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Liampas I, Kyriakoulopoulou P, Akrioti A, Stamati P, Germeni A, Batzikosta P, Tsiamaki E, Veltsista D, Kefalopoulou Z, Siokas V, Chroni E, Dardiotis E. Cognitive deficits and course of recovery in transient global amnesia: a systematic review. J Neurol 2024:10.1007/s00415-024-12563-2. [PMID: 39090229 DOI: 10.1007/s00415-024-12563-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 08/04/2024]
Abstract
OBJECTIVE Published evidence suggests that cognitive impairment during a TGA (transient global amnesia) spell may not be confined to episodic memory. We undertook a systematic review to determine the pattern of cognitive deficits during a TGA episode. As a secondary objective, we aimed to delineate the course of cognitive recovery. METHODS MEDLINE, EMBASE, CENTRAL, and Google scholar were systematically searched up to October 2023. Observational controlled studies including 10 or more TGA patients (Hodges and Warlow criteria) were retrieved. Data from case-control, cross-sectional, and cohort studies were reviewed and qualitatively synthesized. RESULTS Literature search yielded 1302 articles. After the screening of titles and abstracts, 115 full texts were retrieved and 17 of them were included in the present systematic review. During the acute phase, spatiotemporal disorientation, dense anterograde and variable retrograde amnesia, semantic memory retrieval difficulties, and working memory deficits comprised the neuropsychological profile of patients with TGA. Visuospatial abilities, attention and psychomotor speed, semantic memory, confrontation naming, and other measures of executive function (apart from semantic fluency and working memory) were consistently found normal. In the course of recovery, after the resolution of repetitive questioning, the restoration of spatiotemporal orientation follows, working memory and semantic memory retrieval ensue, while episodic memory impairment persists for longer. Meticulous evaluations may reveal subtle residual memory (especially recognition) deficits even after 24 h. CONCLUSIONS Μemory impairment, spatiotemporal disorientation, and working memory deficits constitute the pattern of cognitive impairment during a TGA spell. Residual memory deficits may persist even after 24 h.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece.
| | - Panayiota Kyriakoulopoulou
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Anna Akrioti
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Polyxeni Stamati
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece
| | - Alexandra Germeni
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Paraskevi Batzikosta
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Eirini Tsiamaki
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Dimitra Veltsista
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Zinovia Kefalopoulou
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece
| | - Elisabeth Chroni
- Department of Neurology, University Hospital of Patras, School of Medicine, University of Patras, 26504, Patras, Rio, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece
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Lee DA, Lee HJ, Park KM. Altered cerebellar volumes and intrinsic cerebellar networks in patients with transient global amnesia. Brain Imaging Behav 2024; 18:315-323. [PMID: 38057649 DOI: 10.1007/s11682-023-00833-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/08/2023]
Abstract
This study aimed to investigate the differences in cerebellar volumes and intrinsic cerebellar networks between patients with transient global amnesia (TGA) and healthy controls. We retrospectively enrolled patients with TGA and age- and sex-matched healthy controls. We used three-dimensional T1-weighted imaging at the time of TGA diagnosis to obtain cerebellar volumes, and the intrinsic cerebellar network was calculated by applying graph theory based on cerebellar volumes. The nodes were defined as individual cerebellar volumes, and edges as partial correlations, controlling for the effects of age and sex. The cerebellar volumes and intrinsic cerebellar networks were compared between the two groups. We enrolled 44 patients with TGA and 47 healthy controls. The volume of the left cerebellar white matter in patients with TGA was significantly lower than that in healthy controls (1.0328 vs. 1.0753%, p = 0.0094). In addition, there were significant differences in intrinsic cerebellar networks between the two groups. The small-worldness index in patients with TGA was higher than that in the healthy controls (0.951 vs. 0.880, p = 0.038). In the correlation analysis, the volumes of the right cerebellar cortex and lobules VIIIB were significantly correlated with age in patients with TGA (r = -0.323, p = 0.033; r = -0.313, p = 0.038, respectively). Patients with TGA exhibit alterations in cerebellar volumes and intrinsic cerebellar networks compared with healthy controls. These findings may contribute to a better understanding of the pathophysiology of the TGA.
