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Piffer S, Nannoni S, Maulucci F, Beaud V, Rouaud O, Cereda CW, Maeder P, Michel P. Acute neurological disease as a trigger or co-occurrence of transient global amnesia: a case series and systematic review. Neurol Sci 2022; 43:5959-5967. [PMID: 35838848 DOI: 10.1007/s10072-022-06259-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/05/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Transient global amnesia (TGA) represents a benign neurological syndrome of unknown pathophysiology, often accompanied by vanishing hippocampal punctate lesions on diffusion-weighted imaging (hippocampal punctate diffusion lesion, HPDL). The recent literature suggests that TGA may be triggered by acute neurological conditions. OBJECTIVE To study patients with TGA triggered by an acute neurological disease. METHODS We retrospectively reviewed patients from two neurology centres with TGA (with or without HPDL) in whom an acute neurological condition could be identified as trigger. We also performed a systematic review of the literature of this situation using predefined search terms. RESULTS We identified 38 patients (median age 62 years, 55.3% female): 6 from our centres and 32 from the literature. Acute neurovascular diseases that preceded or were associated with TGA included ischemic and haemorrhagic strokes, convexity subarachnoid haemorrhage, and reversible cerebral vasoconstriction syndrome. As non-vascular acute neurological diseases, we identified migraine and peripheral-origin vertigo. The clinical manifestation of the neurological trigger showed a variable temporal relation with TGA onset; in some cases preceding and in others co-occurring with TGA manifestation. In some cases, presumed neurological triggers were asymptomatic and diagnosed from the neuroimaging done for the TGA. CONCLUSIONS Acute vascular and non-vascular neurological events may trigger TGAs or may occur simultaneously. In the first case, such an acute neurological disease may activate direct pathways within the nervous systems leading to TGA, or alternatively elicit a bodily sympathetic overactivity cascade. In the second case, both neurological events may be the result of a common external stressor.
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Affiliation(s)
- Silvio Piffer
- Stroke Centre and Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
- Neurology Unit, Department of Emergency, Santa Chiara Hospital, Trento, Italy.
| | - Stefania Nannoni
- Stroke Centre and Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Francesco Maulucci
- Stroke Centre EOC, Neurology Department, Neurocentre of Southern Switzerland (NSI), Ospedale Civico, Lugano, Switzerland
| | - Valérie Beaud
- Neuropsychology and Neurorehabilitation Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Olivier Rouaud
- Leenaards Memory Centre, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Carlo W Cereda
- Stroke Centre EOC, Neurology Department, Neurocentre of Southern Switzerland (NSI), Ospedale Civico, Lugano, Switzerland
| | - Philippe Maeder
- Department of Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Patrik Michel
- Stroke Centre and Neurology Service, Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Forgetting the Unforgettable: Transient Global Amnesia Part II: A Clinical Road Map. J Clin Med 2022; 11:jcm11143940. [PMID: 35887703 PMCID: PMC9319625 DOI: 10.3390/jcm11143940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/03/2022] [Accepted: 07/05/2022] [Indexed: 12/14/2022] Open
Abstract
Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of a temporary memory disorder with profound anterograde amnesia and a variable impairment of the past memory. Usually, the attacks are preceded by a precipitating event, last up to 24 h and are not associated with other neurological deficits. Diagnosis can be challenging because the identification of TGA requires the exclusion of some acute amnestic syndromes that occur in emergency situations and share structural or functional alterations of memory circuits. Magnetic Resonance Imaging (MRI) studies performed 24–96 h after symptom onset can help to confirm the diagnosis by identifying lesions in the CA1 field of the hippocampal cornu ammonis, but their practical utility in changing the management of patients is a matter of discussion. In this review, we aim to provide a practical approach to early recognition of this condition in daily practice, highlighting both the lights and the shadows of the diagnostic criteria. For this purpose, we summarize current knowledge about the clinical presentation, diagnostic pathways, differential diagnosis, and the expected long-term outcome of TGA.
