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Cho S, Lee SH, Lee HJ, Chu MK, Kim WJ, Heo K, Kim KM. Changes in heart rate variability over time from symptom onset of transient global amnesia. Sci Rep 2024; 14:6944. [PMID: 38521821 PMCID: PMC10960858 DOI: 10.1038/s41598-024-57546-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/19/2024] [Indexed: 03/25/2024] Open
Abstract
Transient global amnesia (TGA) often involves precipitating events associated with changes in autonomic nervous system (ANS), and heart rate variability (HRV) reflects the ANS state. This study aimed to investigate HRV changes after TGA. A retrospective analysis of HRV included patients diagnosed with TGA between January 2015 and May 2020. The time and frequency domains of HRV were compared among three groups: early (< 1 week after TGA, n = 19), late (1-4 weeks after TGA, n = 38), and healthy control (HC, n = 19). The Pearson's correlation between time and time-domain HRV was also examined. The standard deviation of NN intervals (SDNN) (early, 47.2; late, 35.5; HC, 41.5; p = 0.033) and root mean square of successive RR interval differences (RMSSD) (early, 38.5; late, 21.3; HC, 31.0; p = 0.006) differed significantly among the three groups. Post-hoc analysis showed statistically significant differences only in the early and late groups in both SDNN (p = 0.032) and RMSSD (p = 0.006) values. However, the frequency domain with total power, low-frequency and high-frequency powers, and low-frequency/high-frequency ratio did not differ. SDNN (Pearson correlation coefficient =- 0.396, p = 0.002) and RMSSD (Pearson correlation coefficient =- 0.406, p = 0.002) were negatively correlated with time after TGA. Changes in HRV occurred over time after the onset of TGA, with the pattern showing an increase in the first week and then a decrease within 4 weeks.
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Affiliation(s)
- Soomi Cho
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Sue Hyun Lee
- Department of Neurology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
| | - Hye Jeong Lee
- Department of Neurology, Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, Republic of Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Kyoung Heo
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
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Taheri S, Peters N, Zietz A, Abel B, Hubert G, Barinka F, Wiestler H, Kovacic I, Linker R, Schlachetzki F, Backhaus R. Clinical Course and Recurrence in Transient Global Amnesia: A Study From the TEMPiS Telestroke Network. J Clin Neurol 2023; 19:530-538. [PMID: 37455507 PMCID: PMC10622726 DOI: 10.3988/jcn.2022.0368] [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: 09/25/2022] [Revised: 11/17/2022] [Accepted: 03/07/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND AND PURPOSE While the clinical hallmarks of transient global amnesia (TGA) are well defined, its pathophysiological causes are poorly understood. Specifically, risk factors for recurrences are yet to be determined. METHODS This retrospective study analyzed TGA cases diagnosed and treated within the TEMPiS telestroke network and a university stroke center in Germany. Demographic and clinical data were assessed and characteristics of TGA episodes were recorded, such as season of occurrence, trigger factors, duration, and concomitant symptoms. Follow-up of the potential recurrence of TGA was performed using a standardized questionnaire. RESULTS Overall 109 patients were included (age 64±8 years [mean±SD], 59.6% female). The most common vascular risk factor was arterial hypertension (60.6%), and other concomitant conditions included migraine (11.9%), hypothyroidism (22.9%), and atrial fibrillation (4.6%). The most frequent concomitant clinical feature accompanying the TGA episode at admission was elevated blood pressure (48.6%). Nineteen patients experienced at least one recurrent TGA episode. Migraine and hypothyroidism were only observed in subjects with a single TGA episode without recurrence (migraine: 14.4% without recurrence vs. none in the recurrence group, p=0.02; hypothyroidism: 27.8% without recurrence vs. none in the recurrence group, p=0.009). In contrast, atrial fibrillation was more common in subjects with TGA recurrence (p<0.001). CONCLUSIONS Arterial hypertension is prevalent in TGA patients, with elevated blood pressure being the most-frequent concomitant condition. In our cohort, recurrence of TGA occurred in approximately one-fifth of patients. Concomitant conditions such as migraine, hypothyroidism, and atrial fibrillation occurred at different frequencies in the two groups.
