Structural and Functional Small Fiber Abnormalities in the Neuropathic Postural Tachycardia Syndrome
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{"title"=>"Structural and functional small fiber abnormalities in the neuropathic postural tachycardia syndrome", "type"=>"journal", "authors"=>[{"first_name"=>"Christopher H.", "last_name"=>"Gibbons", "scopus_author_id"=>"8266398200"}, {"first_name"=>"Istvan", "last_name"=>"Bonyhay", "scopus_author_id"=>"14022241300"}, {"first_name"=>"Adam", "last_name"=>"Benson", "scopus_author_id"=>"56028444200"}, {"first_name"=>"Ningshan", "last_name"=>"Wang", "scopus_author_id"=>"55467218400"}, {"first_name"=>"Roy", "last_name"=>"Freeman", "scopus_author_id"=>"7401588363"}], "year"=>2013, "source"=>"PLoS ONE", "identifiers"=>{"isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "pmid"=>"24386408", "doi"=>"10.1371/journal.pone.0084716", "pui"=>"372309703", "issn"=>"19326203", "sgr"=>"84893633634", "scopus"=>"2-s2.0-84893633634"}, "id"=>"dc1e0444-0414-3389-8929-ae4eab884e51", "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<0.05). Neuropathic POTS subjects also had less anxiety and depression and greater overall self-perceived health-related quality of life scores than non-neuropathic POTS subjects. A sub-group of POTS patients (cholinergic POTS) had abnormal proximal sudomotor function and symptoms that suggest gastrointestinal and genitourinary parasympathetic nervous system dysfunction. CONCLUSIONS AND RELEVANCE: POTS subtypes may be distinguished using small fiber and autonomic structural and functional criteria. Patients with non-neuropathic POTS have greater anxiety, greater depression and lower health-related quality of life scores compared to those with neuropathic POTS. These findings suggest different pathophysiological processes underlie the postural tachycardia in neuropathic and non-neuropathic POTS patients. The findings have implications for the therapeutic interventions to treat this disorder.", "link"=>"http://www.mendeley.com/research/structural-functional-small-fiber-abnormalities-neuropathic-postural-tachycardia-syndrome", "reader_count"=>30, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>9, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>2, "Other"=>4, "Student > Master"=>2, "Student > Bachelor"=>5, "Professor"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>1, "Researcher"=>9, "Student > Doctoral Student"=>3, "Student > Ph. D. Student"=>1, "Student > Postgraduate"=>2, "Other"=>4, "Student > Master"=>2, "Student > Bachelor"=>5, "Professor"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>1, "Nursing and Health Professions"=>3, "Biochemistry, Genetics and Molecular Biology"=>1, "Medicine and Dentistry"=>15, "Agricultural and Biological Sciences"=>3, "Neuroscience"=>4, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Psychology"=>1, "Economics, Econometrics and Finance"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>15}, "Neuroscience"=>{"Neuroscience"=>4}, "Psychology"=>{"Psychology"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>3}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>1}, "Unspecified"=>{"Unspecified"=>1}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Korea (South)"=>1, "United States"=>1}, "group_count"=>1}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1330414"], "description"=>"<p>Abnormal results are displayed within the lightly shaded region. The 9 individuals that meet criteria for neuropathic POTS (abnormal skin biopsy and 1 other abnormal test) are in the darkly shaded region. A total of 9 subjects had abnormal intra-epidermal nerve fiber density (skin biopsy). A total of 12 individuals had abnormal quantitative sensory testing (QST). A total of 8 individuals had abnormal sudomotor (QDIRT) testing. * = individuals with neuropathic POTS, <sup>†</sup> = individuals with cholinergic POTS.</p>", "links"=>[], "tags"=>[], "article_id"=>887958, "categories"=>["Biological Sciences"], "users"=>["Christopher H. Gibbons", "Istvan Bonyhay", "Adam Benson", "Ningshan Wang", "Roy Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084716.g001", "stats"=>{"downloads"=>0, "page_views"=>1, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Distribution_of_test_results_/887958", "title"=>"Distribution of test results.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-12-27 03:22:25"}
  • {"files"=>["https://ndownloader.figshare.com/files/1330415"], "description"=>"<div><p>A. The EuroQol VAS for self-perceived healthy-related quality of life (Score of 100 = best imaginable health state, 0= worst imaginable health state). The non-neuropathic POTS had the lowest perceived quality of life, while the neuropathic POTS subjects had lower self-perceived health than control subjects. * <i>p</i>< 0.01 vs. controls, † <i>p</i><0.01 vs. neuropathic POTS (ANOVA with Tamhanes T2 post-hoc test).</p>\n\t\t\t\t\t\t<p>The EuroQol 5D (B) shows the individual sub-dimensions with the percent of individuals reporting abnormalities shown. Significant differences in mobility, usual activities and pain were noted between groups (*=P<0.05, Fishers exact test). A greater percent of non-neuropathic POTS subjects reported self-perceived difficulty across all sub-dimensions than control and neuropathic POTS subjects (with the exception of anxiety which was reported with the same frequency as neuropathic POTS subjects). </p></div>", "links"=>[], "tags"=>["european"], "article_id"=>887959, "categories"=>["Biological Sciences"], "users"=>["Christopher H. Gibbons", "Istvan Bonyhay", "Adam Benson", "Ningshan Wang", "Roy Freeman"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0084716.g002", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Results_of_European_Quality_of_Life_Questionnaire_/887959", "title"=>"Results of European Quality of Life Questionnaire.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2013-12-27 03:22:25"}

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Relative Metric

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