Cerebral Hypoperfusion Could Be A Big Problem(If We Have It)

[sue1234]

I was looking through various studies, and I saw this one on MS and cerebral hypoperfusion.

http://www.nature.com/jcbfm/journal/v35/n9/abs/jcbfm2015131a.html

Specifically, at the end, it says that hypoperfusion can cause the cognitive decline and fatigue in MS. Well, what about us POTS people that could potentially have hypoperfusion? Maybe that alone explains my issues with cognitive decline and fatigue.

If anyone has access to the full article, can you see what their recommended treatment for increasing perfusion is?

BTW, I have my most in-depth TTT coming up in a week, and it is supposed to measure cerebral perfusion during the test. I'm interested to see what it shows.

[sue1234]

So, it seems others don't have a big problem with cognitive issues like me? If that is the case, then I'm to the point that I wonder if my cognitive decline isn't related to my POTS. I have had years of low blood sugar, so that could be a culprit, too. Or, hypoglycemia AND POTS, a double whammy!

[ks42]

This is a big issue with POTS. According to all three POTS docs I've seen, almost all of their patients have it to some degree. It's also been fairly well documented in the scientific literature; there are studies & articles from Mayo and other major POTS researchers documenting cognitive dysfunction in POTS. Here's one that is freely available; I can see if I can find more later: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3655280/

Also, there are a ton of threads on the forum on this topic as well (some are a little older). It seems like a pretty pervasive symptom that a lot of us suffer with. You might want to do a search for "brain fog" or "cognitive decline" and see what comes up. I pulled up a few of the ones I remembered reading recently:

http://forums.dinet.org/index.php?/topic/27162-brain-fog/

http://forums.dinet.org/index.php?/topic/27050-do-you-all-find-that-you-have-trouble-making-decisions/

http://forums.dinet.org/index.php?/topic/26998-effect-of-autonomic-dysfunction-on-your-cognitive-stamina-and-ability/

[ks42]

Also, I forgot to mention - I don't have access to the specific article you posted, to see what they were proposing in order to increase cerebral blood flow (CBF), but one of the key words at the end of the abstract is "Bosentan" (a drug typically used for pulmonary hypertension). A few years ago, a study was done where Bosentan was used to restore CBF in MS patients, so I'm guessing that's probably what your article is proposing too. Here's a link to the older study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3619305/

In MS patients, studies found extremely high levels of endothelin-1 in samples taken from jugular veins, and the hypothesis is that this is what's causing the hypoperfusion in MS. Bosentan is an endothelin-1 antagonist (reduces endothelin-1 levels) and that's why they believe it may be effective. I really don't know if POTS patients would have the same high levels.

[Katybug]

Hi sue,

I haven't been in good shape so I haven't been answering too many posts. But, I definitely have cognitive issues and my POTS neuro has said that it is a cerebral hypoperfusion issue. We have never talked about treatment for that symptom as it hasn't been my biggest worry. I do, however, wonder what the long term effects of this hypoperfusion will be.