背景:主观经历的认知困难在体位性心动过速综合征的青年中很常见。这些认知障碍的病理生理和心理贡献仍不清楚。
方法:受试者为96名被诊断为体位性心动过速综合征并接受强化疼痛治疗的青少年。参与者完成了认知评估和体位性心动过速综合征症状的测量,疼痛强度,痛苦的灾难,焦虑,抑郁症,功能性残疾。
结果:自我报告的自主神经症状强度,但不是心率变化的严重程度,与认知表现有关。抑郁症状与大多数认知功能指标的下降有关。疼痛强度,痛苦的灾难,和抑郁,但不是认知分数和生理指标,是残疾的重要预测因子。
结论:抑郁似乎是青少年体位性心动过速综合征认知困难的重要原因。这些发现强调了评估和治疗该人群的情感症状以及治疗体位性心动过速综合征症状的医学和生活方式的重要性。
BACKGROUND: Subjectively experienced cognitive difficulties are common in youth with postural orthostatic tachycardia syndrome. The pathophysiological and psychological contributions of these cognitive impairments remain unclear.
METHODS: Participants were 96 adolescents and young adults diagnosed with postural orthostatic tachycardia syndrome and admitted to an intensive pain treatment program. Participants completed cognitive assessment and measures of postural orthostatic tachycardia syndrome symptoms, pain intensity, pain catastrophizing, anxiety, depression, and functional disability.
RESULTS: Self-reported autonomic symptom intensity, but not severity of heart rate change, was associated with cognitive performance. Symptoms of depression were associated with decreases in most measures of cognitive functioning. Pain intensity, pain catastrophizing, and depression but not cognitive scores and physiological measures, were significant predictors of disability.
CONCLUSIONS: Depression appears to be a significant contributor to the cognitive difficulties in youth with postural orthostatic tachycardia syndrome. These findings highlight the importance of assessing and treating affective symptoms in this population along with medical and lifestyle approaches to treating postural orthostatic tachycardia syndrome symptoms.