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Does a Periaqueductal Gray-vagus Nerve Interface Malfunction Explain the Nat hx With Its Numerous Co-morbidities?

RECRUITING
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12 years to 21 years old
This study is also accepting healthy volunteers
POTS sample
Inclusion Criteria:
* symptomatic ≥ 40 bpm rise in heart rate in the first 10 min of a tilt table study without a drop in blood pressure * Clinical symptoms of orthostatic intolerance
Exclusion Criteria:
* Pregnant or breastfeeding * Cognitive defects that preclude answering questionnaires or following assessment directions * Other chronic diseases * Unstable medical conditions * Use of narcotics * Limited English proficiency * Investigator discretion that participant would not be suitable to participate * A phone older than 5 years old or unable to support EMA software POST INFECTION
Inclusion Criteria:
* acute upper respiratory or gastrointestinal infection that required admission to the acute care units but not requiring an ICU stay
Exclusion Criteria:
* Pregnant or breastfeeding * Chronic prescriptions, history of POTS or orthostatic symptoms, recent inpatient psychiatric admissions, substance use disorder, trauma such as a motor vehicle accident, surgery, or other significant physical or emotional trauma in the last 5 years * Cognitive defects that preclude answering questionnaires or following assessment directions * Other unstable chronic diseases * Unstable medical conditions * Use of narcotics * Severe depression or anxiety (untreated / unstable) * Limited English proficiency * Investigator discretion that participant would not be suitable to participate * A phone older than 5 years old or unable to support EMA software HEALTHY CONTROLS
Inclusion Criteria:
* Apparently healthy with no known chronic illnesses
Exclusion Criteria:
* Pregnant or breastfeeding * History of POTS or orthostatic symptoms, migraines, fibromyalgia, chronic fatigue, PTSD. Functional gastrointestinal disorders, fainting, dysmenorrhea, or other chronic pain syndrome, inpatient psychiatric admissions, substance use disorder, trauma such as a motor vehicle accident, surgery, or other significant physical or emotional trauma in the last 5 years * Cognitive defects that preclude answering questionnaires or following assessment directions * Other chronic unstable diseases * Unstable medical conditions * Use of narcotics * Severe depression or anxiety (untreated / unstable) * Limited English proficiency * Investigator discretion that participant would not be suitable to participate * A phone older than 5 years old or unable to support EMA software

BEHAVIORAL: Questionnaires to be competed, BEHAVIORAL: Provide list of medication and lifetime events, BEHAVIORAL: Use phone App to record new life events, DEVICE: Will wear an activity monitor, OTHER: Periodic 24-hour urine sodium check, DIAGNOSTIC_TEST: A fMRI scan, DIAGNOSTIC_TEST: A bedside tilt test will be performed, OTHER: IV placed to collect blood samples, OTHER: Stool Sample

POTS - Postural Orthostatic Tachycardia Syndrome

PAG activation, Cardiovagal Modulation

Gisela Chelimsky - Gisela.Chelimsky@vcuhealth.org
NCT06616363

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