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Affiliation(s)
- Shadi Taheri
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
- University of Basel, Basel, Switzerland.
| | - Nils Peters
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
- University of Basel, Basel, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland.
| | - Annaelle Zietz
- University of Basel, Basel, Switzerland
- Department of Neurology and Stroke Center, University Hospital Basel, Basel, Switzerland
| | - Berthold Abel
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
| | - Gordian Hubert
- Department of Neurology, TEMPiS Telemedical Stroke Center, München Klinik Harlaching, Munich, Germany
| | - Filip Barinka
- Stroke Center, Klinik Hirslanden, Zürich, Switzerland
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Hanni Wiestler
- Department of Neurology, TEMPiS Telemedical Stroke Center, München Klinik Harlaching, Munich, Germany
| | - Irena Kovacic
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Ralf Linker
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Felix Schlachetzki
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
| | - Roland Backhaus
- Department of Neurology, University of Regensburg, TEMPiS Telemedical Stroke Center, Medbo Bezirksklinikum Regensburg, Regensburg, Germany
- Swiss Clinical Neuroscience Institute, Zurich, Switzerland
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Komulainen T, Bärlund V, Tanila H, Koivisto A, Jäkälä P. Incidence and Risk Factors of Transient Global Amnesia. Neuroepidemiology 2023; 57:246-252. [PMID: 37231955 DOI: 10.1159/000530713] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 03/27/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Transient global amnesia (TGA) is a spontaneously resolving, anterograde amnesia that lasts mostly <24 h and often occurs with retrograde amnesia. The etiology of TGA remains unclear, although in recent decades, many risk factors and preceding events have been identified. There are few up-to-date reports on the TGA incidence in Northern Europe. In this study, we report the incidence and risk factors associated with TGA in Finland. MATERIALS AND METHODS The study included all patients with suspected TGA that were referred to Kuopio University Hospital (KUH) in 2017. The hospital catchment area included 246,653 individuals. Risk factors and demographic data were collected from medical records. The TGA incidence rates were calculated as the number of patients with TGA divided by the number of individuals at risk in different age groups. RESULTS In 2017, 56 patients were treated for TGA at KUH. Of these, 46 had a first-ever TGA. The most common event preceding TGA was physical effort (n = 28, 50%), followed by emotional stress (n = 11, 19.6%) and water contact or a temperature change (n = 11, 19.6%). The most common comorbidities were hypercholesterolemia (n = 22, 39.3%), hypertensive disease (n = 21, 37.5%), hypothyroidism (n = 11, 19.6%), coronary artery disease (n = 8, 14.3%), and migraine (n = 7, 12.5%). TGA occurred most often in December (n = 9, 16.0%), March (n = 8, 14.3%), or October (n = 8, 14.3%), and least often in November and May (n = 2, 3.6% in both months). The crude incidence of a first TGA in Eastern Finland was 18.6/100,000 inhabitants, and when standardized to the European population in 2010, it was 14.3/100,000 inhabitants. Therefore, the TGA incidence was higher than previously reported in European countries. DISCUSSION The most common precipitating factors for TGA were physical effort, emotional stress, and water contact/temperature change. The incidence of TGA was high in the Eastern Finnish population.
