Cognitive functioning in orthostatic hypotension due to pure autonomic failure |
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| Authors: | Hannah C Heims Hugo D. Critchley Naomi H. Martin H. Rolf Jäger Christopher J. Mathias Lisa Cipolotti |
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| Affiliation: | (1) Dept. of Neuropsychology, BOX 37, National Hospital for Neurology and Neurosurgery, Queen Square, London,WC1N 3BG, UK;(2) Dept. of Neuropsychiatry, National Hospital for Neurology and Neurosurgery, London, UK;(3) Institute of Cognitive Neuroscience, Alexandra House, London, UK;(4) Lysholm Dept. of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK;(5) Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, UK;(6) Institute of Neurology, University College London, London, UK;(7) Imperial College London at St. Mary’s Hospital, London, UK |
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| Abstract: | Abstract Psychophysiological science proposes close interactions between cognitive processes and autonomic responses, yet the consequences of autonomic failure on cognitive functioning have not been documented. This pilot study investigates, for the first time, the cognitive profile of 14 patients with Pure Autonomic Failure (PAF). Each patient was administered a comprehensive battery of neuropsychological tests and neuroimaging investigation. A number of patients (n = 6) presented with cognitive impairment. The two most frequent types of impairment were: deficits of speed and attention, and executive functioning. Impairments of free recall memory, intellectual functioning, nominal and calculation functions were also documented, albeit in a much lower frequency. These cognitive changes were not always associated with white matter abnormalities. We speculate that the cognitive impairments associated with PAF represent consequences of systemic hypotension with cerebral underperfusion. However, a failure in integrated bodily arousal responses during cognitive behaviours may also contribute to some of the observed deficits. |
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| Keywords: | pure autonomic failure cognition orthostatic hypotension autonomic nervous system |
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