NCT04137757

Brief Summary

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.

Trial Health

75
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
21

participants targeted

Target at below P25 for not_applicable

Timeline
7mo left

Started Feb 2022

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
active not recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress88%
Feb 2022Dec 2026

First Submitted

Initial submission to the registry

October 22, 2019

Completed
2 days until next milestone

First Posted

Study publicly available on registry

October 24, 2019

Completed
2.3 years until next milestone

Study Start

First participant enrolled

February 18, 2022

Completed
4.8 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

December 1, 2026

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

December 1, 2026

Last Updated

September 19, 2025

Status Verified

September 1, 2025

Enrollment Period

4.8 years

First QC Date

October 22, 2019

Last Update Submit

September 18, 2025

Conditions

Outcome Measures

Primary Outcomes (1)

  • Cognitive Brain Region Activation

    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 Outcomes (4)

  • Brain Oxygen Perfusion

    60 minutes

  • Blood Pressure

    60 minutes

  • Heart Rate

    60 minutes

  • Stroop Word-Color Score

    10 minutes

Study Arms (2)

Lower Body Negative Pressure (LBNP)

EXPERIMENTAL

Participants complete mental tasks and imaging while undergoing lower body negative pressure (LBNP).

Other: Lower Body Negative Pressure

Sham Pressure

SHAM COMPARATOR

Participants complete mental tasks and imaging with pressure noise but no pressure.

Other: Sham Pressure

Interventions

Lower body negative pressure will be applied.

Lower Body Negative Pressure (LBNP)

Noise will be turned on but no pressure will be applied.

Sham Pressure

Eligibility Criteria

Age18 Years - 60 Years
Sexall
Healthy VolunteersYes
Age GroupsAdult (18-64)

You may qualify if:

  • Men and women of all races or ethnicity
  • 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).
  • Healthy participants must have cognitive testing scores within normal range (defined by Stroop word-color test score between 40-70) and be able to tolerate lower body negative pressure.
  • POTS participants must have either mild cognitive dysfunction (defined by Stroop word-color t-score \<40 and \>30) or normal cognitive function (defined by Stroop word-color test score between 40-70), and able to tolerate lower body negative pressure.
  • Capable of giving informed consent
  • Fluent in written and spoken English

You may not qualify if:

  • 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

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Penn State Milton S. Hershey Medical Center

Hershey, Pennsylvania, 17033, United States

Location

MeSH Terms

Conditions

Postural Orthostatic Tachycardia Syndrome

Interventions

Lower Body Negative Pressure

Condition Hierarchy (Ancestors)

Orthostatic IntolerancePrimary DysautonomiasAutonomic Nervous System DiseasesNervous System Diseases

Intervention Hierarchy (Ancestors)

DecompressionTherapeutics

Study Officials

  • Amy Arnold, Ph.D.

    Pennsylvania State University College of Medicine

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
DOUBLE
Who Masked
PARTICIPANT, OUTCOMES ASSESSOR
Purpose
BASIC SCIENCE
Intervention Model
CROSSOVER
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

October 22, 2019

First Posted

October 24, 2019

Study Start

February 18, 2022

Primary Completion (Estimated)

December 1, 2026

Study Completion (Estimated)

December 1, 2026

Last Updated

September 19, 2025

Record last verified: 2025-09

Data Sharing

IPD Sharing
Will not share

Locations