Evidence map›Paper›PMID 40672035›Full record

ArticleCureus2025

Association Between Orthostatic Intolerance Symptoms and Cognitive Complaints in Hypermobile Ehlers-Danlos Syndrome (hEDS) and Joint Hypermobility Spectrum Disorder (JHSD): A Cross-Sectional Analysis.

Ansa Tariq, Marium Nadeem Khan, Ayesha Ghazal Jamali, Manaal Amir Basra, Aakash Mahato, Syed Mariyum Imran, Zainab Mohsin, Shivam Singla, Imran K Mirani, Uzma Asmat and 1 more

Abstract read
In one paragraph

Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Impaired attention and cognitive deficits associated with pain and autonomic symptoms in hypermobile Ehlers-Danlos syndrome: a pilot study.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Ansa TariqInternal Medicine, Lahore Medical and Dental College, Lahore, PAK.
Marium Nadeem KhanMedicine, Shifa College of Medicine, Islamabad, PAK.
Ayesha Ghazal JamaliInternal Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, PAK.
Manaal Amir BasraInternal Medicine, Rahbar Medical and Dental College, Lahore, PAK.
Aakash MahatoInternal Medicine, Mirbat Hospital, Salalah, OMN.
Syed Mariyum ImranInternal Medicine, Jinnah Sindh Medical University, Karachi, PAK.
Zainab MohsinInternal Medicine, Shifa College of Medicine, Islamabad, PAK.
Shivam SinglaInternal Medicine, TidalHealth Peninsula Regional, Salisbury, USA.
Imran K MiraniInternal Medicine, Via Medica International Healthcare, Abu Dhabi, ARE.
Uzma AsmatMedicine, Continental Medical College, Lahore, PAK.
Habiba MalikInternal Medicine, Shifa College of Medicine, Islamabad, PAK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany people with hypermobile Ehlers-Danlos syndrome (hEDS) and joint hypermobility spectrum disorder (JHSD) often experience both orthostatic intolerance (OI) and brain fog. They are both clinically significant, even though their direct link has rarely been studied. This research examines whether there is a link between OI symptoms and complaints of poor concentration in patients with hEDS and JHSD. MATERIALS AND

methodsA study was carried out with 385 individuals who were clinically diagnosed with hEDS or JHSD in Islamabad, Pakistan. Both the Composite Autonomic Symptom Score (COMPASS-31) and the Cognitive Failure Questionnaire (CFQ) were used to collect data. To investigate the relationship between OI problems and cognitive symptoms, a statistical analysis was conducted using SPSS Statistics version 26 (IBM Corp. Released 2019. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY: IBM Corp.), including Pearson correlation, t-tests, ANOVA, and linear regression. Data were collected from November 15, 2024, to March 25, 2025.

resultsOrthostatic symptoms were present in 249 (65%) of participants, and cognitive changes were reported by 282 (73%). The correlation between OI and CFQ scores was found to be moderate and statistically significant (r = 0.449, p = 0.03). Participants who experienced brain fog often (36%) scored a bit higher on CFQ than others. Although the differences between the groups were found to be significant, the effect sizes were very small (η² = 0.004), which corresponds to practically irrelevant distinctions. In a regression model, it was confirmed that the OI symptoms were significant predictors of cognitive complaints (r = 0.449, p = 0.03).

conclusionsThe researchers found a statistically significant yet low level of association between OI and cognitive complaints in individuals with hEDS and JHSD. These results suggest that autonomic dysfunction may play a role in the cognitive symptoms experienced by this group of individuals. Future objective assessment studies should be conducted to better understand the mechanisms involved and the contributions of psychological and emotional factors.

Indexed as

autonomic dysfunctionbrain fogcognitive failurehypermobile ehlers-danlos syndromeorthostatic intolerance

Identifiers

PMID40672035
PMCPMC12265850

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.