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Background: Choline was frequently reported to have some beneficial effects on memory function. However, the association of dietary choline with different types of amnesia is not well understood. The objective of this study was to examine the association between dietary intake of choline and transient global amnesia (TGA). Methods: This case–control study was carried out on 258 patients with TGA and 520 participants without amnesia. Data on dietary choline intake was collected using a validated food frequency questionnaire (FFQ). All participants were examined for amnesia by a neurologist according to the Kaplan and Hodges criteria. Results: There was an inverse association between TGA and dietary choline intake after adjustment for age and gender (OR: 0.98, CI 95% 0.96–0.98, P = 0.03). The association remained significant after additional adjusting for physical activity, body mass index (BMI), occupation, marital status, smoking, and drinking alcohol (OR: 0.98, CI 95% 0.96–0.99, P = 0.04) and after further adjustment for calorie and food groups intake (OR: 0.98, CI 95% 0.96–0.99, P = 0.03). Conclusion: The results of this study indicated that choline may have beneficial effects against TGA. Further longitudinal studies are warranted. [ABSTRACT FROM AUTHOR]

Transient global amnesia (TGA) is characterized by sudden and temporary memory impairment, while transient epileptic amnesia (TEA) represents amnestic attacks as the main manifestation of focal epilepsy with presumed temporal origin. We present a 48‐year‐old patient who experienced transient amnesia 10 weeks after right selective amygdalo‐hippocampectomy for right temporal lobe epilepsy. Despite TEA being a plausible explanation for amnesia in patients with temporal lobe epilepsy, no epileptiform discharges were found during the amnestic episode and key features indicative of TGA, including long duration, isolated occurrence, and dense anterograde amnesia of the episode, argued against a diagnosis of TEA in this case. Notably, the patient has remained seizure‐free (now 4,5 years) and stopped taking antiseizure medication 32 months after surgery. Although TGA clinical criteria formally exclude patients with recent active epilepsy, neurologists should be aware that TGA can occur after epilepsy surgery in the temporal lobe. Therefore, we consider it of high clinical relevance to establish a careful differential diagnosis between TGA and epileptic amnestic attacks after epilepsy surgery to avoid unnecessary reintroduction or continuation of antiseizure medication. Additionally, this case presents the first comparison of detailed neuropsychological test results before and after a presumed TGA episode, revealing a complete recovery of anterograde memory functions within 1 day. Plain Language Summary: A 48‐year‐old patient experienced an episode of transient amnesia 10 weeks after epilepsy surgery. Given the patient's history, an epileptic origin of the episode initially seemed likely. However, tests revealed no seizure activity during the episode and the characteristics matched a condition called transient global amnesia. This case highlights the importance of correctly diagnosing memory impairments after epilepsy surgery to prevent unnecessary treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Choline was frequently reported to have some beneficial effects on memory function. However, the association of dietary choline with different types of amnesia is not well understood. The objective of this study was to examine the association between dietary intake of choline and transient global amnesia (TGA). Methods This case–control study was carried out on 258 patients with TGA and 520 participants without amnesia. Data on dietary choline intake was collected using a validated food frequency questionnaire (FFQ). All participants were examined for amnesia by a neurologist according to the Kaplan and Hodges criteria. Results There was an inverse association between TGA and dietary choline intake after adjustment for age and gender (OR: 0.98, CI 95% 0.96–0.98, P = 0.03). The association remained significant after additional adjusting for physical activity, body mass index (BMI), occupation, marital status, smoking, and drinking alcohol (OR: 0.98, CI 95% 0.96–0.99, P = 0.04) and after further adjustment for calorie and food groups intake (OR: 0.98, CI 95% 0.96–0.99, P = 0.03). Conclusion The results of this study indicated that choline may have beneficial effects against TGA. Further longitudinal studies are warranted. Graphical Abstract

