Research square · 2026
Feasibility and Preliminary Outcomes of a Brain/Body Intervention for Postural Tachycardia Syndrome (POTS): Pilot Trial of POts Reprocessing Therapy (PORT).
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Crouch Taylor B, Chase Spencer Owen, Redman Tammy, Wells Mary, Ashar Yoni K, Schubiner Howard, Maxwell Madison, Popoff Elliot, Chelimsky Gisela, Chelimsky Thomas
Аннотация
PURPOSE: Postural tachycardia syndrome (POTS) is a chronic autonomic disorder characterized by orthostatic intolerance and frequently accompanied by a broad constellation of debilitating symptoms. Emerging evidence suggests that dysregulation within central-autonomic regulatory networks may contribute to symptom persistence. We developed POts Reprocessing Therapy (PORT), a neuroplasticity-informed behavioral intervention adapted from Pain Reprocessing Therapy. This pilot study evaluated the feasibility, acceptability, and preliminary clinical outcomes of PORT for individuals with POTS.
METHODS: We conducted a non-randomized, two-arm, open-label pilot feasibility trial. Adults with clinically significant POTS symptoms (Malmö POTS Symptom Score ≥ 42) received eight weekly PORT sessions (n = 14). A comparison group of adults with POTS receiving community care while awaiting entry to an autonomic clinic served as controls (n = 15). Self-report measures were collected at baseline and 8-week follow-up, including POTS symptom severity (Malmö), symptom catastrophizing, anxiety, depression, pain, fatigue, and quality of life. Feasibility and acceptability were assessed via recruitment, retention, and treatment satisfaction.
RESULTS: PORT demonstrated strong feasibility and acceptability, with 83% retention and strong satisfaction ratings among completers. Participants receiving PORT reported greater symptom improvement compared with community care controls. Mixed ANOVA analyses revealed significant group × time interactions for POTS symptoms (ηp2 = 0.283), anxiety (ηp2 = 0.363), symptom catastrophizing (ηp2 = 0.193), and depression (ηp2 = 0.186), reflecting moderate-to-large effect sizes.
CONCLUSION: This pilot study suggests that PORT is a feasible and acceptable intervention and may be associated with improvements in POTS symptom burden and related psychological processes. Findings provide preliminary support for targeting central-autonomic processes through neuroplasticity-based interventions and warrant larger randomized controlled trials to evaluate efficacy and underlying mechanisms.
METHODS: We conducted a non-randomized, two-arm, open-label pilot feasibility trial. Adults with clinically significant POTS symptoms (Malmö POTS Symptom Score ≥ 42) received eight weekly PORT sessions (n = 14). A comparison group of adults with POTS receiving community care while awaiting entry to an autonomic clinic served as controls (n = 15). Self-report measures were collected at baseline and 8-week follow-up, including POTS symptom severity (Malmö), symptom catastrophizing, anxiety, depression, pain, fatigue, and quality of life. Feasibility and acceptability were assessed via recruitment, retention, and treatment satisfaction.
RESULTS: PORT demonstrated strong feasibility and acceptability, with 83% retention and strong satisfaction ratings among completers. Participants receiving PORT reported greater symptom improvement compared with community care controls. Mixed ANOVA analyses revealed significant group × time interactions for POTS symptoms (ηp2 = 0.283), anxiety (ηp2 = 0.363), symptom catastrophizing (ηp2 = 0.193), and depression (ηp2 = 0.186), reflecting moderate-to-large effect sizes.
CONCLUSION: This pilot study suggests that PORT is a feasible and acceptable intervention and may be associated with improvements in POTS symptom burden and related psychological processes. Findings provide preliminary support for targeting central-autonomic processes through neuroplasticity-based interventions and warrant larger randomized controlled trials to evaluate efficacy and underlying mechanisms.