SyndromeUnited States
-
Mayo ClinicCompletedHypotension and ShockUnited States
-
University Hospital, LinkoepingCompleted
-
Mayo ClinicCompletedHypotension and ShockUnited States
-
University of Illinois at ChicagoEunice Kennedy Shriver National Institute of Child Health and Human Development...Terminated
-
Oslo University HospitalCompleted
-
Oslo University HospitalUniversity Hospital, AkershusRecruitingHypovolemia | Hemodynamic Instability | Fluid LossNorway