Abstract Transient global amnesia (TGA) is characterized by sudden and temporary memory impairment, while transient epileptic amnesia (TEA) represents amnestic attacks as the main manifestation of focal epilepsy with presumed temporal origin. We present a 48‐year‐old patient who experienced transient amnesia 10 weeks after right selective amygdalo‐hippocampectomy for right temporal lobe epilepsy. Despite TEA being a plausible explanation for amnesia in patients with temporal lobe epilepsy, no epileptiform discharges were found during the amnestic episode and key features indicative of TGA, including long duration, isolated occurrence, and dense anterograde amnesia of the episode, argued against a diagnosis of TEA in this case. Notably, the patient has remained seizure‐free (now 4,5 years) and stopped taking antiseizure medication 32 months after surgery. Although TGA clinical criteria formally exclude patients with recent active epilepsy, neurologists should be aware that TGA can occur after epilepsy surgery in the temporal lobe. Therefore, we consider it of high clinical relevance to establish a careful differential diagnosis between TGA and epileptic amnestic attacks after epilepsy surgery to avoid unnecessary reintroduction or continuation of antiseizure medication. Additionally, this case presents the first comparison of detailed neuropsychological test results before and after a presumed TGA episode, revealing a complete recovery of anterograde memory functions within 1 day. Plain Language Summary A 48‐year‐old patient experienced an episode of transient amnesia 10 weeks after epilepsy surgery. Given the patient's history, an epileptic origin of the episode initially seemed likely. However, tests revealed no seizure activity during the episode and the characteristics matched a condition called transient global amnesia. This case highlights the importance of correctly diagnosing memory impairments after epilepsy surgery to prevent unnecessary treatment.

Transient global amnesia (TGA) and transient epileptic amnesia (TEA) are rare phenomena in clinical practice that manifest as transient cognitive amnestic impairments. Despite the similarity in clinical picture, such conditions are pathogenetically heterogeneous and require different therapeutic approaches. TGA is a clinical syndrome characterized by sudden anterograde amnesia of the event lasting up to 24 hours, lacking focal neurological symptoms, and not prone to recurrence. Mimicking TGA, TEA often occurs manifested as epileptic seizures with impaired awareness of varying duration, including long-term (more than 24 hours), as a variant of focal epilepsy. TEA is characterized by recurrent episodes, combination with other manifestations of epilepsy, and comorbidity with neurodegenerative diseases (dementia). For differential diagnosis, it is necessary to use prolonged video-electroencephalographic monitoring with sleep recording, neuroimaging methods (brain magnetic resonance imaging, positron emission tomography), psychological testing, biochemical examination for markers of neurodegeneration.

Background:Methods:Results:Conclusion:Different types of dietary fat may influence memory and cognitive functions. This study aimed to investigate the association between dietary fat intake and transient global amnesia (TGA).This case–control study was conducted using Persian Sabzevar cohort data on 258 individuals with TGA and 520 individuals without amnesia in Sabzevar Iran. The food frequency questionnaire (FFQ) was used to assess the intake of dietary fats of the participants. All study participants were screened for TGA by a neurologist and their status was determined based on the diagnostic symptoms defined by the Kaplan and Hodges criteria.There was an inverse association between the risk of TGA and dietary intake of alpha-linolenic acid (ALA) (OR = 0.94, CI95%:0.88-0.99, P = 0.01). Also, a positive association was observed between TGA and dietary intake of n-6 fatty acids (OR = 1.18, CI 95%: 1.04-1.33, P = 0.01). The results remained significant after adjustment for age, sex, education, job, marital status, physical activity, BMI, and calorie intake.Omega-3 fatty acids may have beneficial effects; however, omega-6 fatty acids may have adverse effects on the risk of amnesia. Further longitudinal studies are warranted. [ABSTRACT FROM AUTHOR]

Introduction: The long-term cognitive outcomes after transient global amnesia (TGA) have been contradictory in the literature. Our study aimed to longitudinally investigate the association between TGA and incident dementia using long-term data from a nationwide population-based cohort in South Korea. Methods: The study population was recruited between 2002 and 2020 using the International Classification of Diseases (Tenth Revision; ICD-10) codes from the Korean National Health Insurance Service database. The cumulative incidence curve was plotted to compare the incidence of dementia between the TGA (ICD-10 code G45.4; n = 10,276) and non-TGA (n = 27,389) groups, determined using 1:3 propensity score matching. Using Cox proportional hazard regression models, we obtained crude and adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for the incident dementia in patients with TGA compared to non-TGA controls. To examine independent variables determining dementia in the TGA group, logistic regression analysis was performed, and adjusted odds ratios (aORs) and 95% CIs were calculated. Results: The TGA group had a significantly higher cumulative incidence of dementia than the non-TGA group (p < 0.001, log-rank test). TGA was significantly associated with incident dementia in the univariate and multivariate Cox models (HR 1.34, 95% CI 1.28–1.39 and aHR 1.40, 95% CI 1.34–1.46, respectively). The adjusted logistic regression for incident dementia in the TGA group showed that age (per 1 year, aOR 1.09, 95% CI 1.09–1.10), female sex (aOR 1.31, 95% CI 1.18–1.45), diabetes (aOR 1.21, 95% CI 1.08–1.35), stroke (aOR 1.30, 95% CI 1.16–1.46), depression (aOR 1.53, 95% CI 1.33–1.76), anxiety (aOR 1.24, 95% CI 1.01–1.39), and rural residence (aOR 1.24, 95% CI 1.10–1.41) were independently associated with incident dementia. Conclusion: Our results suggest a longitudinal association of TGA with incident dementia. [ABSTRACT FROM AUTHOR]

