Aussie research – prolonged cognitive stress affects cerebral blood flow in POTS

[Sarah Tee]

Abstract: https://pubmed.ncbi.nlm.nih.gov/33280488/#full-view-affiliation-1

Full study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7955388/

Quote

Reduced cerebral blood flow velocity and cognitive dysfunction were evident in patients with POTS following prolonged cognitive stress even in the absence of orthostatic stress.

The authors wanted to investigate whether the “brain fog” that POTS patients experience when doing mental tasks seated corresponded to a drop in cerebral blood flow. It did.

I would have liked them to give the cognitive stress test to supine patients as well, but perhaps that would be too hard because the testing was done via visual tests on an iPad. So the subject would have to lift their hand/arm to tap the screen. Maybe an audio test could work supine? Or use a screen but you answer verbally?

[Sarah Tee]

Oh, they thought of doing it supine:

Quote

Undertaking the study with participants in a supine position would have removed the degree of orthostatic stress associated with sitting but would have hampered performance of the PCST and introduced additional noise to CBFv recordings. 

(PCST = prolonged cognitive stress testing)

Smart bunch, these scientists!

[Sarah Tee]

Sorry, my text has gone small and I can’t seem to fix it.

[MikeO]

have seen this and even the faint clinic i fired 10 times over knows that the lack of cerebral perfusion is a stressor. still comes down to what works for a person. weather being over meded is a cause or some other issue like clogged arteries, vascular or a ans issue. I still see no fix in the dysautonomia outside of trying stuff to improve your well being. some of this IMO can be just off the wall. 

[MaineDoug]

Explains a lot! My cognition is in the tank all the time!

[Sarah Tee]

I feel awful if I look down at something and concentrate. Before I realised this, I would find myself in tears at my sewing machine after trying to make a buttonhole.

Edited to add: For those who don’t sew, I should explain that making a buttonhole is somewhat challenging if your sewing machine doesn’t have an automatic setting or automatic buttonhole attachment. You have to concentrate and look closely at the markings you’ve made on the fabric to get it straight and the right size.

[MaineDoug]

In thinking about this topic I realized why I keep picking up my phone to look for something only to forget what I’m looking for. I think it’s the transient reduction in cerebral blood flow when I look DOWN at my phone! I’ll try keeping my head upright while searching and see if the memory loss improves. 🤔

[Sarah Tee]

I got to wondering whether cerebral blood flow changes with head position in seated people normally.

Found this study – bit obtuse so I wouldn’t recommend reading it – but basically the researchers didn’t find any differences in cerebral blood flow in healthy people seated with their heads upright, tilted forwards, or tilted back.

https://physoc.onlinelibrary.wiley.com/doi/10.14814/phy2.15622

I thought maybe there was a change when looking down, and that normal people can absorb that and don’t notice it. But it looks like there isn’t.

So if looking down is a factor for us, it must be to do with dysautonomia.