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Oliveira R, Teodoro T, Marques IB. Risk factors predicting recurrence of transient global amnesia. Neurol Sci 2020; 42:2039-2043. [DOI: 10.1007/s10072-020-04788-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 09/30/2020] [Indexed: 12/14/2022]
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Spiegel DR, Smith J, Wade RR, Cherukuru N, Ursani A, Dobruskina Y, Crist T, Busch RF, Dhanani RM, Dreyer N. Transient global amnesia: current perspectives. Neuropsychiatr Dis Treat 2017; 13:2691-2703. [PMID: 29123402 PMCID: PMC5661450 DOI: 10.2147/ndt.s130710] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of an extraordinarily large reduction of anterograde and a somewhat milder reduction of retrograde episodic long-term memory. Additionally, executive functions are described as diminished. Although it is suggested that various factors, such as migraine, focal ischemia, venous flow abnormalities, and epileptic phenomena, are involved in the pathophysiology and differential diagnosis of TGA, the factors triggering the emergence of these lesions are still elusive. Recent data suggest that the vulnerability of CA1 neurons to metabolic stress plays a pivotal part in the pathophysiological cascade, leading to an impairment of hippocampal function during TGA. In this review, we discuss clinical aspects, new imaging findings, and recent clinical-epidemiological data with regard to the phenotype, functional anatomy, and putative cellular mechanisms of TGA.
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Affiliation(s)
- David R Spiegel
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Justin Smith
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Ryan R Wade
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Nithya Cherukuru
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Aneel Ursani
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Yuliya Dobruskina
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Taylor Crist
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Robert F Busch
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Rahim M Dhanani
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
| | - Nicholas Dreyer
- Department of Psychiatry and Behavioral Sciences, Eastern Virginia Medical School, Norfolk, VA, USA
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Shen P, Hou S, Zhu M, Zhao M, Ouyang Y, Feng J. Cortical spreading depression preconditioning mediates neuroprotection against ischemic stroke by inducing AMP-activated protein kinase-dependent autophagy in a rat cerebral ischemic/reperfusion injury model. J Neurochem 2017; 140:799-813. [PMID: 27987215 DOI: 10.1111/jnc.13922] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 11/30/2016] [Accepted: 12/02/2016] [Indexed: 12/11/2022]
Affiliation(s)
- Pingping Shen
- Institute of Neuroscience Center and Neurology Department; The First Affiliated Hospital of Jilin University; Changchun Jilin China
| | - Shuai Hou
- Institute of Neuroscience Center and Neurology Department; The First Affiliated Hospital of Jilin University; Changchun Jilin China
| | - Mingqin Zhu
- Institute of Neuroscience Center and Neurology Department; The First Affiliated Hospital of Jilin University; Changchun Jilin China
| | - Mingming Zhao
- Institute of Neuroscience Center and Neurology Department; The First Affiliated Hospital of Jilin University; Changchun Jilin China
| | - Yibing Ouyang
- Institute of Neuroscience Center and Neurology Department; The First Affiliated Hospital of Jilin University; Changchun Jilin China
- Department of Anesthesia; Stanford University School of Medicine; Stanford California USA
| | - Jiachun Feng
- Institute of Neuroscience Center and Neurology Department; The First Affiliated Hospital of Jilin University; Changchun Jilin China
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Park YH, Jeong HY, Jang JW, Park SY, Lim JS, Kim JY, Im CH, Ahn S, Park SH, Kim S. Disruption of the Posterior Medial Network during the Acute Stage of Transient Global Amnesia: A Preliminary Study. Clin EEG Neurosci 2016; 47:69-74. [PMID: 25392008 DOI: 10.1177/1550059414543684] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 06/20/2014] [Indexed: 11/15/2022]
Abstract
Acute perturbation of the corticohippocampal circuitry is a primary pathophysiological mechanism underlying transient global amnesia (TGA). With regard to memory, 2 distinct corticohippocampal circuitries potentially exist: the anterior temporal network and the posterior medial network. We used electroencephalography (EEG) spectral analysis to determine which network is disrupted during the acute stage of TGA. Patients with TGA who visited Seoul National University Bundang Hospital within 24 hours after symptom onset were retrospectively identified. Twenty patients underwent EEG twice, once in the acute stage (<24 hours after symptom onset) and once in the resolved stage (>2 months after symptom onset). A fast Fourier transform was applied to compute the spectral power of the 6 frequency bands: delta, theta, alpha, beta 1, beta 2, and gamma. We assumed that the frontocentral and temporal regions belonged to the anterior temporal network, whereas the parieto-occipital regions belonged to the posterior medial network. A paired Student's t test was used to evaluate the difference in the regional spectral powers in each frequency band between the acute and resolved TGA stages. Compared with the resolved stage, relative theta power in the left parieto-occipital region was increased and relative alpha power in the right parieto-occipital region was reduced during the acute stage of TGA, with a statistical significance of P<.05 (uncorrected). The cortical regions that belonged to the posterior medial network showed alterations of neuronal activity, which reflects disruption of the posterior medial network during the acute stage of TGA.