Transient global amnesia (TGA) is considered as one of the variants of transient ischemic attack (TIA). Unlike the diagnosis of cerebral infarction, the definition of TIA presupposes not only the reversibility of neurological symptoms, but also the absence of morphological signs of cerebral infarction detected by imaging methods. While the clinical diagnosis of TGA is not difficult, there is no clear opinion regarding changes on MRI. The use of high-field MRI devices (3T, 7T) shows a fairly high frequency of detecting point DWI changes in the hippocampal projection (up to 50%), which can be used as one of the objective criteria for the diagnosis of TGA

Transient global amnesia (TGA) is characterized by a sudden onset of total memory dysfunction, and loss of the ability to memorize information, followed by anterograde, and sometimes, retrograde amnesia, and reproduction of current events with patient’s consciousness alert, accompanied by one’s repetitive questioning during this very episode that lasts less than 24 hours (usually 1-8 hours). The process involves mesial temporal lobes and hippocampi. Pathogenesis of TGA includes venous congestion with Valsalva-like activities, other vascular dysfunction, and migraine. The article contains literature review on the development of TGA in patients with Multiple Sclerosis and Cerebral Autosomal Dominant Arteriopathy and Subcortical Infarcts and Leukoencephalopathy (CADASIL), which is not common for such patients, and describes a rare clinical case of confirmed CADASIL, in whom first acute vascular ischemic attack presented by TGA developed. In this patient, CADASIL was diagnosed earlier, and was based on the presence of migraine in anamnesis, common for CADASIL patients MRI abnormalities, and the result of molecular-genetic analysis, which showed gene NOTCH3 heterozygous mutation: р.207 R>R/C. Neurological examination revealed no focal neurological signs. Brain MRI in diffusion option (DWI) revealed a small pinpoint ischemic focus in left hyppocampus, which is characteristic for TGA. Despite of frequent review of migraine and subcortical ischemic events in these patients, the history of TGA is solely reported in literature. Reports of TGA development in patients with multiple sclerosis are also sole.

Transient global amnesia (TGA) is a benign, stress-induced neurological syndrome associated with reversible hippocampal dysfunction that manifests as isolated, predominantly anterograde amnesia. Since it is impossible to make a definitive diagnosis of TGA when the patient is admitted to hospital, the primary condition should be interpreted as an acute cerebrovascular accident, which implies a mandatory neuroimaging examination and clarification of the question of thrombolysis according to general principles. When taking a medical history, attention should be paid to the presence of predisposing conditions and triggers: migraine, chronic and acute stress, physical activity, sudden changes in temperature, Valsalva maneuver, coitus, medical procedures. If amnesia does not resolve within 24 hours, a differential diagnosis with stroke, Wernicke–Korsakoff encephalopathy, limbic encephalitis, intoxication and psychogenic (dissociative) amnesia is required. If the symptoms resolve within 24 hours and the classic diagnostic criteria are met, magnetic resonance imaging of the brain in diffusion-weighted mode is performed on days 2 to 4 in order to detect pinpoint zones of diffusion restriction in the hippocampus. If these lesions are visible and a typical medical history is available, the diagnosis of TGA can be made; if no lesions are present, the diagnosis is probable. In the absence of lesions and an atypical history of TGA, differentiation from transient epileptic or dissociative amnesia and transient ischemic attack is required.

