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Cognitive functioning in orthostatic hypotension due to pure autonomic failure

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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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Authors and Affiliations

  1. Dept. of Neuropsychology, BOX 37, National Hospital for Neurology and Neurosurgery, Queen Square, London,WC1N 3BG, UK

    Hannah C Heims, Naomi H. Martin & Lisa Cipolotti

  2. Dept. of Neuropsychiatry, National Hospital for Neurology and Neurosurgery, London, UK

    Hugo D. Critchley

  3. Institute of Cognitive Neuroscience, Alexandra House, London, UK

    Hugo D. Critchley

  4. Lysholm Dept. of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK

    H. Rolf Jäger

  5. Autonomic Unit, National Hospital for Neurology and Neurosurgery, London, UK

    Christopher J. Mathias

  6. Institute of Neurology, University College London, London, UK

    Christopher J. Mathias

  7. Imperial College London at St. Mary’s Hospital, London, UK

    Christopher J. Mathias

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  1. Hannah C Heims
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  2. Hugo D. Critchley
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  3. Naomi H. Martin
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  4. H. Rolf Jäger
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  5. Christopher J. Mathias
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  6. Lisa Cipolotti
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Correspondence to Lisa Cipolotti.

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Heims, H.C., Critchley, H.D., Martin, N.H. et al. Cognitive functioning in orthostatic hypotension due to pure autonomic failure. Clin Auton Res 16, 113–120 (2006). https://doi.org/10.1007/s10286-006-0318-7

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  • DOI: https://doi.org/10.1007/s10286-006-0318-7

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