Post-Concussive Orthostatic Tachycardia is Distinct from POTS in Children and Adolescents, 2022, Rachel Pearson MD et al

[Mij]

Abstract

Background: Orthostatic tachycardia (OT) affects some patients after concussion/mild traumatic brain injury (mTBI). In this study, we sought to identify the factors associated with increased risk for OT in patients with mTBI.

Methods: We conducted a retrospective review of 268 patients (8-25 years) with mTBI/concussion to determine the prevalence of OT, defined as orthostatic heart rate change ≥40 bpm for those ≤19 years of age and ≥30 bpm on active standing test for those >19 years of age.

Results: Among the study population, 7% (n = 19) exhibited post-concussive OT. The only significant difference between OT and non-OT groups was that history of prior concussion was more prevalent in the OT group.

Conclusion: A substantial subset (7%) of concussion clinic patients exhibit OT. While POTS literature describes female and adolescent predominance, post-concussive OT had similar prevalence across age and gender groups in this study, suggesting that it may be distinct from POTS.

https://journals.sagepub.com/doi/full/10.1177/2329048X221082753

 

[Hutan]

Just working off the title and the abstract:
The title says that post-concussive orthostatic tachycardia is different to POTS. However, the abstract tells us that the criteria used was the same - a defined increase in beats per minute in an active standing test. The abstract is much less absolutist about whether post-concussive orthostatic tachycardia is different to POTS - "suggesting that it may be distinct".

And the reason for the the two things being (or possibly being) different? The abstract says that they are different because the patterns of prevalence in terms of age and gender are different. Surely that alone is not enough to suggest diseases are different, much less to know for sure that they are different.

It's not just the orthostatic tachycardia that is shared

There is considerable overlap between POTS symptoms and post-concussion symptoms, such as headache, fatigue, brain fog, disturbance in mood, and anxiety.

I can't manage to finish reading the paper, but am interested to know if they identify any differences other than prevalence in gender and age group.

 

[Jonathan Edwards]

This looks like a write up of a trainee fellowship project.