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Affiliation(s)
- Young Ho Park
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Han-Yeong Jeong
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Won Jang
- Department of Neurology, Kangwon National University Hospital, Chuncheon, Korea
| | - So Young Park
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jae-Sung Lim
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea Department of Neurology, Seoul National University Boramae Hospital, Seoul, Korea
| | - Jeong-Youn Kim
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Chang-Hwan Im
- Department of Biomedical Engineering, Hanyang University, Seoul, Korea
| | - Soyeon Ahn
- Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seong-Ho Park
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University College of Medicine, Seoul, Korea Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Korea
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Shen PP, Hou S, Ma D, Zhao MM, Zhu MQ, Zhang JD, Feng LS, Cui L, Feng JC. Cortical spreading depression-induced preconditioning in the brain. Neural Regen Res 2016; 11:1857-1864. [PMID: 28123433 PMCID: PMC5204245 DOI: 10.4103/1673-5374.194759] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Cortical spreading depression is a technique used to depolarize neurons. During focal or global ischemia, cortical spreading depression-induced preconditioning can enhance tolerance of further injury. However, the underlying mechanism for this phenomenon remains relatively unclear. To date, numerous issues exist regarding the experimental model used to precondition the brain with cortical spreading depression, such as the administration route, concentration of potassium chloride, induction time, duration of the protection provided by the treatment, the regional distribution of the protective effect, and the types of neurons responsible for the greater tolerance. In this review, we focus on the mechanisms underlying cortical spreading depression-induced tolerance in the brain, considering excitatory neurotransmission and metabolism, nitric oxide, genomic reprogramming, inflammation, neurotropic factors, and cellular stress response. Specifically, we clarify the procedures and detailed information regarding cortical spreading depression-induced preconditioning and build a foundation for more comprehensive investigations in the field of neural regeneration and clinical application in the future.
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Affiliation(s)
- Ping-Ping Shen
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Shuai Hou
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Di Ma
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ming-Ming Zhao
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Ming-Qin Zhu
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jing-Dian Zhang
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Liang-Shu Feng
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Li Cui
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
| | - Jia-Chun Feng
- Institute of Neuroscience Center and Neurology Department, the First Affiliated Hospital of Jilin University, Changchun, Jilin Province, China
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Donnet A. Transient Global Amnesia Triggered by Migraine in a French Tertiary-Care Center: An 11-Year Retrospective Analysis. Headache 2015; 55:853-9. [PMID: 25877480 DOI: 10.1111/head.12545] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The etiology of transient global amnesia (TGA) remains unclear, and flow disturbances in the mesial temporal lobes secondary to venous congestion have been proposed as a potential cause. The occurrence of TGA during a migraine attack is a rare condition. METHODS This 11-year retrospective study in one French center describes patients' characteristics, type of migraine, investigations, treatment with vasoconstrictor during the TGA/migraine attack, and outcome in patients who had TGA during a migraine attack. RESULTS Among 8821 new patients, 6 cases of TGA occurring during a migraine attack were identified. For a majority of patients, TGA occurs after the beginning of the attack. TGA always occurs during a severe migraine attack, with vomiting or vomiting efforts. Vomiting or vomiting efforts always precede a TGA episode. CONCLUSIONS TGA occurring during a migraine attack is rare. Since a Valsalva maneuver, such as forceful vomiting, is frequently described at the origin of the attack, blocking venous return through the superior venous cava may allow brief retrograde transmission of high venous pressure from the arms to the cerebral venous system, resulting in venous ischemia to the diencephalon or mesial temporal lobes and causing TGA.