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Affiliation(s)
- Dong Ah Lee
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-Ro 875, Haeundae-Gu, Busan, Republic of Korea
| | - Ho-Joon Lee
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Kang Min Park
- Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-Ro 875, Haeundae-Gu, Busan, Republic of Korea.
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Network localization of transient global amnesia beyond the hippocampus. Neurol Sci 2023; 44:649-657. [PMID: 36222907 DOI: 10.1007/s10072-022-06439-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 09/29/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Transient global amnesia is common in the older adult, but the cause and mechanism remain unclear. Focal brain lesions allow for causal links between the lesion location and resulting symptoms, and we based on the reported TGA-causing lesions and used lesion network mapping to explore the causal neuroanatomical substrate of TGA. METHODS Fifty-one cases of transient global amnesias with DWI lesions from the literature were identified, and clinical data were extracted and analyzed. Next, we mapped each lesion volume onto a reference brain and computed the network of regions functionally connected to each lesion location using a large normative connectome dataset. RESULTS Lesions primarily occurred in the hippocampus, and in addition to the hippocampus, there are also other locations of TGA-causing lesions such as the cingulate gyrus, anterior thalamic nucleus (ATN), putamen, caudate nucleus, corpus callosum, fornix. More than 90% of TGA-causing lesions inside the hippocampus were functionally connected with the default mode network (DMN). CONCLUSION Structural abnormality in the hippocampus was the most consistently reported in TGA, and besides the hippocampus, lesions occurring at several other brain locations also could cause TGA. The DMN may also be involved in the pathophysiology of TGA. According to the clinical and neuroimaging characteristics, TGA may be a syndrome with multiple causes and cannot be treated simply as a subtype of TIA.
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Segobin S, Renault C, Viader F, Eustache F, Pitel AL, Quinette P. Disruption in normal correlational patterns of metabolic networks in the limbic circuit during transient global amnesia. Brain Commun 2023; 5:fcad082. [PMID: 37101832 PMCID: PMC10123398 DOI: 10.1093/braincomms/fcad082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/06/2022] [Accepted: 03/17/2023] [Indexed: 04/28/2023] Open
Abstract
Transient global amnesia is characterized by the sudden apparition of severe episodic amnesia, mainly anterograde, associated with emotional changes. Even though the symptoms are stereotyped, cerebral mechanism underlying transient global amnesia remains unexplained and previous studies using positron emission tomography do not show any clear results or consensus on cerebral regions impacted during transient global amnesia. This study included a group of 10 transient global amnesic patients who underwent 18F-fluorodeoxyglucose positron emission tomography during the acute or recovery phase of the episode and 10 paired healthy controls. Episodic memory was evaluated with the encoding-storage-retrieval paradigm and a story recall test of the Wechsler's memory scale and anxiety was assessed with the Spielberger scale. We used statistical parametric mapping to identify modifications of whole-brain metabolism. Regarding hypometabolism, there was no brain region systematically affected in all transient global amnesic patients and the comparison between amnesic patients and controls did not show any significant differences. To better understand the specific implication of the limbic circuit in the pathophysiology of transient global amnesia, we then conducted a correlational analysis that included regions of this network. Our findings showed that in healthy controls, regions of the limbic circuit seem to operate in a synchronized way with all regions being highly correlated to each other. On the opposite, in transient global amnesic patients, we observed a clear disruption of this normal correlational patterns between regions with the medial temporal lobe (the hippocampus, parahippocampal gyrus and amygdala) included in one cluster and the orbitofrontal cortex, anterior and posterior cingulate gyrus and thalamus gathered in the other one. Given the individual variability in the time course of transient global amnesia, the direct comparison between a group of patients and controls does not seem to favour the identification of subtle and transient alterations in regional metabolism. The involvement of an extended network, such as the limbic circuit, seems more likely to explain the symptoms of patients. Indeed, the synchronization of regions within the limbic circuit seems to be altered during transient global amnesia, which could explain the amnesia and anxiety observed in transient global amnesic patients. The present study thus deepens our understanding of the mechanisms underlying not only amnesia but also the emotional component of transient global amnesia by considering it as a disruption in the normal correlational patterns within the limbic circuit.
