Stewart e.a. hebben het verschijnsel "brain fog"
bij mensen met orthostatische intolerantie onderzocht:
- Wat is "brain fog"? Met welke woorden kan men "brain fog"het best omschrijven?
- Welke gebeurtenissen doen "brain fog" ontstaan/verergeren en
- welke (alternatieve) behandelingen zijn er (passen mensen toe)?
Twee belangrijke (neven)conclusies van deze studie:
- Het feit dat "brain fog" aanhoudt in liggende positie impliceert dat de klachten
niet (alleen) door dysfunctie van het autonoom zenuwstelsel (bloeddrukregulatiecentrum) veroorzaakt worden.
- Wandelen, douchen en inspanning doen bij 50-60% van de mensen
de "brain fog" toenemen.
Enkele relevante citaten:
Brain fog is not limited to the upright posture
In this study,
87% of subjects reported prolonged standing to trigger their brain fog and
81% recommended lying down to improve brain fog.
Since orthostatic intolerance is defined by
the onset of symptoms with upright posture
that are relieved by recumbence,
we had previously assumed that brain fog was posturally driven.
Our finding that brain fog
can be triggered by upright posture
but not relieved by recumbence
is consistent with a carry-over effect from a physiological provocation.
Alternatively, brain fog may have a multifactorial etiology
with factors not restricted solely to prolonged upright posture.
The interventions that were reported to make brain fog worse were
What is brain fog? An evaluation of the symptom in postural tachycardia syndrome
Clin Auton Res. 2013 Sep 3. doi: 10.1007/s10286-013-0212-z.
Ross AJ, Medow MS, Rowe PC, Stewart JM.
Adolescents with postural tachycardia syndrome (POTS)
often experience ill-defined cognitive impairment
referred to by patients as "brain fog."
The objective of this study was
to evaluate the symptom of brain fog
as a means of gaining
further insight into
its etiology and
potential palliative interventions.
Eligible subjects who reported having been diagnosed with POTS
were recruited from social media web sites.
Subjects were asked to complete
a 38-item questionnaire designed for this study, and the Wood mental fatigue inventory (WMFI).
Responses were received from
138 subjects with POTS (88 % female), ranging in age from 14 to 29 years;
132 subjects reported brain fog.
WMFI scores correlated with brain fog frequency and severity (P < 0.001).
The top ranked descriptors of brain fog were
- "cloudy," and
- "difficulty focusing, thinking and communicating."
The most frequently reported brain fog triggers were
- fatigue (91%),
- lack of sleep (90%),
- prolonged standing (87%),
- dehydration (86%), and
- feeling faint (85%).
Although aggravated by upright posture,
brain fog was reported to persist after assuming a recumbent posture.
The most frequently reported interventions for the treatment of brain fog were
- intravenous saline (77%),
- stimulant medications (67%),
- salt tablets (54%),
- intra-muscular vitamin B-12 injections (48%), and
- midodrine (45%).
Descriptors for "brain fog" are most consistent with it being a cognitive complaint.
Factors other than upright posture may play a role in the persistence of this symptom.
Subjects reported a number of therapeutic interventions for brain fog
not typically used in the treatment of POTS that may warrant further investigation.
Postural tachycardia syndrome, Orthostatic intolerance, Cognition