An alternative "Port"? Rationale and development process for POts Reprocessing Therapy (PORT), a brain-body therapy...

Area of Science:

• Neuroscience
• Autonomic Dysfunction
• Psychiatry

Background:

• Postural tachycardia syndrome (POTS) is a chronic disorder characterized by excessive orthostatic tachycardia without a clear organic cause.
• Emerging evidence suggests central nervous system dysregulation may drive POTS symptoms, similar to centralized chronic pain disorders.

Purpose of the Study:

• To describe the rationale and development of a novel brain-body intervention, POTS Reprocessing Therapy (PORT), for POTS.
• To leverage brain plasticity for reducing orthostatic symptomatology.

Main Methods:

• PORT was adapted from pain reprocessing therapy (PRT), an established mind-body intervention for chronic pain.
• A focus group with five POTS patients who received an early version of PORT was conducted.
• Rapid qualitative analysis informed protocol refinement based on participant feedback.

Main Results:

• The PORT protocol includes medical evaluation and eight weekly sessions with components like psychoeducation, symptom exposure, somatic inquiry, and emotional processing.
• Focus group participants reported reduced symptom-related fear, better condition understanding, and improved functioning.
• Participant feedback highlighted the need for sensitive communication and implementation due to emotional challenges.

Conclusions:

• PORT is a novel therapeutic treatment targeting centrally mediated processes in POTS.
• The intervention aims to address hypothesized underlying mechanisms of autonomic dysregulation.
• Further trials are ongoing to evaluate PORT's feasibility, acceptability, and efficacy.