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Affiliation(s)
| | | | - Fausto Viader
- Normandie University, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14032, Caen, Normandie, France
| | - Francis Eustache
- Normandie University, UNICAEN, PSL Research University, EPHE, INSERM, U1077, CHU de Caen, Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14032, Caen, Normandie, France
| | | | - Peggy Quinette
- Correspondence to: Peggy Quinette Unité de recherche Inserm-EPHE-Unicaen U1077 Neuropsychologie et Imagerie de la Mémoire Humaine Pôle des Formations et de Recherches en Santé 2, rue des Rochambelles, F-14032 Caen Cedex CS, France E-mail:
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Kim J, Kim Y. Distorted time perception in patients with transient global amnesia: time perception task and imaging analysis. Neurol Sci 2022; 43:5951-5958. [DOI: 10.1007/s10072-022-06219-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2022]
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Sparaco M, Pascarella R, Muccio CF, Zedde M. Forgetting the Unforgettable: Transient Global Amnesia Part I: Pathophysiology and Etiology. J Clin Med 2022; 11:3373. [PMID: 35743444 PMCID: PMC9225344 DOI: 10.3390/jcm11123373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 06/04/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of a temporary memory disorder with a profound anterograde amnesia and a variable impairment of the past memory. Since the first description, dating back over 60 years, several cases have beenreported in the literature. Nevertheless, TGA remains one of the most mysterious diseases in clinical neurology. The debate regarding the etiology of this disease has focused mainly on three different mechanisms: vascular (due to venous flow changes or focal arterial ischemia), epileptic, and migraine related. However, to date there is no scientific proof of any of these mechanisms. Furthermore, the demonstration by diffusion-weighted MRI of lesions in the CA1 field of the hippocampus cornu ammonis led us to hypothesize that the selective vulnerability of CA1 neurons to metabolic stress could play a role in the pathophysiology of TGA. In this review, we summarize current knowledge on the anatomy, vascularization and function of the hippocampus. Furthermore, we discuss the emerging theories on the etiology and the pathophysiological cascade leading to an impairment of hippocampal function during the attacks.
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Affiliation(s)
- Marco Sparaco
- Neurology Unit, Stroke Unit, Department of Neurosciences, A.O. “San Pio”, P.O. “G. Rummo”, Via Dell’Angelo 1, 82100 Benevento, BN, Italy;
| | - Rosario Pascarella
- Neuroradiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, RE, Italy;
| | - Carmine Franco Muccio
- Neuroradiology Unit, Department of Neurosciences, A.O. “San Pio”, P.O. “G. Rummo”, Via Dell’Angelo 1, 82100 Benevento, BN, Italy;
| | - Marialuisa Zedde
- Neurology Unit, Stroke Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Via Amendola 2, 42122 Reggio Emilia, RE, Italy
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The remains of the day: neuropsychological findings in postacute transient global amnesia. J Neurol 2022; 269:4764-4771. [PMID: 35394173 DOI: 10.1007/s00415-022-11110-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/09/2022] [Accepted: 03/27/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Current clinical diagnostic criteria of transient global amnesia (TGA) require the episode to completely resolve within 24 h. Small case series investigating the neuropsychological profiles obtained during the first days after TGA are inconclusive, with some suggesting the persistence of memory deficits. METHODS In this retrospective observational study, neuropsychological data of 185 TGA patients obtained during the first days following an attack were analysed. Data of cognitive functions assessed in at least 50 patients were evaluated and dichotomised according to z-values as "impaired" or "unimpaired". Moreover, the results of magnetic resonance imaging (MRI) were collected. RESULTS Neuropsychological assessment was performed within the first 3 days after TGA in 158 (85.4%) of all patients. The majority of patients showed no significant neuropsychological sequelae in the postacute phase of TGA. However, Mini-Mental Status Examination showed impairment in 22.6% of 159 patients, and we found subtle reductions of patients' performance in tests of verbal long-term memory and executive function in 16.3-24.6% of patients. Patients with hippocampal diffusion-weighted imaging (DWI) lesions performed significantly worse in a verbal recognition task than those without DWI lesions. DISCUSSION Our findings reflect subtle performance reductions in different cognitive domains in a small subgroup of TGA patients. This implies that the gradual resolution of subclinical symptoms may take longer than the 24 h required as maximum episode duration by current diagnostic criteria.