Abstract Aim Amnesia is a cognitive disorder that may lead to memory loss. Caffeine is a psychoactive substance which have an effect on memory and cognitive functions. This study aimed to assess the association of transient global amnesia (TGA) with dietary intake of caffeine. Methods This cross‐sectional study was conducted on the Sabzevar Persian cohort data of 258 patients with TGA and 520 healthy individuals in Sabzevar, Iran. The Nutritional data were gathered in face‐to‐face interviews using a valid Food Frequency Questionnaire. Different models of logistic regression were used to determine the association between TGA and dietary caffeine intake after adjusting the confounders including age, sex, education, job, marital status, physical activity, BMI, and calorie intake. Results There was no significant difference in terms of dietary calorie intake of (2279.5 ± 757.9 vs. 2365.5 ± 799.5, p = 0.19), protein (70.79 ± 25.27 vs. 72.94 ± 24.83, p = 0.31), fat (59.97 ± 23.79 vs. 60.13 ± 26.38, p = 0.93), carbohydrate (376 ± 134 vs. 393.1 ± 137.8, p = 0.14), and caffeine (196.4 ± 127.9 vs. 186.3 ± 128.5, p = 0.36) between the groups. No significant association was found between TGA and dietary intake of caffeine (OR: 0.99, 95% CI: 0.99–1.01, p = 0.36). The results did not change after adjusting the confounders. Conclusions No significant association was found between TGA and dietary intake of caffeine. Further prospective studies are required to confirm this finding.

Introduction: The aetiology of transient global amnesia (TGA) is still a matter of debate. Besides ischemia of the mesial temporal lobe including the hippocampus, migraine-like mechanisms, epileptic seizures affecting mnestic structures, or venous congestion in the (para) hippocampal area due to jugular vein insufficiency have been discussed. We assessed the diameters of the intracranial arteries of TGA patients compared to controls to identify differences that support the hypothesis of reduced hippocampal perfusion as a pivotal factor in the pathophysiology of TGA. Methods: We reviewed magnetic resonance imaging time of flight angiographies (TOF-MRA) that were acquired during in-patient treatment of 206 patients with acute TGA. Results: The diameters of the vertebral artery (VA) in the V4 segment, the proximal basilar artery, and the internal carotid arteries were measured manually. We compared the findings with TOF-MRA images of an age and sex matched control group of neurological patients without known cerebrovascular pathology. In TGA patients the diameter of the right VA was significantly (p < 0.01) smaller compared to controls (2.09 mm vs. 2.35 mm). There were no significant differences in the diameters of the other vessels. Only the fetal variant of the posterior cerebral artery was slightly more common in TGA. Discussion: The smaller diameter (hypoplasia) of the right VA supports the hypothesis of a contribution of hemodynamic factors to the pathophysiology of TGA. The fact that hypoplasia represents a congenital condition might be the explanation why previous studies failed to find an increased rate of the classical (acquired) vascular risk factors. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Takotsubo syndrome and transient global amnesia can occur simultaneously, not only in the context of acute but also long‐standing emotional stress. Probably, hypothyroidism and migraine make the patient more susceptible to both of these disorders. [ABSTRACT FROM AUTHOR]

Transient global amnesia (TGA) is a neurological condition characterized by temporary memory loss and classically associated with a reversible unilateral punctate focus of restricted diffusion in the cornu ammonis 1 (CA1) region of the hippocampus. Historically, the lesions were considered to be transient in nature with no long-term imaging abnormality. However, more recent studies have challenged the concept that there are no long-term neurological sequelae. In line with this evidence, we explore the role of ultra-high-resolution imaging using 7 Tesla MRI to evaluate for long-term imaging abnormalities in a 63-year-old woman with a typical clinical course and acute TGA imaging findings. The 7 Tesla MRI revealed a residual lesion on susceptibility-weighted imaging (SWI) with evidence of gliosis and volume loss at the site of the acute lesion in CA1 eight months after the acute episode. This case challenges the traditional mantra of TGA as a fully reversible condition with no long-term imaging findings, suggesting the need for further research using ultra-high-field MRI to determine TGA's potential long-term imaging sequelae and any association with neurocognitive sequelae. [ABSTRACT FROM AUTHOR]

