Abstract
A portable near infrared spectroscopy (NIRS) system was used to evaluate alterations in cerebral total hemoglobin concentration (HbT) in individuals with orthostatic hypotension (OH) and orthostatic intolerance (OI) symptoms. We enrolled 238 healthy participants (mean age, 47.9 years) and assessed the presence of OH (orthostatic blood pressure (BP) drop of systolic BP ≥ 20 mmHg or diastolic BP ≥ 10 mmHg within 3 minutes of supine-to-stand) and OI symptoms using the OH questionnaire. The participants were categorized into three groups based on the presence of OH and OI symptoms: the classic OH (OH-BP) group, symptom alone (OH-Sx) group, and control group. Random case-control matching sets (age, sex, hypertension, and diabetes mellitus) were constructed consisting of 16 OH-BP and 69 OH-Sx-control sets. We measured the time-derivative of HbT change in the prefrontal cortex during the squat-to-stand maneuver. There were no differences in demographics, baseline BP, and heart rate among the matched sets. Among the NIRS parameters, the peak-time of maximum slope variation was significantly longer in the OH-Sx and OH-BP groups than in the matched control groups during transition to the standing position after squatting. Our results suggested that OH and OI symptoms are associated with dynamic alteration in cerebral HbT.