title: Changes in cerebral blood oxygenation induced by active standing test in children with POTS and NMS.
abstract: Orthostatic dysregulation (OD) has been classified into subtypes by heart rate and blood pressure; however, the hemodynamics of brains have not yet been revealed. Therefore, we investigated changes in cerebral blood flow and oxygenation during an active standing test to clarify the pathophysiology of two subtypes: postural tachycardia syndrome (POTS) and neurally mediated syncope (NMS). We studied 31 children (15 boys, 16 girls; mean age, 14.0 ± 1.7 years) who presented with OD at the Department of Pediatrics and Child Health, Nihon University School of Medicine between 2009 and 2011. OD was diagnosed using the Japanese clinical guidelines for juvenile orthostatic dysregulation. After a 10-min resting period in the supine position, patients were asked to quickly stand up and keep upright for 10 min. Cerebral blood flow and cerebral oxygenation were measured using transcranial Doppler sonography and near-infrared spectroscopy. POTS showed a significant decrease of oxy-Hb and resistance index (RI), suggesting transient ischemia with maintainable cerebral autoregulation. NMS showed a decrease of oxy-Hb and an increase of RI, suggesting ischemia and impairment of autoregulation.
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Endo
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan. fujita.yukihiko@nihon-u.ac.jp.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Fujita
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Fuchigami
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Shori
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchi-Kamicho, Itabashi-ku, Tokyo, 173-8610, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Mugishima
authors.affiliation: Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan.|Nihon University College of Engineering, Tokyo, Japan.
authors.forename: Kaoru
authors.initials: K
authors.lastname: Skatani
mesh_terms: D002560:Cerebrovascular Circulation; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010100:Oxygen / Q000097:blood*; D054972:Postural Orthostatic Tachycardia Syndrome / Q000097:blood*; D011187:Posture; D013575:Syncope / Q000097:blood*
chemical_list: D010100:Oxygen