Post-Concussive Orthostatic Tachycardia is Distinct from Postural Orthostatic Tachycardia Syndrome (POTS) in Children and Adolescents

Rachel Pearson; Christopher A Sheridan; Kaylee Kang; Anne Brown; Michael Baham; Robert Asarnow; Christopher C Giza; Meeryo C Choe

doi:10.1177/2329048X221082753

Post-Concussive Orthostatic Tachycardia is Distinct from Postural Orthostatic Tachycardia Syndrome (POTS) in Children and Adolescents

Child Neurol Open. 2022 Mar 2:9:2329048X221082753. doi: 10.1177/2329048X221082753. eCollection 2022 Jan-Dec.

Authors

Rachel Pearson^{1

2

3}, Christopher A Sheridan^{1

4}, Kaylee Kang¹, Anne Brown¹, Michael Baham^{1

5}, Robert Asarnow⁶, Christopher C Giza^{1

2}, Meeryo C Choe^{1

2}

Affiliations

¹ UC-Los Angeles Steve Tisch BrainSPORT Program, UCLA Easton Clinic for Brain Health, Los Angeles, CA, USA.
² Division of Pediatric Neurology, UC-Los Angeles Mattel Children's Hospital, David Geffen School of Medicine, Los Angeles, CA, USA.
³ Children's Hospital Orange County, Orange, California, USA.
⁴ Wake Forest School of Medicine, Winston-Salem, NC, USA.
⁵ UC-Irvine School of Medicine, Irvine, CA, USA.
⁶ Psychiatry and Biobehavioral Science, University of California-Los Angeles, Los Angeles, CA, USA.

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.

Keywords: adolescents; children; concussion; rehabilitation; traumatic brain injury.