Clinical Autonomic Research

, Volume 23, Issue 2, pp 73–80 | Cite as

Abnormal gastric myoelectrical activity in postural tachycardia syndrome

  • William H. SeligmanEmail author
  • David A. Low
  • Masato Asahina
  • Christopher J. Mathias
Research Article



Postural tachycardia syndrome (PoTS) is an important cause of orthostatic intolerance resulting from cardiovascular autonomic dysfunction. In addition to postural symptoms, PoTS patients may have allied features, including gastrointestinal (GI) symptoms, which have not yet been thoroughly investigated. We evaluated gastric myoelectrical activity in PoTS patients.


Using cutaneous electrogastrography (EGG), we recorded gastric myoelectrical activity before and after standard liquid meal ingestion in 15 PoTS patients (age 27 ± 4 years); including 7 with and 8 without GI symptoms, and in 11 healthy individuals (age 23 ± 7 years). We performed spectral analysis of EGG recordings to obtain the dominant frequency of gastric pacemaker rhythm (DF), instability coefficient of DF (ICDF), and low (LFR%), normal (NFR%), and high (HFR%) range power percentages of the total power.


Instability coefficient of DF, an index of variability of gastric pacemaker rhythm, was significantly elevated both pre- and post-prandially (30–45 min after the meal) in the PoTS group (8.8 ± 6, 10.0 ± 8 %) compared with controls (4.0 ± 3, 4.0 ± 3 %; both p < 0.05). Patients with GI symptoms had significantly higher post-prandial ICDF (15.0 ± 5 %) than those without GI symptoms (5.6 ± 4 %; p < 0.05). There were no significant differences in DF, LFR%, NFR% and HFR% before and after the meal between the PoTS and control groups, or between PoTS patients with and without GI symptoms.


Our study revealed increased variability of gastric pacemaker rhythm in PoTS, and these findings might be related to pathophysiology of functional GI symptoms in PoTS.


Orthostatic intolerance Autonomic nervous system Electrogastrography Gastric motility 



We thank Madeline Tippetts, Michael Peche and Vanessa Ponnusamy for their support with the clinical testing of the patients.

Conflict of interest

None declared.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  • William H. Seligman
    • 1
    • 2
    Email author
  • David A. Low
    • 1
    • 3
  • Masato Asahina
    • 4
  • Christopher J. Mathias
    • 1
    • 3
  1. 1.Department of Medicine, Autonomic and Neurovascular Medicine UnitImperial College LondonLondonUK
  2. 2.Department of Physiology, Anatomy and GeneticsUniversity of OxfordOxfordUK
  3. 3.Autonomic Unit National Hospital for Neurology & Neurosurgery Queen Square/ Division of Clinical Neurology Institute of Neurology University College LondonLondonUK
  4. 4.Department of NeurologyChiba University School of MedicineChibaJapan

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