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Affiliation(s)
- Tiina Komulainen
- Department of Neurology, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Venla Bärlund
- Department of Medicine, Päijät-Häme Central Hospital, Lahti, Finland
| | - Heikki Tanila
- A. I. Virtanen Institute, University of Eastern Finland, Kuopio, Finland
| | - Anne Koivisto
- Department of Neurology, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
- Helsinki University Hospital, Geriatrics, Internal Medicine and Rehabilitation, Helsinki, Finland
- Department of Neurosciences, University of Helsinki, Helsinki, Finland
| | - Pekka Jäkälä
- Department of Neurology, University of Eastern Finland, Kuopio, Finland
- Department of Neurology, Kuopio University Hospital, Kuopio, Finland
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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: 3] [Impact Index Per Article: 1.5] [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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Hippocampal infarction: redefining transient global amnesia. Neurol Sci 2022; 43:4281-4286. [DOI: 10.1007/s10072-022-05980-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 02/21/2022] [Indexed: 10/18/2022]
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Hernández MA, Arena JE, Alessandro L, Allegri RF, Calandri IL. Transient Global Amnesia Recurrence: Prevalence and Risk Factor Meta-analysis. Neurol Clin Pract 2022; 12:e35-e48. [DOI: 10.1212/cpj.0000000000001181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/24/2022] [Indexed: 11/15/2022]
Abstract
ABSTRACTBackground:Transient global amnesia (TGA) is an acute amnestic disorder with unclear pathophysiology. Although considered a benign phenomenon, the possibility of a recurrence is a major concern for the patient. Our objective is to identify the prevalence and risk factors of relapse, to help clinicians counsel patients about it.Methods:According to PRISMA guidance, we screened 1658 studies from MEDLINE, Lilacs and Embase databases, published from 1985 to April 2021, in English or Spanish. We included 36 observational case-control and cohort studies that included patients with TGA according to Caplan’s or Hodges and Warlow’s diagnostic criteria. We performed a meta-analysis with a random effect model for proportions and calculation of odds ratio for identified risk factors. Methodological quality was assessed according to the Newcastle-Ottawa Scale.Results:We identified 4514 TGA and 544 recurrence events (12.73%). Follow-up had no impact on its variance. We identified a statistically significant association between recurrence and sexual activity as a trigger, past or present personal history of migraine and depression (OR 1,481 95%CI [1,0341; 2,1222] p=0,04; OR=2,0795 IC95% [1,3892; 3,1128] p=0,003; and OR=4,487195%CI [1,890; 10,651] p=0,0288, respectively).Conclusions:The analysis showed that about 1 out of 8 subjects may have recurrence, with an increased risk in case of past or present history of migraine, depression or sexual intercourse prior to the event. Personal history of migraine and depression are associated with two and four times risk, respectively.
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Rogalewski A, Beyer A, Friedrich A, Plümer J, Zuhorn F, Klingebiel R, Woermann FG, Bien CG, Greeve I, Schäbitz WR. Transient Global Amnesia (TGA): Younger Age and Absence of Cerebral Microangiopathy Are Potentially Predisposing Factors for TGA Recurrence. Front Neurol 2021; 12:736563. [PMID: 34777205 PMCID: PMC8579867 DOI: 10.3389/fneur.2021.736563] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 09/13/2021] [Indexed: 11/19/2022] Open
Abstract
Background: Transient global amnesia (TGA) is defined by an acute memory disturbance of unclear etiology for a period of less than 24 h. TGA occurs as a single event in most cases. Prevalence rates of recurrent TGA vary widely from 5.4 to 27.1%. This retrospective study aimed to determine predictors for TGA recurrence. Methods: Cardiovascular risk profile and magnetic resonance imaging (MRI) of 340 hospitalized TGA patients between 2011 and 2020 were retrospectively analyzed. The median follow-up period amounted to 4.5 ± 2.7 years. Comparisons were made between TGA patients with and without subsequent recurrence. Results: TGA patients with subsequent recurrence were significantly younger (recurrent vs. single episode, 63.6 ± 8.6 years vs. 67.3 ± 10.5 years, p = 0.032) and showed a lower degree of cerebral microangiopathy compared to TGA patients without recurrence. The mean latency to recurrence was 3.0 years ± 2.1 years after the first episode. In a subgroup analysis, patients with at least five years of follow-up (N = 160, median follow-up period 7.0 ± 1.4 years) had a recurrence rate of 11.3%. A 24.5% risk of subsequent TGA recurrence in the following five years was determined for TGA patients up to 70 years of age without microangiopathic changes on MRI (Fazekas' score 0). Conclusion: Younger TGA patients without significant microangiopathy do have an increased recurrence risk. In turn, pre-existing cerebrovascular pathology, in the form of chronic hypertension and cerebral microangiopathy, seems to counteract TGA recurrence.