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Affiliation(s)
- Anne Donnet
- Centre d'Evaluation et de Traitement de la Douleur, Hôpital Timone, Marseille, France
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Abstract
Diagnostically, headache is the easy part of migraine. It is the surrounds of migraine--the aura, prodrome and postdrome--that can be most challenging, and confused with other pathologies. This article examines the definition and variants of migraine; alternative diagnoses for which migraine may be mistaken (mimics); conditions that lie between migraine and other diagnoses (borderlands) and the possible presentations of migraine posing as other conditions (chameleons). The focus is on adults, with only passing reference to children. Migraine is more often a chameleon than a mimic; and it is the careful history that usually makes the distinction. Given migraine's prevalence of 10-15%, relatively uncommon features of migraine occur quite often, in comparison with frequent manifestations of less common diseases. Thus, even rare or under-recognised presentations of migraine come into the differential diagnosis of many presentations.
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Bongsebandhu-Phubhakdi S, Maneepark M, Srikiatkhachorn A. Cortical spreading depression impairs hippocampal long-term potentiation by the alteration of glutamate receptor responses. J Headache Pain 2013. [PMCID: PMC3620428 DOI: 10.1186/1129-2377-14-s1-p66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Maneepark M, Srikiatkhachorn A, Bongsebandhu-phubhakdi S. Involvement of AMPA receptors in CSD-induced impairment of LTP in the hippocampus. Headache 2012; 52:1535-45. [PMID: 22862296 DOI: 10.1111/j.1526-4610.2012.02229.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the alteration of hippocampal long-term plasticity and basal synaptic transmission induced by repetitive cortical spreading depressions (CSDs). BACKGROUND There is a relationship between migraine aura and amnesia attack. CSD, a state underlying migraine attacks, may be responsible for hippocampus-related symptoms. However, the precise role of CSD on hippocampal activity has not been investigated. METHODS Male Wistar rats were divided into CSD and control groups. Repetitive CSDs were induced in vivo by topical application of solid KCl. Forty-five minutes later, the ipsilateral hippocampus was removed, and hippocampal slices were prepared for a series of electrophysiological studies. RESULTS Repetitive CSDs led to a decrease in the magnitude of long-term potentiation in the hippocampus. CSD also reduced hippocampal synaptic efficacy, as shown by a reduction in post-synaptic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor responses. In contrast, the post-synaptic N-methyl-d-aspartate receptor responses remained unchanged. In addition, there were no changes in paired-pulse profiles between the groups, indicating that CSD did not induce any presynaptic alterations. CONCLUSION These findings suggest that a reduction of post-synaptic α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor responses is the mechanism responsible for impaired hippocampal long-term potentiation induced by CSD.
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Affiliation(s)
- Montree Maneepark
- Department of Physiology, Faculty of Medicine, Chulalongkorn University, Patumwan, Bangkok, Thailand
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Segal NL. The Value of Twin Studies: A Response to Slate Magazine / Research Reviews / Twin News Worth Noting. Twin Res Hum Genet 2011; 14:593-5. [DOI: 10.1375/twin.14.6.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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