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Wittayer M, Hoyer C, Roßmanith C, Platten M, Gass A, Szabo K. Hippocampal subfield involvement in patients with transient global amnesia. J Neuroimaging 2022; 32:264-267. [PMID: 35106877 DOI: 10.1111/jon.12973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/12/2022] [Accepted: 01/12/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Transient global amnesia (TGA) is a rare neurological disorder causing a transient disturbance of episodic long-term memory. Its etiology remains yet to be identified; the only consistently reported findings in patients with TGA are small hyperintense lesions in the hippocampus on diffusion-weighted magnetic resonance imaging (DWI). The aim of this study was to define whether these lesions are subfield specific, as suggested previously. METHODS High-resolution multiplanar reformation T1 and DWI of the hippocampus were acquired in 25 patients after TGA with a total of 43 hippocampal lesions. Hippocampal subfields were determined using the FreeSurfer software and the location of the DWI lesions was transformed to the T1 images after data co-registration. Additionally, hippocampal subfield volumes in each patient were calculated and compared with that of 20 healthy controls. RESULTS Hippocampal lesions were most frequently detected in the cornu ammonis area 1 (CA1) subfield (30.2%), the hippocampal tail (28.0%), and the subiculum (21.0%); however, lesions were also found in other subfields. There was no significant difference between patients and controls concerning the volumes of the hippocampal subfields. CONCLUSIONS Contrasting previous assumptions, we found DWI hyperintense lesions not to be restricted to the CA1 subfield. The visualization of focal hippocampal lesions on diffusion imaging located to several different hippocampal subfields suggests a potential pathophysiology of TGA independent of microstructural hippocampal anatomy and subfield-specific vulnerability.
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Affiliation(s)
- Matthias Wittayer
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
| | - Carolin Hoyer
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
| | - Christina Roßmanith
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
| | - Michael Platten
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
| | - Achim Gass
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
| | - Kristina Szabo
- Department of Neurology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Mannheim Center for Translational Neurosciences (MCTN), Heidelberg University, Mannheim, Germany
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Kim GH, Kim BR, Chun MY, Park KD, Lim SM, Jeong JH. Aberrantly higher functional connectivity in the salience network is associated with transient global amnesia. Sci Rep 2021; 11:20598. [PMID: 34663883 PMCID: PMC8523536 DOI: 10.1038/s41598-021-97842-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 08/30/2021] [Indexed: 11/25/2022] Open
Abstract
Triple intrinsic brain networks including the salience network (SN), default mode network (DMN), and central executive network (CEN), are known to be important in human cognition. Therefore, investigating those intrinsic brain networks in transient global amnesia (TGA) may offer novel insight useful for the pathophysiology of TGA. Fifty TGA patients underwent the resting state functional magnetic resonance imaging (rsfMRI) within 24 h, at 72 h, and 3 months after TGA onset. Twenty-five age, gender matched controls also underwent rsfMRI. Within 24 h of TGA onset, TGA patients showed greater functional connectivity in the SN and lower functional connectivity in the DMN, while relatively preserved functional connectivity was observed in the CEN. Interestingly, TGA patients continued to show decreased connectivity in the DMN, while no alterations were shown in the SN 72 h after illness onset. Three months after TGA onset, alterations of functional connectivity in the SN or the DMN were normalized. Our findings suggest that TGA is associated with transient greater functional connectivity in the SN and lower connectivity in the DMN.
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Affiliation(s)
- Geon Ha Kim
- Department of Neurology, College of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Bori R Kim
- Department of Neurology, College of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea.,Ewha Medical Research Institute, Ewha Womans University, Seoul, Republic of Korea
| | - Min Young Chun
- Department of Neurology, College of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Kee Duk Park
- Department of Neurology, College of Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Soo Mee Lim
- Department of Radiology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Jee Hyang Jeong
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, 1071, 260, Gonghang-daero, Gangseo-gu, Seoul, 07804, Republic of Korea.
