The distribution of the transient global amnesia in the province of Ferrara, Italy, a clue to the pathogenesis?

Govoni, Vittorio; Cesnik, Carlos E. S.; Ferri, Caterina; Fallica, Elisa

doi:10.1007/s10072-020-04696-9

Cited by 4 publications

(1 citation statement)

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“…Monthly and seasonal variation have been previously reported in samples from Israel and South Korea [ 58 , 59 ], both of these studies noted a preference for TGA occurring in the winter, corroborating an observation by Akawi and colleagues [ 60 ] and arguing for an association of TGA occurrence with lower ambient temperatures. Other studies, however, found either even monthly and seasonal distributions [ 61 ], or identified a summer preference [ 34 , 62 , 63 ]. Hence, the resulting picture is inconclusive, currently not allowing for any definite implications.…”

Section: Discussionmentioning

confidence: 99%

Chronobiology of transient global amnesia

et al. 2021

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Introduction The etiology of transient global amnesia (TGA) is still a matter of debate. Based, among others, on the observation of a close temporal relation between certain events and subsequent TGA episodes, recent proposals discuss the relevance of stress-associated processes impacting on hippocampal functioning. Circadian, infra- and ultradian rhythmicity has been found to play a relevant role in the multifactorial pathomechanisms of various disorders but has not been thoroughly studied in TGA. Methods Data of patients with a final diagnosis of TGA were collected in Mannheim, Germany (06/1999–01/2018, n = 404), and in the Kansai district, Japan (04/2006–03/2018, n = 261). Chronological patterns of TGA occurrence were determined. Results Significant circadian rhythmicity of TGA occurrence with bimodal peaks (mid-morning, late afternoon) was found for the entire population (p = 0.002) and for either sub-cohort (Mannheim: p = 0.003, Kansai: p = 0.007). This finding was confirmed for either sex (women: p = 0.004, men: p = 0.004) and different age groups (< 65 years: p = 0.0009, ≥ 65 years: p = 0.003). There was no variation according to day of the week, month or season, but the proportion of patients with a weekday episode was significantly higher in the Mannheim cohort (p = 0.002). Discussion We identified a robust circadian rhythm in TGA occurrence which remarkably applied to either of the two study sites located on different continents and which was independent of sex and age. In light of abundant evidence of circadian rhythmicity of both, components of the human stress response system and memory, chronobiological analyses may provide an opportunity to further uncover the mechanisms underlying TGA.

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