Transient global amnesia: current perspectives

Spiegel, David R.; Smith, Justin M.; Wade, Ryan R; Cherukuru, Nithya; Ursani, Aneel; Dobruskina, Yuliya; Crist, Taylor; Busch, Robert F; Dhanani, Rahim; Dreyer, N. B.

doi:10.2147/ndt.s130710

Cited by 75 publications

(103 citation statements)

References 104 publications

(154 reference statements)

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“…Brain MRI All subjects underwent MRI using the following imaging protocol: sagittal-oriented 3D T2-weighted images (repetition time/ echo time = 2,500.0/244.6 ms, field of view = 256 × 256 mm 2 directions (repetition time/echo time = 8,620/85 ms, slice thickness = 2.25 mm, acquisition matrix = 120 × 120, field of view = 240 × 240 mm 2 , and bvalue = 1,000 s/mm 2 ). All of the scans were obtained using a 3.0T MRI scanner equipped with an 8-channel head coil (AchievaTx, Phillips Healthcare, Best, The Netherlands).…”

Section: Subjectsmentioning

confidence: 99%

“…Transient global amnesia (TGA) is a sudden onset of reversible anterograde amnesia with various degrees of retrograde amnesia accompanied by repetitive questioning that lasts up to 24 h [1,2]. The incidence of TGA has been estimated as 3-10 per 100,000 per year [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of TGA has been estimated as 3-10 per 100,000 per year [2,3]. The majority of episodes occur in individuals between the ages of 50 and 80 years, and most cases of TGA occur once in a lifetime [2,3].…”

Section: Introductionmentioning

confidence: 99%

“…The etiology of TGA remains obscure despite extensive research. Several researchers have suggested that the pathophysiologic mechanisms of TGA may be similar to those of cerebral ischemia, epi-DOI: 10.1159/000496511 lepsy, migraine, or a disturbance of venous hemodynamics [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

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Is Transient Global Amnesia a Network Disease?

2018

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Background: We evaluated a brain network using graph theoretical analysis and microstructural abnormalities of the white matter in patients with transient global amnesia (TGA). Methods: Twenty patients with TGA and healthy control subjects were recruited, and they underwent diffusion tensor imaging (DTI) scans. Graph theory was applied to obtain network measures based on DTI data. We investigated the network measures and microstructural abnormalities of white matter using tract-based spatial statistics (TBSS) analysis in the patients with TGA. Results: Measures of global topology were not different between the patients with TGA and healthy subjects. However, there were significant differences of hubs organization; the strength of the right superior and inferior orbitofrontal, the right inferior frontal operculum, the left superior parietal, and left postcentral gyrus, the cluster coefficient of the right middle orbitofrontal and left inferior parietal gyrus, the betweenness centrality of the left angular gyrus, and the pagerank centrality of the right superior and inferior orbitofrontal, right inferior frontal operculum, left superior parietal, and left postcentral gyrus in the patients with TGA were significantly lower than those in healthy subjects. Regarding the analysis of the white matter microstructure with TBSS, there were no differences in the fractional anisotropy and mean diffusivity values between the 2 groups. Conclusions: We newly identify a reorganization of network hubs of the brain network in patients with TGA, especially in the regions of the default-mode network. These alterations of the brain network may play a role in the pathophysiologic mechanism underlying TGA and suggest that TGA is a network disease.

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Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Is Transient Global Amnesia a Network Disease?

2018

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“…A sympathetic surge leading to increased epinephrine and norepinephrine serum levels may lead to vasoconstriction, transiently impeding blood flow to the hippocampus, and medial temporal lobe. 10 It is suggested that the vulnerability of neurons in the cornu ammonis field of the hippocampus to metabolic stress plays an important role in the pathophysiological cascade, leading to an impairment of hippocampal function during TGA. 11 In the presented patient, the onset of symptoms was associated with lifting of heavy weights.…”

Section: Discussionmentioning

confidence: 99%

Anterograde Amnesia as a Manifestation of Acute Type A Aortic Dissection

et al. 2019

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Objectives Memory impairment has been only rarely reported in association with acute aortic dissection type A. We report a patient with pure anterograde amnesia and memory impairment of contents occurring after the event, accompanying acute aortic dissection type A. Case Report A previously healthy 53-year-old Caucasian male was admitted because of sudden chest pain after having lifted a heavy object. Clinical examination and electrocardiogram showed no abnormalities. Since blood tests showed leukocytosis, anemia, and elevated D-dimer level, either pulmonary embolism or aortic dissection was suspected; therefore, computed tomography was suggested. The patient seemed disoriented to time, and neurologic investigation confirmed that the patient was disoriented to time; short time memory was severely impaired and concentration was reduced. An amnestic episode with anterograde amnesia was diagnosed. Computed tomography showed type A aortic dissection. A supracoronary replacement of the ascending aorta was performed. The patient was discharged on the 7th postoperative day. Three months postoperatively, the patient is clinically stable; however, amnesia for the interval between pain onset and cardiac surgery persists. Conclusions Transient amnesia, usually considered a benign syndrome, may be more common than generally recognized in aortic dissection. The suspicion for aortic dissection or other cardiovascular emergencies is substantiated when amnesia is associated with sudden onset of chest pain, leukocytosis, and elevated D-dimer levels. Computed tomography of the aorta with contrast medium is the imaging method of choice to confirm or exclude the diagnosis.

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Factors Associated With Risk of Recurrent Transient Global Amnesia

2020

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IMPORTANCETransient 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 PARTICIPANTSThis 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. RESULTSOf 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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Transient global amnesia: current perspectives

Cited by 75 publications

References 104 publications

Is Transient Global Amnesia a Network Disease?

Is Transient Global Amnesia a Network Disease?

Anterograde Amnesia as a Manifestation of Acute Type A Aortic Dissection

Factors Associated With Risk of Recurrent Transient Global Amnesia

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