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Prakash J, Ali T, Chaudhury S, Srivastava K. Transient global amnesia following deliberate self-harm by hanging: Case report and review. Ind Psychiatry J 2021; 30:S328-S330. [PMID: 34908724 PMCID: PMC8611530 DOI: 10.4103/0972-6748.328844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/21/2021] [Accepted: 06/02/2021] [Indexed: 11/23/2022] Open
Abstract
A 25-year-old female was hospitalized subsequent to an attempt to hang herself. She was unconscious for a few minutes but responded to initial resuscitative measures. Relevant investigations, including X-ray neck, computed tomography scan brain, and electroencephalogram were normal. Physical examination was consistent with attempted hanging. On mental status examination, speech was relevant. Mood was euthymic. Attention was arousable, but concentration was impaired. Orientation to time and recent memory were impaired. Remote memory, insight, and judgment were unimpaired. Serial Mental Status Examination (MSE) revealed improvement in concentration and orientation. Due to sudden onset memory loss of <24 h in duration without other signs of cognitive impairment or concomitant focal neurological symptoms, she was diagnosed as a case of transient global amnesia. The pathophysiology of the condition is briefly reviewed.
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Affiliation(s)
- Jyoti Prakash
- Department of Psychiatry, AFMC, Pune, Maharashtra, India
| | - Tahoora Ali
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth, Pune, Maharashtra, India
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Becquet C, Viader F, Eustache F, Quinette P. Self-awareness in Transient Global Amnesia: distinguishing the effects of transient memory disorder vs. pre-existing vulnerability factors. Neurocase 2021; 27:196-204. [PMID: 33856957 DOI: 10.1080/13554794.2021.1912359] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Numerous evidences suggest the existence of relationships between the impairment of episodic memory, acute stress exposure and variations in self-awareness (SA). Here, we examined 27 patients presenting transient global amnesia (TGA), a clinical condition which combines episodic amnesia and high anxiety, thanks to state and trait questionnaires of SA. We observed variation of SA depending on the stage of TGA (acute, recovery and follow-up). We also found preexisting differences in patient's awareness of their own image when the precipitating event was physical, encouraging us to give more consideration to the social determinants of stress in physiological cascade of TGA.
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Affiliation(s)
- Céline Becquet
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, Centre Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Fausto Viader
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, Centre Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Francis Eustache
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, Centre Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
| | - Peggy Quinette
- Normandie Univ, UNICAEN, PSL Université Paris, EPHE, INSERM, U1077, CHU de Caen, Centre Cyceron, Neuropsychologie et Imagerie de la Mémoire Humaine, 14000, Caen, France
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12
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Liampas I, Raptopoulou M, Mpourlios S, Siokas V, Tsouris Z, Aloizou AM, Dastamani M, Brotis A, Bogdanos D, Xiromerisiou G, Dardiotis E. Factors associated with recurrent transient global amnesia: systematic review and pathophysiological insights. Rev Neurosci 2021; 32:751-765. [PMID: 33675214 DOI: 10.1515/revneuro-2021-0009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/15/2021] [Indexed: 12/20/2022]
Abstract
The examination of the risk factors that affect the recurrence of transient global amnesia (TGA) may shed light on the pathophysiological substrate of the disease. A systematic review was performed to identify the factors associated with the recurrence of TGA. MEDLINE, EMBASE, CENTRAL and PsycINFO were meticulously searched. Observational controlled studies involving patients with single (s-TGA) and recurrent TGA (r-TGA) according to Hodges and Warlow's criteria were retrieved. Differences in the demographic characteristics, personal and family medical history, previous exposure to precipitating events and laboratory findings were examined. Retrieved evidence was assessed in the context of the individual article validity, based on the numerical power and methodological quality of each study. Nine cohort studies with retrospective, prospective or mixed design were retrieved. In total, 1989 patients