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Advanced Neurology POTS with tics versus tic-like behaviors

Preliminary evidence pointed toward a possible Ethics approval and consent to participate
association between POTS and functional neurological
disorder, and the “pandemic within the pandemic” of All patients provided informed consent to participate in
the study, which was approved by the local section of the
functional tic-like behaviors opened up the opportunity National Research Ethics Service (ethics approval code: 10/
of exploring the possible links between POTS and H1207/1).
different types of tic disorders. In the present study, we
retrospectively assessed the prevalence of POTS in two Consent for publication
large patient populations from a specialist clinic for tic
disorders: 638 patients with neurodevelopmental tics Consent for publication was obtained from all patients.
who received a diagnosis of GTS, and 177 patients who Availability of data
developed tic-like behaviors and received a diagnosis of
functional tics since the onset of the pandemic. In our The anonymized study data are available from the authors
sample, the prevalence of POTS was 0% in the GTS group upon reasonable request.
and 2.3% in the functional tics group. A significantly References
larger population is required to establish the actual
prevalence of POTS in patients with different types of 1. Vernino S, Bourne KM, Stiles LE, et al. Postural orthostatic
tic disorders and functional neurological symptoms. The tachycardia syndrome (POTS): State of the science and
four patients with POTS from the functional tic group clinical care from a 2019 National Institutes of Health
were females, with age at assessment ranging from 17 Expert Consensus Meeting - Part 1. Auton Neurosci.
2021;235:102828.
to 24 years. Our preliminary finding about the selective
association between POTS and functional tic-like doi: 10.1016/j.autneu.2021.102828
behaviors, in the absence of comorbidity between POTS 2. Fedorowski A. Postural orthostatic tachycardia syndrome:
and neurodevelopmental tics, suggested a possible link Clinical presentation, aetiology and management. J Intern
between POTS and functional neurological disorder. This Med. 2019;285(4):352-366.
was in line with the clinical comorbidity pattern of the doi: 10.1111/joim.12852
four patients with POTS and functional tic-like behaviors, 3. Staples A, Thompson NR, Moodley M. Pediatric-onset
which included high-functioning ASD (4/4), anxiety postural orthostatic tachycardia syndrome in a single
(3/4), and other functional neurological symptoms tertiary care center. J Child Neurol. 2020;35(8):526-535.
(2/4). Our findings require validation in further studies
conducted across large samples of patients with different doi: 10.1177/0883073820916260
functional neurological phenotypes. 4. Khoo A, Saxena Y, Zaidi A, Vaou EO, Hohler AD. Postural
orthostatic tachycardia syndrome during pregnancy,
Acknowledgments labor, and post-delivery: A case series. Advanced Neurol.
2024;3(2):3164.
None.
doi: 10.36922/an.3164
Funding 5. Narasimhan B, Calambur A, Moras E, et al. Postural
None. orthostatic tachycardia syndrome in COVID-19:
A contemporary review of mechanisms, clinical course and
Conflict of interest management. Vasc Health Risk Manag. 2023;19:303-316.
doi: 10.2147/VHRM.S380270
The authors declare that they have no competing interests.
6. Sebastian SA, Co EL, Panthangi V, et al. Postural orthostatic
Author contributions tachycardia syndrome (POTS): An update for clinical
practice. Curr Probl Cardiol. 2022;47(12):101384.
Conceptualization: Andrea E. Cavanna
Data curation: Andrea E. Cavanna doi: 10.1016/j.cpcardiol.2022.101384
Formal analysis: Andrea E. Cavanna 7. Raj SR, Bourne KM, Stiles LE, et al. Postural orthostatic
Investigation: Andrea E. Cavanna tachycardia syndrome (POTS): Priorities for POTS care
Methodology: Andrea E. Cavanna and research from a 2019 National Institutes of Health
Writing–original draft: Andrea E. Cavanna, Silvia Expert Consensus Meeting - Part 2. Auton Neurosci.
Chiereghin, Silvia Ferrari, Giulia Paini, Laura Spini 2021;235:102836.
Writing–review & editing: All authors doi: 10.1016/j.autneu.2021.102836

Volume 4 Issue 2 (2025) 108 doi: 10.36922/an.8525