Aim: Amnesia is a cognitive disorder that may lead to memory loss. Caffeine is a psychoactive substance which have an effect on memory and cognitive functions. This study aimed to assess the association of transient global amnesia (TGA) with dietary intake of caffeine. Methods: This cross‐sectional study was conducted on the Sabzevar Persian cohort data of 258 patients with TGA and 520 healthy individuals in Sabzevar, Iran. The Nutritional data were gathered in face‐to‐face interviews using a valid Food Frequency Questionnaire. Different models of logistic regression were used to determine the association between TGA and dietary caffeine intake after adjusting the confounders including age, sex, education, job, marital status, physical activity, BMI, and calorie intake. Results: There was no significant difference in terms of dietary calorie intake of (2279.5 ± 757.9 vs. 2365.5 ± 799.5, p = 0.19), protein (70.79 ± 25.27 vs. 72.94 ± 24.83, p = 0.31), fat (59.97 ± 23.79 vs. 60.13 ± 26.38, p = 0.93), carbohydrate (376 ± 134 vs. 393.1 ± 137.8, p = 0.14), and caffeine (196.4 ± 127.9 vs. 186.3 ± 128.5, p = 0.36) between the groups. No significant association was found between TGA and dietary intake of caffeine (OR: 0.99, 95% CI: 0.99–1.01, p = 0.36). The results did not change after adjusting the confounders. Conclusions: No significant association was found between TGA and dietary intake of caffeine. Further prospective studies are required to confirm this finding. [ABSTRACT FROM AUTHOR]

Transient global amnesia (TGA) is a rare symptom complex characterized by a brief episode of severe fixation, anterograde and retrograde amnesia. The prevalence of TGA increases with age. Risk factors for this disease include physical overexertion, severe emotional stress, exposure to cold or hot water, hypothermia and pain. The diagnosis of TGA is based on the Kaplan and Hodges–Warlow criteria, according to which TGA is characterized by: complete resolution of mnestic disturbances within 24 hours; absence of other neurological and cognitive impairments; absence of previous head trauma or seizures. In cases where the clinical picture of TGA does not meet the criteria for the disease, a differential diagnosis should be performed, especially with cases of ischemic stroke in the vertebrobasilar region and transient epileptic amnesia. If acute ischemia is confirmed by the brain MRI results, further comprehensive diagnostic investigation must be performed to determine the subtype of acute cerebrovascular accident with further appropriate secondary prevention of cardiovascular complications. If a non-cardioembolic stroke type is identified, antiplatelet therapy has a crucial role. The clinical case of a patient with a left-sided hippocampal infarction clinically manifested by a TGA is presented.

Introduction: We aimed to investigate the alterations in the multilayer network in patients with transient global amnesia (TGA). Methods: We enrolled 124 patients with TGA and 80 healthy controls. Both patients with TGA and healthy controls underwent a three-teslar brain magnetic resonance imaging (MRI). A gray matter layer matrix was created using a morphometric similarity network derived from the T1-weighted imaging, and a white matter layer matrix was constructed using structural connectivity based on the diffusion tensor imaging. A multilayer network analysis was performed by applying graph theoretical analysis. Results: There were no significant differences in global network measures between the groups. However, several regions, related to the default mode network, showed significant differences in nodal network measures between the groups. Multi-richness in the left pars opercularis, multi-rich-club degree in the right posterior cingulate gyrus, and weighted multiplex participation in the right posterior cingulate gyrus were higher in patients with TGA compared with healthy controls (15.47 vs. 12.26, p = 0.0005; 41.68 vs. 37.16, p = 0.0005; 0.90 vs. 0.80, p = 0.0005; respectively). The multiplex core–periphery in the left precuneus was higher (0.96 vs. 0.84, p = 0.0005), whereas that in the transverse temporal gyrus was lower in patients with TGA compared with healthy controls (0.00 vs. 0.02, p = 0.0005). Conclusion: We newly find the alterations in the multilayer network in patients with TGA compared with healthy controls, which shows the involvement of the default mode network. These changes may be related to the pathophysiology of TGA. [ABSTRACT FROM AUTHOR]

Key Clinical Message Takotsubo syndrome and transient global amnesia can occur simultaneously, not only in the context of acute but also long‐standing emotional stress. Probably, hypothyroidism and migraine make the patient more susceptible to both of these disorders.