with TGA were included, 269 of whom suffered from r-TGA (13.5%). R-TGA presented an earlier age of onset. Evidence was suggestive of a relationship between recurrence and a family or personal history of migraine, as well as a personal history of depression. There was weaker evidence that associated recurrence with a positive family history of dementia, a personal history of head injury and hippocampal lesions in diffusion-weighted MRI. On the other hand, no connection was found between recurrence and electroencephalographic abnormalities, impaired jugular venous drainage, cardiovascular risk factors, atrial fibrillation, previous cerebrovascular events, exposure to precipitating events, a positive family history of TGA and hypothyroidism. Important pathophysiological insights that arised from these findings were discussed.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Maria Raptopoulou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece.,First Department of Internal Medicine, General Hospital of Trikala, Karditsis 56, 42100Trikala, Greece
| | - Stefanos Mpourlios
- School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Zisis Tsouris
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Athina-Maria Aloizou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Metaxia Dastamani
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Alexandros Brotis
- Department of Neurosurgery, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Dimitrios Bogdanos
- Department of Rheumatology and clinical Immunology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Georgia Xiromerisiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100Larissa, Greece
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13
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Ding X, Peng D. Transient Global Amnesia: An Electrophysiological Disorder Based on Cortical Spreading Depression-Transient Global Amnesia Model. Front Hum Neurosci 2020; 14:602496. [PMID: 33363460 PMCID: PMC7753037 DOI: 10.3389/fnhum.2020.602496] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 11/17/2020] [Indexed: 01/09/2023] Open
Abstract
Transient global amnesia (TGA) is a benign memory disorder with etiologies that have been debated for a long time. The prevalence of stressful events before a TGA attack makes it hard to overlook these precipitating factors, given that stress has the potential to organically effect the brain. Cortical spreading depression (CSD) was proposed as a possible cause decades ago. Being a regional phenomenon, CSD seems to affect every aspect of the micro-mechanism in maintaining the homeostasis of the central nervous system (CNS). Corresponding evidence regarding hemodynamic and morphological changes from TGA and CSD have been accumulated separately, but the resemblance between the two has not been systematically explored so far, which is surprising especially considering that CSD had been confirmed to cause secondary damage in the human brain. Thus, by deeply delving into the anatomic and electrophysiological properties of the CNS, the CSD-TGA model may render insights into the basic pathophysiology behind the façade of the enigmatic clinical presentation.
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Affiliation(s)
- Xuejiao Ding
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Dantao Peng
- Department of Neurology, China-Japan Friendship Hospital, Beijing, China
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14
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Higashida K, Okazaki S, Todo K, Sasaki T, Ohara N, Kohara N, Yamamoto S, Yamagami H, Hashikawa K, Yoshimoto T, Ihara M, Koga M, Szabo K, Mochizuki H. A multicenter study of transient global amnesia for the better detection of magnetic resonance imaging abnormalities. Eur J Neurol 2020; 27:2117-2124. [DOI: 10.1111/ene.14408] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/12/2020] [Accepted: 06/13/2020] [Indexed: 11/29/2022]
Affiliation(s)
- K. Higashida
- Department of Neurology Osaka University Graduate School of Medicine OsakaJapan
| | - S. Okazaki
- Department of Neurology Osaka University Graduate School of Medicine OsakaJapan
| | - K. Todo
- Department of Neurology Osaka University Graduate School of Medicine OsakaJapan
| | - T. Sasaki
- Department of Neurology Osaka University Graduate School of Medicine OsakaJapan
| | - N. Ohara
- Department of Neurology Kobe City Medical Center General Hospital HyogoJapan
| | - N. Kohara
- Department of Neurology Kobe City Medical Center General Hospital HyogoJapan
| | - S. Yamamoto
- Division of Stroke Neurology National Hospital Organization Osaka National Hospital OsakaJapan
| | - H. Yamagami
