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Structural and Functional Small Fiber Abnormalities in the Neuropathic Postural Tachycardia Syndrome

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  • Christopher H Gibbons
  • Istvan Bonyhay
  • Adam Benson
  • Ningshan Wang
  • Roy Freeman

Abstract

Objective: To define the neuropathology, clinical phenotype, autonomic physiology and differentiating features in individuals with neuropathic and non-neuropathic postural tachycardia syndrome (POTS). Methods: Twenty-four subjects with POTS and 10 healthy control subjects had skin biopsy analysis of intra-epidermal nerve fiber density (IENFD), quantitative sensory testing (QST) and autonomic testing. Subjects completed quality of life, fatigue and disability questionnaires. Subjects were divided into neuropathic and non-neuropathic POTS, defined by abnormal IENFD and abnormal small fiber and sudomotor function. Results: Nine of 24 subjects had neuropathic POTS and had significantly lower resting and tilted heart rates; reduced parasympathetic function; and lower phase 4 valsalva maneuver overshoot compared with those with non-neuropathic POTS (P

Suggested Citation

  • Christopher H Gibbons & Istvan Bonyhay & Adam Benson & Ningshan Wang & Roy Freeman, 2013. "Structural and Functional Small Fiber Abnormalities in the Neuropathic Postural Tachycardia Syndrome," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
    • Handle: RePEc:plo:pone00:0084716
    DOI: 10.1371/journal.pone.0084716
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