Decision-Making in Patients with Vasovagal Syncope: A Preliminary Study

SIMPLE SUMMARY: This study looked at how people with syncope, mainly due to blood phobia or mainly occurring during prolonged standing positions, perform a task that measures their decision-making ability. Out of 332 young participants, 98 were in a control group, 10 in the blood phobia group, and 38 in the position group. The participants performed a computer task to see how well they could handle uncertainty when choosing options. The results showed that people with blood phobia took longer to make decisions in uncertain situations compared to the control and position groups. These results suggest that blood phobia and position syncope are separate conditions and that decision-making can be targeted in the management of patients with blood phobia. ABSTRACT: The aim of this study was to evaluate the differences in performance during a decisional conflict task between subjects with emotional/blood phobia and those with an orthostatic vasovagal syncope. A total of 332 young subjects were included, from which 99 were excluded because of their condition or treatment. The subjects were classified into four groups depending on their responses to a questionnaire: 98 in a control group, 10 in an emotional/blood phobia syncope group, 38 in an orthostatic syncope group, and 87 in an unclear status group. This former group was excluded. The subjects performed a decisional conflict task to quantify their conflict-management ability. The task was the computer version of the Simon Task. Emotional/blood phobia syncope subjects showed a delayed reaction time when faced with decisional conflict in comparison with the control and orthostatic syncope subjects (55.8 ± 17.7 ms, 20.5 ± 4.9 ms, and 13.4 ± 9.2 ms, respectively, p ≤ 0.05). Our result suggests that emotional/blood phobia and orthostatic syncope are two clinical entities. Decisions could be a target of management in patients with emotional/blood phobia syncope. The altered decision-making of subjects with emotion/blood phobia syncope emphasized the role of higher cerebral functions in blood pressure control.