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Affiliation(s)
- Andreas Rogalewski
- Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Anne Beyer
- Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Anja Friedrich
- Department of Psychology, Bielefeld University, Bielefeld, Germany
| | - Jorge Plümer
- Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Frédéric Zuhorn
- Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Randolf Klingebiel
- Department of Neuroradiology, Evangelisches Klinikum Bethel EvKB, University Hospital OWL, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Friedrich G Woermann
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Christian G Bien
- Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany
| | - Isabell Greeve
- Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Wolf-Rüdiger Schäbitz
- Department of Neurology, Evangelisches Klinikum Bethel, University Hospital OWL, University Bielefeld, Campus Bielefeld-Bethel, Bielefeld, Germany
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Morris KA, Rabinstein AA, Young NP. Factors Associated With Risk of Recurrent Transient Global Amnesia. JAMA Neurol 2021; 77:1551-1558. [PMID: 32865551 DOI: 10.1001/jamaneurol.2020.2943] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Transient global amnesia (TGA) is usually considered a benign event with a low recurrence rate. However, recurrence rates vary considerably among studies and there are no known risk factors for TGA. Objective To examine risk factors for the recurrence of TGA. Design, Setting, and Participants This retrospective cohort study involved medical record review of patients with isolated or recurrent TGA presenting to the Mayo Clinic in Rochester, Minnesota, between August 1, 1992, and February 28, 2018. A total of 1491 cases were reviewed and 1044 met diagnostic inclusion criteria for TGA, with the remainder excluded owing to indeterminate or alternate diagnoses or limited information available in the medical record. Exposures Single vs recurrent episodes of TGA. Main Outcomes and Measures Demographics, precipitating factors, migraine history, imaging and electrodiagnostic findings, and family history of TGA were collected. The main outcome measure was TGA recurrence. Results Of 1044 included patients, 575 (55.1%) were male, and the mean (SD) age at inclusion was 75.0 (11.5) years. A total of 901 patients (86.3%) had a single episode of TGA and 143 (13.7%) had recurrent episodes of TGA. The 2 groups were similar in age at inclusion, sex, identifiable triggers, and duration of anterograde amnesia. The number of recurrences ranged from 1 to 9, with 137 individuals (95.8%) having 3 or fewer recurrences. The mean (SD) age at first episode of TGA was 65.2 (10.0) years for individuals with a single episode vs 58.8 (10.3) years for those with recurrent episodes (P < .001). There was a personal history of migraine in 180 individuals (20.0%) with a single episode of TGA and 52 individuals (36.4%) with recurrent episodes of TGA (P < .001), and a family history of migraine in 167 individuals (18.5%) with a single episode of TGA and 44 individuals (30.8%) with recurrent episodes of TGA (P = .001). There were no electroencephalographic findings associated with increased risk of TGA recurrence. Acute and subacute temporal lobe abnormalities on results of magnetic resonance imaging were seen rarely and did not require intervention. A family history of TGA was identified in 12 individuals (1.3%) with a single episode of TGA and 4 individuals (2.8%) with recurrent episodes of TGA. Conclusions and Relevance This study suggests that, in this large cohort of patients with TGA, recurrent TGA was associated with earlier age at the time of first TGA episode and higher prevalence of both personal and family history of migraine compared with isolated cases. These results can be used to counsel patients about risks of recurrence and may have implications for the understanding of TGA pathophysiology.
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Affiliation(s)
- Ken A Morris
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
| | | | - Nathan P Young
- Department of Neurology, Mayo Clinic, Rochester, Minnesota
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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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Migraine in transient global amnesia: a meta-analysis of observational studies. J Neurol 2021; 269:184-196. [PMID: 33388926 DOI: 10.1007/s00415-020-10363-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND PURPOSE: Although many studies have investigated the relationship between transient global amnesia (TGA) and migraine, to date, no meta-analysis has confirmed the existence and size of their association. METHODOLOGY Literature search involved MEDLINE, EMBASE, CENTRAL and PsycINFO. Observational controlled studies including TGA patients (Caplan, Hodges and Warlow) were retrieved. Quality evaluation was based on the Newcastle-Ottawa scale. The prevalence of migraine was compared in TGA patients vs. healthy controls (HC), as well as in TGA against TIA individuals. Data from case-control, cross-sectional and cohort studies were pooled separately. RESULTS Literature search yielded 1178 articles, 12 of which were included in the present meta-analysis. Results from case-control (ten), cohort (one) and cross-sectional (one) studies were compatible with an association between TGA and migraine. The nationwide inpatient cross-sectional study was of lesser value due to its inpatient orientation. The high-quality, population-based, retrospective cohort (158,301 participants per group) determined a higher relative-risk (RR) of TGA for migraine vs. non-migraine individuals [RR = 2.48, 95%confidence-interval (95% CI) = (1.32, 4.87)]. Sensitivity testing based on stricter diagnostic criteria strengthened the estimated association [RR = 3.84, 95% CI = (1.57, 9.38)]. Additionally, pooled data from eight case-control studies (700 TGA, 746 HC) yielded similar results [Odds-Ratio, OR = 2.51, 95% CI = (1.85, 3.41)], with the association mainly driven by the three high-quality studies, rather than the five articles of moderate quality. Finally, pooled findings from four case-control studies of moderate-quality revealed a higher prevalence of migraine among TGA compared to TIA patients [OR = 1.82, 95% CI = (1.22, 2.73)]. CONCLUSIONS A significant association between TGA and migraine was established. The underlying connecting mechanism remains undetermined, yet.
