Association Between Orthostatic Intolerance Symptoms and Cognitive Complaints in Hypermobile Ehlers-Danlos Syndrome (hEDS) and Joint Hypermobility Spectrum Disorder (JHSD): A Cross-Sectional Analysis
Bibliographic record
Abstract
BACKGROUND: Many 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 METHODS: A 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. RESULTS: Orthostatic 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). CONCLUSIONS: The 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.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".