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Quinette P, Constans JM, Hainselin M, Desgranges B, Eustache F, Viader F. Hippocampal modifications in transient global amnesia. Rev Neurol (Paris) 2015; 171:282-8. [PMID: 25769554 DOI: 10.1016/j.neurol.2015.01.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Accepted: 01/28/2015] [Indexed: 10/23/2022]
Abstract
Transient global amnesia (TGA) is an acute and transient syndrome with a remarkably stereotypical set of signs and symptoms. It is characterized by the abrupt onset (no forewarning) of massive episodic memory impairment, both anterograde and retrograde. Ever since it was first described, TGA has fascinated neurologists and other memory experts, and in recent years, there has been a surge of neuroimaging studies seeking to pin down the brain dysfunction responsible for it. Several pathophysiological hypotheses have been put forward, including the short-lived suggestion of an epileptic mechanism. All the available data indicate that the brain modifications are reversible, and that the mechanism behind TGA is of a functional nature. However, while diffusion-weighted imaging studies have clearly identified the hippocampus and, more specifically, the CA1 area, as the locus of brain modifications associated with TGA, researchers have yet to determine whether the origin of the mechanism is vascular or neurochemical. Spectroscopy may provide a means of settling this issue once and for all.
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Affiliation(s)
- P Quinette
- U1077, Inserm, 5, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen Cedex 9, France; UMR-S1077, University of Caen - Basse-Normandie, esplanade de la Paix, 14032 Caen Cedex 5, France; UMR-S1077, École Pratique des Hautes Études, 5, avenue de la Côte-de-Nacre, 14032 Caen Cedex 5, France; U1077, Caen University Hospital, 5, avenue de la Côte-de-Nacre, 14033 Caen Cedex 9, France
| | - J M Constans
- Radiology and Medical Imaging Department, Amiens University Hospital, place Victor-Pauchet, 80054 Amiens Cedex 1, France
| | - M Hainselin
- U1077, Inserm, 5, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen Cedex 9, France; UMR-S1077, University of Caen - Basse-Normandie, esplanade de la Paix, 14032 Caen Cedex 5, France; UMR-S1077, École Pratique des Hautes Études, 5, avenue de la Côte-de-Nacre, 14032 Caen Cedex 5, France; U1077, Caen University Hospital, 5, avenue de la Côte-de-Nacre, 14033 Caen Cedex 9, France; CRPCPO, EA 7273, University of Picardie Jules Verne, chemin du Thil, 80000 Amiens, France
| | - B Desgranges
- U1077, Inserm, 5, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen Cedex 9, France; UMR-S1077, University of Caen - Basse-Normandie, esplanade de la Paix, 14032 Caen Cedex 5, France; UMR-S1077, École Pratique des Hautes Études, 5, avenue de la Côte-de-Nacre, 14032 Caen Cedex 5, France; U1077, Caen University Hospital, 5, avenue de la Côte-de-Nacre, 14033 Caen Cedex 9, France
| | - F Eustache
- U1077, Inserm, 5, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen Cedex 9, France; UMR-S1077, University of Caen - Basse-Normandie, esplanade de la Paix, 14032 Caen Cedex 5, France; UMR-S1077, École Pratique des Hautes Études, 5, avenue de la Côte-de-Nacre, 14032 Caen Cedex 5, France; U1077, Caen University Hospital, 5, avenue de la Côte-de-Nacre, 14033 Caen Cedex 9, France.
| | - F Viader
- U1077, Inserm, 5, avenue de la Côte-de-Nacre, CS 30001, 14033 Caen Cedex 9, France; UMR-S1077, University of Caen - Basse-Normandie, esplanade de la Paix, 14032 Caen Cedex 5, France; UMR-S1077, École Pratique des Hautes Études, 5, avenue de la Côte-de-Nacre, 14032 Caen Cedex 5, France; U1077, Caen University Hospital, 5, avenue de la Côte-de-Nacre, 14033 Caen Cedex 9, France; Neurology Department, Caen University Hospital, avenue de la Côte-de-Nacre, 14033 Caen Cedex 9, France
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Abstract
The impact of advanced brain imaging procedures in the field of human memory disorder is reviewed, with particular emphasis on current and potential applications that may impact upon the diagnosis and management of memory-disordered patients. While both advanced structural, resting physiological and functional physiological brain imaging procedures have been applied to conditions where memory disorder is a major feature, the specific implications of research findings for diagnosis and treatment in routine clinical practice remain tentative and promising, but not yet substantive enough to inform clinical decisions to a significant degree. In terms of diagnostic applications, several promising areas include dementia, epilepsy, and transient amnesic states. In the case of applications in treatment settings, advanced brain imaging procedures may help to monitor neural correlates of spontaneous recovery or progression of memory function, and may also help in the planning and monitoring of therapeutic intervention.
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Affiliation(s)
- Narinder Kapur
- Wessex Neurological Centre, Department of Psychology, University of Southampton, UK.
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