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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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Govoni V, Cesnik E, Ferri C, Fallica E. The distribution of the transient global amnesia in the province of Ferrara, Italy, a clue to the pathogenesis? Neurol Sci 2020; 42:1821-1826. [DOI: 10.1007/s10072-020-04696-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 08/28/2020] [Indexed: 11/29/2022]
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Caramelli P. For how long is memory lost in transient global amnesia? Eur J Neurol 2020; 27:737-738. [DOI: 10.1111/ene.14187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 02/20/2020] [Indexed: 11/29/2022]
Affiliation(s)
- P. Caramelli
- Behavioral and Cognitive Neurology Unit Faculdade de Medicina Universidade Federal de Minas Gerais Belo Horizonte Brazil
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Acute amnestic syndromes. J Neurol Sci 2020; 413:116781. [PMID: 32203745 DOI: 10.1016/j.jns.2020.116781] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/09/2020] [Accepted: 03/16/2020] [Indexed: 11/22/2022]
Abstract
Acute amnestic syndromes are usually rare clinical events occurring in emergency situations. Etiological diagnosis can be challenging and underlying causes diverse. They can be transient and totally reversible, or accompanied by other neurological symptoms resulting in serious and irreversible brain damage. Pathophysiology of these syndromes mainly corresponds to structural or functional alteration of memory circuits, including those in the hippocampus. One of the most frequent forms is transient global amnesia (TGA), characterized by sudden onset of anterograde amnesia lasting less than 24 hours, in the absence of other neurological signs or symptoms. Another acute and transient memory disorder is transient epileptic amnesia (TEA), due to focal crisis activity. Stroke injuries occurring at strategic memory-related sites can also present as sudden episodes of amnesia. In addition to neurological etiologies, amnesia may be a symptom of a psychiatric disorder (dissociative amnesia). Traumatic brain injuries, autoimmune encephalitis and acute toxic metabolic disorders can also cause amnesia and should be included among the differential diagnoses. In this review, we summarize the most relevant clinical findings in acute amnestic syndromes, and discuss the different ancillary tests needed to establish a correct diagnosis and management as well the best treatment options. Relevant anatomical and pathophysiological aspects underlying these conditions will be also be presented.
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Mazokopakis EE. Transient global amnesia. Have you considered hyperhomocysteinemia? ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:756-757. [PMID: 31664355 DOI: 10.1590/0004-282x20190128] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/06/2019] [Indexed: 11/22/2022]
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Kamm K, Schöberl F, Grabova D, Straube A, Zwergal A. RCVS and TGA: a common pathophysiology? J Neurol 2019; 266:2872-2874. [PMID: 31385018 DOI: 10.1007/s00415-019-09495-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Katharina Kamm
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Schöberl
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany.,Department of Neurology and German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Denis Grabova
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany.,Department of Neurology and German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Andreas Straube
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany.,Department of Neurology and German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - Andreas Zwergal
- Department of Neurology, Ludwig-Maximilians-University, Munich, Germany. .,Department of Neurology and German Center for Vertigo and Balance Disorders (DSGZ), Ludwig-Maximilians-University Munich, Marchioninistrasse 15, 81377, Munich, Germany.
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Pantoni L. Transient global amnesia: an intriguing yet benign disturbance. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:1-2. [DOI: 10.1590/0004-282x20180151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 12/01/2018] [Indexed: 11/22/2022]
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