Evidence map›Paper›PMID 41758479›Full record

ArticleClinical autonomic research : official journal of the Clinical Autonomic Research Society2026

An alternative "Port"? Rationale and development process for POts Reprocessing Therapy (PORT), a brain-body therapy for postural tachycardic syndrome (POTS).

Taylor B Crouch, Maggie Nguyen, Mary Wells, Tammy Redman, Yoni Ashar, Howard Schubiner, Grace Westcott, Patricia Kinser, Madison Maxwell, Gisela Chelimsky and 1 more

Abstract read
In one paragraph

Article in Clinical autonomic research : official journal of the Clinical Autonomic Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. The new PORT needs the same old evidence-based standards.Clinical autonomic research : official journal of the Clinical Autonomic Research Society · 2026
    Article
  2. Article
  3. Review
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.

Taylor B CrouchSchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA. taylor.crouch@vcuhealth.org.ORCID http://orcid.org/0000-0003-2386-8956
Maggie NguyenSchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Mary WellsSchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Tammy RedmanSchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Yoni AsharUniversity of Colorado Anschutz Department of Medicine, Aurora, CO, USA.
Howard SchubinerAscension Providence Hospital, Southfield, MI, USA.
Grace WestcottDepartment of Psychology, Virginia Commonwealth University, Richmond, VA, USA.
Patricia KinserSchool of Nursing, Virginia Commonwealth University, Richmond, VA, USA.
Madison MaxwellSchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Gisela ChelimskySchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Thomas ChelimskySchool of Medicine, Virginia Commonwealth University, Richmond, VA, USA.

Funding

Addressing the “Readiness Gap:” An eHealth Intervention to Increase Patient Motivation for Evidence-Based Chronic Pain Interventions and Reduced Opioid RelianceK23DA058785 · NIDA · VIRGINIA COMMONWEALTH UNIVERSITY · PI Taylor Berens Crouch · 2023 to 2026
$682k
NHLBI NIH HHS 5R01HL163577-02NIDA NIH HHS K23 DA058785NIDA NIH HHS K23DA058785-02Virginia Commonwealth University Clinical and Translational Science Award UM1TR004360
6 · The paper itself

Abstract

purposePostural tachycardia syndrome (POTS) is a chronic disorder marked by excessive orthostatic tachycardia, without clear structural/organic (e.g., cardiovascular) etiology. Recent evidence suggests that persistent autonomic symptoms may be driven by threat-induced and central nervous system-maintained dysregulation, similar to centralized chronic pain disorders. This study describes the rationale and development process of a brain-body intervention-POts Reprocessing Therapy (PORT)-aimed at reducing orthostatic symptomatology by taking advantage of the brain's plasticity.

methodsPORT was adapted from pain reprocessing therapy (PRT), an evidence-based mind-body approach for treating centralized chronic pain. The initial protocol was developed through consultations with multidisciplinary experts, including the developers of PRT. To refine the protocol, a focus group was conducted with five women participants with POTS who underwent an early version of PORT. Rapid qualitative analysis was conducted to identify themes and inform intervention improvements.

resultsThe intervention consists of a medical evaluation followed by eight weekly treatment sessions. Intervention components include psychoeducation, safety learning-based exposure to symptoms, somatic inquiry, and emotional processing. Focus group participants identified reduced fear about symptoms, greater understanding of their condition, and improved functioning. Participants provided suggestions around language and content, and some shared emotional challenges of the treatment, underscoring the need for sensitive provider communication and implementation.

conclusionThis study introduces a novel therapeutic treatment for POTS that targets centrally mediated processes hypothesized to underlie persistent autonomic dysregulation. Trials are underway to formally assess feasibility, acceptability, and efficacy.

Indexed as

Mind-Body TherapiesPostural Orthostatic Tachycardia SyndromeAdultFemaleHumansMiddle AgedTreatment OutcomeYoung AdultBehavioral interventionsCentral nervous systemMind/body approachesPostural tachycardia syndrome

Identifiers

PMID41758479
PMCPMC13265598

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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.