Transient Global Amnesia: An Electrophysiological Disorder Based on Cortical Spreading Depression—Transient Global Amnesia Model

Ding, Xuejiao; Peng, Dantao

doi:10.3389/fnhum.2020.602496

Cited by 19 publications

(9 citation statements)

References 91 publications

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“…The cause of TGA is still unknown, but numerous findings in recent years point to a multifactorial genesis [ 15 ]. Based on the clinical picture, as a common pathophysiological correlate a dysfunction of mediobasal temporal lobe components including both hippocampi is assumed, as these structures are involved in both memory consolidation and retrieval [ 16 ]. This notion is supported by imaging findings using diffusion-weighted magnetic resonance imaging, which shows hippocampal lesions in more than half of patients in the acute stage [ 17 – 23 ].…”

Section: Pathophysiologymentioning

confidence: 99%

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

Sander¹,

Bartsch²,

Connolly³

et al. 2023

Neurol. Res. Pract.

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Introduction In 2022 the DGN (Deutsche Gesellschaft für Neurologie) published an updated Transient Global Amnesia (TGA) guideline. TGA is characterized by a sudden onset of retrograde and anterograde amnesia for a period of one to a maximum of 24 h (with an average of 6 to 8 h). The incidence is estimated between 3 and 8 per 100,000 population/year. TGA is a disorder that occurs predominantly between 50 and 70 years. Recommendations The diagnosis of TGA should be made clinically. In case of an atypical clinical presentation or suspicion of a possible differential diagnosis, further diagnostics should be performed immediately. The detection of typical unilateral or bilateral punctate DWI/T2 lesions in the hippocampus (especially the CA1 region) in a proportion of patients proves TGA. The sensitivity of MRI is considered higher when performed between 24 and 72 h after onset. If additional DWI changes occur outside the hippocampus, a vascular etiology should be considered, and prompt sonographic and cardiac diagnostics should be performed EEG may help to differentiate TGA from rare amnestic epileptic attacks, especially in recurrent amnestic attacks. TGA in patients < 50 years of age is a rarity, therefore it is mandatory to rapidly search for other causes in particular in younger patients. The cause of TGA is still unknown. Numerous findings in recent years point to a multifactorial genesis. Because the pathomechanism of TGA is not yet clearly known, no evidence-based therapeutic or prophylactic recommendations can be made. Conclusions There is no evidence for chronic sequelae of TGA with respect to cerebral ischemia, chronic memory impairment, or the onset of dementia-related syndromes.

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Section: Pathophysiologymentioning

confidence: 99%

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

Sander¹,

Bartsch²,

Connolly³

et al. 2023

Neurol. Res. Pract.

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“…Thus, migraine, especially when vaccine-associated, ( Göbel et al, 2021 ), may lead to an increased incidence of TGA. ( Ding and Peng, 2020 ). The psychological impact of vaccination itself, as a factor of sudden change and anxiety, may contribute to the occurrence of TGA following COVID-19 vaccination.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine-Associated Transient Global Amnesia: A Disproportionality Analysis of the WHO Safety Database

Merino

Gérard

Obberghen³

et al. 2022

Front. Pharmacol.

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Coronavirus disease 2019 (COVID-19) spread rapidly, resulting in a global pandemic for which vaccines were quickly developed. As their safety continues to be monitored, cases of transient global amnesia (TGA) following mRNA vaccination with elasomeran have been reported. TGA is characterized by sudden onset of anterograde amnesia with preservation of other cognitive functions and resolution within 24 h. We aimed to investigate the potential link of TGA with COVID-19 vaccines. We queried the World Health Organization VigiBase® for all reports of “Transient global amnesia”, up to 6 December 2021. Disproportionality analysis relied on the Reporting Odds Ratio (ROR) with its 95% Confidence Interval (CI) and the Information Component (IC). A positive lower end of the 95% CI of the IC (IC025) is used to statistically detect a signal. Of all TGA cases, 289 were associated with a COVID-19 vaccine, representing the most frequent association. Tozinameran was mostly represented (147, 50.8%), followed by AZD1222 (69, 23,8%), elasomeran (60, 20.8%), and JNJ-78436735 (12, 4.2%). With an IC025 > 0, COVID-19 vaccines showed a significant ROR (5.1; 95%CI 4.4–6.0). Tozinameran reached the strongest ROR (4.6; 95%CI 3.9–5.0), followed by elasomeran (4.4; 95%CI 3.4–6.0), AZD1222 (3.8; 95%CI 3.0–5.0), and JNJ-78436735 (3.7; 95%CI 2.1–6.0). Our analysis of COVID-19 vaccines-related TGA reports shows significant disproportionality. Cerebrovascular, inflammatory, or migrainous mechanisms may underlie this association. Yet, numerous confounding factors cannot be tackled with this approach, and causality cannot be ascertained. The identification of this trigger of TGA may help the clinician in his etiological research.

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“…Notably, both the migraine theory and stress theory implicate the role of excessive glutamate release as well as CNS depression. 31,32 Glutamate targets the CA1 region of the hippocampus, which is involved in TGA and is known to have the highest density of N-methyl-d-aspartate receptors among hippocampal regions. 33 Given the heterogeneity of the demographics and stressors associated with TGA, multiple mechanisms for the disease process may coexist, leading to a similar clinical picture.…”

Section: Etiology and Pathogenesis Of Transient Global Amnesia: Curre...mentioning

confidence: 99%

“…Box 2 1,3,23,[27][28][29][30][31][32][33] (page 33) outlines current theories of the etiology and pathogenesis of TGA.…”

Section: Transient Global Amnesiamentioning

confidence: 99%

Transient global amnesia: Psychiatric precipitants, features, and comorbidities

Rand¹

2023

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Transient Global Amnesia: An Electrophysiological Disorder Based on Cortical Spreading Depression—Transient Global Amnesia Model

Cited by 19 publications

References 91 publications

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline

COVID-19 Vaccine-Associated Transient Global Amnesia: A Disproportionality Analysis of the WHO Safety Database

Transient global amnesia: Psychiatric precipitants, features, and comorbidities

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