Effective connectivity alteration according to recurrence in transient global amnesia

Lee, Dong Ah; Lee, Sungjoon; Kim, Due Won; Lee, Ho‐Joon; Park, Kang Min

doi:10.1007/s00234-021-02645-7

Cited by 10 publications

(21 citation statements)

References 36 publications

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“…In line with our present findings, several studies demonstrated significantly different radiologic findings in patients with TGA according to recurrence 30 . Moreover, we recently evaluated alterations in the structural covariance network and effective connectivity of the intra‐hippocampal circuit in patients with TGA using a structural event 31 31 …”

Section: Discussionsupporting

confidence: 89%

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Brain networks in patients with isolated or recurrent transient global amnesia

et al. 2021

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Objectives The aim of this study was to investigate differences in cerebral blood flow (CBF) and functional networks between transient global amnesia (TGA) patients with a single event and those with recurrent events using arterial spin labeling (ASL) MRI. Methods We enrolled patients with TGA and classified them into two groups according to the number of TGA events: TGA patients with a single event and those with recurrent events. MRI scans were performed within 24 h after TGA ictal onset in all patients. We quantified CBF and analyzed the functional network based on CBF using graph theory, and determined the differences in CBF and functional networks between the groups. Results We enrolled 44 patients with TGA. Among them, 6 patients had recurrent TGA events, whereas 38 patients had a single TGA event. No regions had significantly different CBFs between TGA patients with recurrent events and those with a single event. The global functional network analysis found that the eccentricity was significantly higher in TGA patients with recurrent events than in those with a single event (5.829 vs. 4.657, p = .001). The local functional network analysis showed that several regions had significantly different betweenness centrality and eccentricity measures between TGA patients with recurrent events and those with a single event. Conclusions We demonstrated the differences in the functional network based on CBF using graph theory according to recurrence in patients with TGA. These findings suggest that TGA is a network disease, and functional network alterations in TGA are related to clinical symptoms.

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Section: Discussionsupporting

confidence: 89%

“…Moreover, we recently evaluated alterations in the structural covariance network and effective connectivity of the intra‐hippocampal circuit in patients with TGA using a structural event 31 31 …”

Section: Discussionmentioning

confidence: 99%

Brain networks in patients with isolated or recurrent transient global amnesia

et al. 2021

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“…Quantitative structural imaging analysis studies are also controversial. Some studies have found significant quantitative structural alterations in the brain [16,17] as well as connectivity network changes [19,23] in patients with TGA compared to healthy controls. However, another study using neurite orientation dispersion, density imaging, and arterial spin labeling examined whether or not the microstructure and perfusion status of the hippocampus showed any obvious microstructural or perfusion abnormalities in patients with TGA was negative [37].…”

Section: Discussionmentioning

confidence: 99%

“…TGA typically occurs only once in a patient's life-time; however, in an estimated 6-10% of patients, TGA may occur repeatedly [3]. We have recently demonstrated that the functional network of patients with TGA differs according to the frequency of recurrence [22], and discovered significant structural covariance network changes as well as disruptions of the intrahippocampal circuit in TGA compared to control subjects, which is more pronounced when amnestic events recur [23]. As a result, we hypothesized that the glymphatic system function might be different in terms of recurrence.…”

Section: Introductionmentioning

confidence: 99%

Glymphatic System Function in Patients with Transient Global Amnesia

Lee¹,

Park²,

Park³

et al. 2022

J. Integr. Neurosci.

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Background:The purpose of this study was to examine glymphatic system function in patients with transient global amnesia (TGA), as well as to conduct a recurrence analysis. Methods: We enrolled patients with TGA and healthy controls from our hospital retrospectively. The patients and healthy controls were all scanned with the same 3T scanner, which included diffusion tensor imaging (DTI). We investigated the function of the glymphatic system using DTI analysis along the perivascular space (DTI-ALPS). The ALPS index was compared between patients with TGA and healthy controls, as well as between patients who had recurrent TGA events and those who had only a single TGA event. Results: Seventy-two patients with TGA and 53 healthy controls were enrolled. Sixty-five patients with TGA had a single TGA event, while seven patients had recurrent TGA events. The ALPS index did not differ significantly between patients with TGA and healthy controls (1.665 vs. 1.618, p = 0.436). The ALPS index, on the other hand, varied significantly according to recurrence in patients with TGA. The ALPS index was significantly higher in patients with recurrent TGA events compared to those with a single event (1.928 vs. 1.636, p = 0.049). Conclusions: We investigated the glymphatic system function in patients with TGA compared to healthy controls for the first time using the DTI-ALPS method. We discovered that these groups did not differ in terms of glymphatic system function. However, glymphatic system function in patients with TGA may differ according to recurrence. Additional research is required to substantiate these findings.

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“…In that case, only the study with the highest sample size, follow-up time, and methodological quality was included. 10,11,16 The following data categories were collected: (1) demographic and personal history, (2) exposure to trigger events, (3) duration and characteristics of the event, (4) ancillary studies (brain MRI, EEG, and jugular doppler ultrasound), and (5) a follow up. All aspects concerning personal history, characteristics of the event, and findings in complementary studies were considered as potential risk factors for recurrence.…”

Section: Data Extraction and Synthesis And Risk Of Biasmentioning

confidence: 99%

Transient Global Amnesia Recurrence

et al. 2022

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Background: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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Effective connectivity alteration according to recurrence in transient global amnesia

Cited by 10 publications

References 36 publications

Brain networks in patients with isolated or recurrent transient global amnesia

Brain networks in patients with isolated or recurrent transient global amnesia

Glymphatic System Function in Patients with Transient Global Amnesia

Transient Global Amnesia Recurrence

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