The structural connectivity of the recurrent transient global amnesia

Objective To study the long-term risk of cerebrovascular events, seizures, and cognitive impairment in patients with transient global amnesia (TGA). Patients and Methods Data for all patients diagnosed with possible TGA in Olmsted County, Minnesota, between January 1, 1985, through December 31, 2010, were retrieved from the Rochester Epidemiology Project database. Transient global amnesia was defined clinically. End points were cerebrovascular event (stroke or transient ischemic attack), seizure, or cognitive impairment (mild cognitive impairment or dementia) during follow-up. End points were studied using Kaplan-Meier survival plots and log-rank test. Results A total of 221 patients with TGA were identified and 221 age- and sex-matched controls were included in the analysis. The mean duration of follow-up was 12 years in both groups (range, 0.07-29.93). Prevalence of vascular risk factors and history of seizures were similar between both groups. Previous migraine was more common in the TGA group (42 patients [19.1%] vs 12 patients [5.4%]; P<.001). There was no statistically significant difference between survival curves for the TGA group and the control group using time to any type of cerebrovascular event (log-rank P=.30), time to seizures event (log-rank P=.55), and time to cognitive impair event (log-rank P=.88) as end points. The TGA recurrence occurred in 5.4% of patients after a median interval of 4.21 years (interquartile range, 2.82-8.44). Modified Rankin scale and death rates at last follow-up were also similar between both groups. Conclusion Our findings indicate that having an episode of TGA does not increase the risk of subsequent cerebrovascular events, seizures, or cognitive impairment.

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“…This is also supported by previous imaging studies that have shown no evidence of structural brain injury after TGA. 40 …”

Section: Discussionmentioning

confidence: 99%

Long-Term Outcome in Patients With Transient Global Amnesia: A Population-Based Study

Arena

Brown

Mandrekar

et al. 2017

Mayo Clinic Proceedings

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“…A previous study analyzed the DTI data of 7 patients with recurrent TGA compared to 14 patients with only a single episode of TGA event, and they found the FA and mean diffusivity (MD) were not different between the 2 groups [10]. However, they did not investigate DTI data of the patients with TGA compared to the healthy subjects [10].…”

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%

“…Reduced diffusion anisotropy at the expense of increased radial diffusivity is interpreted as reduced axonal density and alteration of myelin architecture [8]. Although DTI has been applied in various diseases, few studies have investigated the microstructural architecture of white matter in patients with TGA using DTI [10]. A previous study analyzed the DTI data of 7 patients with recurrent TGA compared to 14 patients with only a single episode of TGA event, and they found the FA and mean diffusivity (MD) were not different between the 2 groups [10].…”

Section: Introductionmentioning

confidence: 99%

“…Although DTI has been applied in various diseases, few studies have investigated the microstructural architecture of white matter in patients with TGA using DTI [10]. A previous study analyzed the DTI data of 7 patients with recurrent TGA compared to 14 patients with only a single episode of TGA event, and they found the FA and mean diffusivity (MD) were not different between the 2 groups [10]. However, they did not investigate DTI data of the patients with TGA compared to the healthy subjects [10].…”

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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Investigation of TGA (2): Neuroimaging

Larner

2022

Transient Global Amnesia

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The structural connectivity of the recurrent transient global amnesia

Cited by 12 publications

References 13 publications

Long-Term Outcome in Patients With Transient Global Amnesia: A Population-Based Study

Long-Term Outcome in Patients With Transient Global Amnesia: A Population-Based Study

Is Transient Global Amnesia a Network Disease?

Investigation of TGA (2): Neuroimaging

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