Decision-Making in Patients with Vasovagal Syncope: A Preliminary Study

The aim of this study was to evaluate the differences in performance during a decisional conflict task between subjects with emotional/blood phobia and those with an orthostatic vasovagal syncope. A total of 332 young subjects were included, from which 99 were excluded because of their condition or treatment. The subjects were classified into four groups depending on their responses to a questionnaire: 98 in a control group, 10 in an emotional/blood phobia syncope group, 38 in an orthostatic syncope group, and 87 in an unclear status group. This former group was excluded. The subjects performed a decisional conflict task to quantify their conflict-management ability. The task was the computer version of the Simon Task. Emotional/blood phobia syncope subjects showed a delayed reaction time when faced with decisional conflict in comparison with the control and orthostatic syncope subjects (55.8 ± 17.7 ms, 20.5 ± 4.9 ms, and 13.4 ± 9.2 ms, respectively, p ≤ 0.05). Our result suggests that emotional/blood phobia and orthostatic syncope are two clinical entities. Decisions could be a target of management in patients with emotional/blood phobia syncope. The altered decision-making of subjects with emotion/blood phobia syncope emphasized the role of higher cerebral functions in blood pressure control.