- Division of Stroke Neurology National Hospital Organization Osaka National Hospital OsakaJapan
| | - K. Hashikawa
- Division of Stroke Neurology National Hospital Organization Osaka National Hospital OsakaJapan
| | - T. Yoshimoto
- Department of Neurology National Cerebral and Cardiovascular Center OsakaJapan
| | - M. Ihara
- Department of Neurology National Cerebral and Cardiovascular Center OsakaJapan
| | - M. Koga
- Department of Cerebrovascular Medicine National Cerebral and Cardiovascular Center Osaka Japan
| | - K. Szabo
- Department of Neurology Medical Faculty Mannheim University of Heidelberg Mannheim Germany
| | - H. Mochizuki
- Department of Neurology Osaka University Graduate School of Medicine OsakaJapan
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15
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Hodel J, Leclerc X, Zuber M, Gerber S, Besson P, Marcaud V, Roubeau V, Brasme H, Ganzoui I, Ducreux D, Pruvo JP, Bertoux M, Zins M, Lopes R. Structural Connectivity and Cortical Thickness Alterations in Transient Global Amnesia. AJNR Am J Neuroradiol 2020; 41:798-803. [PMID: 32381542 DOI: 10.3174/ajnr.a6530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 03/12/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Transient global amnesia (TGA) is a sudden onset of anterograde and retrograde amnesia. We aimed to assess differences in terms of cortical thickness and structural brain connectome between patients with TGA (at acute and delayed postrecovery stages) and matched controls. MATERIALS AND METHODS We report on 18 consecutive patients with TGA who underwent 3T MR imaging, including DTI and MPRAGE sequences, at the acute (mean delay postonset: 44 hours) and delayed post-recovery (mean delay: 35 days) stages. Structural connectome was assessed in patients with TGA and in 18 age- and sex-matched controls by using probabilistic fiber- tracking and segmentation of 164 cortical/subcortical structures ("nodes"). Connectivity graphs were computed and global network metrics were calculated. Network-based statistical analysis (NBS) was applied to compare patients with TGA at each stage with controls. We also compared cortical thickness between patients with TGA and healthy controls. RESULTS Global network metrics were not altered in patients with TGA. NBS-analysis showed structural connectome alterations in patients with TGA compared with controls, in core regions involving the limbic network, with 113 nodes and 114 connections (33 left intrahemispheric, 31 right intrahemispheric, and 50 interhemispheric connections) showing significantly decreased structural connectivity (P < .05 NBS corrected, t-values ranging from 3.03 to 8.73). Lower cortical thickness compared with controls was associated with these structural alterations in patients with TGA, involving the orbitofrontal, cingulate, and inferior temporal cortices. All the abnormalities were visible at both acute and delayed postrecovery stages. CONCLUSIONS Our preliminary study suggests there are structural abnormalities of the limbic network in patients with TGA compared with controls, including decreased structural connectivity and cortical thickness.
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Affiliation(s)
- J Hodel
- From the Departments of Radiology (J.H., S.G., I.G., M.Z.)
| | - X Leclerc
- Department of Neuroradiology (X.L., J.-P.P., R.L.), Roger Salengro Hospital, Lille, France
| | - M Zuber
- Neurology (M.Z., V.M., V.R., H.B.), Saint Joseph Hospital, Paris, France.,INSERM UMR S919 (M.Z.), Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - S Gerber
- From the Departments of Radiology (J.H., S.G., I.G., M.Z.)
| | - P Besson
- Department of Radiology (P.B.), Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - V Marcaud
- Neurology (M.Z., V.M., V.R., H.B.), Saint Joseph Hospital, Paris, France
| | - V Roubeau
- Neurology (M.Z., V.M., V.R., H.B.), Saint Joseph Hospital, Paris, France
| | - H Brasme
- Neurology (M.Z., V.M., V.R., H.B.), Saint Joseph Hospital, Paris, France
| | - I Ganzoui
- From the Departments of Radiology (J.H., S.G., I.G., M.Z.)
| | - D Ducreux
- Department of Neuroradiology (D.D.), Bicêtre Hospital, Kremlin-Bicêtre, France
| | - J-P Pruvo
- Department of Neuroradiology (X.L., J.-P.P., R.L.), Roger Salengro Hospital, Lille, France
| | - M Bertoux
- University of Lille (M.B., R.L.), Inserm U1171, CHU Lille, F-59000, Lille, France
| | - M Zins
- From the Departments of Radiology (J.H., S.G., I.G., M.Z.)
| | - R Lopes
- Department of Neuroradiology (X.L., J.-P.P., R.L.), Roger Salengro Hospital, Lille, France.,University of Lille (M.B., R.L.), Inserm U1171, CHU Lille, F-59000, Lille, France
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