Structural brain abnormalities in postural tachycardia syndrome: A VBM-DARTEL study

Area of Science:

• Neuroscience
• Cardiology
• Psychiatry

Background:

• Postural tachycardia syndrome (PoTS) is a prevalent form of dysautonomia causing orthostatic intolerance.
• PoTS symptoms include palpitations, lightheadedness, fatigue, anxiety, and depression.
• The neural underpinnings of PoTS remain poorly understood.

Purpose of the Study:

• To investigate regional brain structural variations in patients with PoTS using MRI.
• To explore the relationship between brain structure and psychiatric symptoms in PoTS.

Main Methods:

• Magnetic resonance imaging (MRI) with voxel-based morphometry (VBM) and DARTEL procedure.
• Comparison of brain gray and white matter volumes between 11 PoTS patients and 23 controls.
• Correlation analysis between insula volume and anxiety/depression scores.

Main Results:

• PoTS patients exhibited reduced gray matter volume in the left anterior insula, right middle frontal gyrus, and right cingulate gyrus.
• Decreased white matter volume was observed beneath the precentral gyrus, paracentral lobule, and other frontal regions.
• Left insula volume negatively correlated with trait anxiety and depression scores.

Conclusions:

• Structural brain differences, particularly in the insula and cingulate cortex, are associated with PoTS.
• These findings suggest a link between autonomic dysfunction, altered interoception, and psychiatric comorbidities in PoTS.
• Compromised central autonomic control may increase vulnerability to anxiety and depression in PoTS patients.