What is the clinical evidence from this study?

Study design: Other. Population: Adult female patients aged 24-53 years with postural tachycardia syndrome (POTS) and chronic orthostatic intolerance symptoms impacting functioning (n=5). Intervention: POts Reprocessing Therapy (PORT). Primary outcome: Improvement in symptoms and functioning as reported qualitatively by patients after PORT treatment.

What does this research mean for the field?

POts Reprocessing Therapy (PORT), a novel brain-body intervention adapted from pain reprocessing therapy, improves symptom understanding, reduces fear, and enhances daily functioning in patients with postural tachycardia syndrome (POTS). Novelty: ClaimNovelty.METHODOLOGICAL. Consensus alignment: ConsensusAlignment.ESTABLISHES_NEW_DIRECTION.

What question did this study set out to answer?

The aim is to develop a brain-body therapy, POts Reprocessing Therapy (PORT), to alleviate symptoms of POTS by leveraging the brain’s plasticity.

February 28, 2026Clinical Autonomic Research1 citationsOpen Access

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

TCTaylor CrouchVirginia Commonwealth University MNMaggie NguyenDuke University MWMary J. WellsVirginia Commonwealth University

Key Result

PORT improved understanding of symptoms and reduced fear, leading to significant improvements in daily functioning and symptom management in five female POTS patients aged 24-53 in a qualitative focus group.

Key Points

The aim is to develop a brain-body therapy, POts Reprocessing Therapy (PORT), to alleviate symptoms of POTS by leveraging the brain’s plasticity.
Adapted from pain reprocessing therapy (PRT) for centralized chronic pain.
Consulted with multidisciplinary experts to develop the intervention protocol.
Conducted a focus group with POTS patients to refine the intervention.
Performed rapid qualitative analysis to identify themes and suggested improvements.
Participants underwent eight weekly treatment sessions and reported reduced fear about symptoms.
Increased understanding of POTS and improved daily functioning were noted.
Emotional challenges were highlighted, indicating the need for careful communication from providers.

Structured PICO

Does POts Reprocessing Therapy (PORT) improve symptom perception and functioning in patients with postural tachycardia syndrome (POTS)?

Population

5 women with postural tachycardia syndrome (POTS), ages 24-53, who underwent an early version of the intervention.

Intervention

POts Reprocessing Therapy (PORT), an 8-week brain-body intervention adapted from pain reprocessing therapy, including psychoeducation, safety learning-based exposure to symptoms, somatic inquiry, and emotional processing.

Outcome

Qualitative themes regarding patient perceptions of symptoms management and treatment outcomes.patient reported

PORT is a novel brain-body intervention for POTS that targets centrally mediated processes and demonstrated initial qualitative benefits in reducing symptom-related fear and improving condition understanding.

Limitations

Small sample size of five participants limits generalizability
Lack of control or comparison group
No quantitative efficacy data reported
Results based on qualitative feedback without standardized outcome measures
Early stage intervention development without formal efficacy trial results

Abstract

Abstract Purpose Postural 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. Methods PORT 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. Results The 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. Conclusion This 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.

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