IntroductionThe aetiology of transient global amnesia (TGA) is still a matter of debate. Besides ischemia of the mesial temporal lobe including the hippocampus, migraine-like mechanisms, epileptic seizures affecting mnestic structures, or venous congestion in the (para) hippocampal area due to jugular vein insufficiency have been discussed. We assessed the diameters of the intracranial arteries of TGA patients compared to controls to identify differences that support the hypothesis of reduced hippocampal perfusion as a pivotal factor in the pathophysiology of TGA.MethodsWe reviewed magnetic resonance imaging time of flight angiographies (TOF-MRA) that were acquired during in-patient treatment of 206 patients with acute TGA.ResultsThe diameters of the vertebral artery (VA) in the V4 segment, the proximal basilar artery, and the internal carotid arteries were measured manually. We compared the findings with TOF-MRA images of an age and sex matched control group of neurological patients without known cerebrovascular pathology. In TGA patients the diameter of the right VA was significantly (p

The article discusses a case of transient global amnesia (TGA) in a 42-year-old woman with painless spontaneous internal carotid artery dissection. TGA is a neurological condition characterized by sudden memory loss that resolves within 24 hours. The patient's anterograde amnesia was linked to reduced cerebral perfusion due to the carotid artery dissection, which was confirmed by Doppler ultrasound. The article highlights the importance of considering rare underlying causes like carotid artery dissection in TGA cases and emphasizes the need for appropriate diagnostic tools and follow-up care for such patients. [Extracted from the article]

Transient global amnesia (TGA) is a clinical syndrome that is characterized by the sudden onset of anterograde amnesia and a less prominent impairment in retrograde memory lasting up to 24 h. Although several etiologies have been proposed, including migraine, epilepsy, ischemia, venous congestion, and glutamate toxicity, none sufficiently explain the disorder in its entirety. We retrospectively investigated images obtained using single‐photon emission computed tomography (SPECT), performed with 99mtechnetium hexamethylpropyleneamine oxime, from 11 patients with TGA divided into the following groups based on the timing of SPECT: during TGA (n = 2, Group 1), at the start of the attenuation of memory impairments (n = 2, Group 2), and after TGA (n = 7, Group 3). Regional isotope accumulation was examined using a three‐dimensional stereotactic surface projection (3D‐SSP) analysis. After calculating the mathematical product of the mean severity and extent ratio, unique comparable bar graphs were prepared with respect to Brodmann's areas (B). Increases in isotope accumulation were the largest in the retrosplenial cortex (B29, B30), posterior cingulate cortex (B23, B31), and precuneus (B7) in Groups 1 and 2, whereas decreases were noted in the same regions in Group 3. This is the first study to identify cerebral sites and describe changes consistent with the completion of amnesia as a symptom using an image analysis, such as a 3D‐SSP analysis. We consider cortical spreading depression (CSD) to be the etiology of TGA based on maximum isotope accumulation in the above sites and a literature review on CSD. [ABSTRACT FROM AUTHOR]

Transient global amnesia, both persistent and transient, is a very common neuropsychiatric syndrome. Among animal models for amnesia and testing new drugs, the scopolamine test is the most widely used for transient global amnesia (TGA). This study examined the scopolamine-induced deficits in working memory, discriminative memory, anxiety, and motor activity in the presence of intranasal PEA-OXA, a dual antagonist of presynaptic α2 and H3 receptors. Male C57BL/6 mice were treated with intraperitoneal scopolamine (1 mg/kg) with or without pre-treatment (15 min) or post-treatment (15 min) with intranasal PEA-OXA (10 mg/kg). It was seen that scopolamine induced deficits of discriminative and spatial memory and motor deficit. These changes were associated with a loss of synaptic plasticity in the hippocampal dentate gyrus: impaired LTP after lateral entorhinal cortex/perforant pathway tetanization. Furthermore, hippocampal Ach levels were increased while ChA-T expression was reduced following scopolamine administration. PEA-OXA either prevented or restored the scopolamine-induced cognitive deficits (discriminative and spatial memory). However, the same treatment did not affect the altered motor activity or anxiety-like behavior induced by scopolamine. Consistently, electrophysiological analysis showed LTP recovery in the DG of the hippocampus, while the Ach level and ChoA-T were normalized. This study confirms the neuroprotective and pro-cognitive activity of PEA-OXA (probably through an increase in the extracellular levels of biogenic amines) in improving transient memory disorders for which the available pharmacological tools are obsolete or inadequate and not directed on specific pathophysiological targets. [ABSTRACT FROM AUTHOR]

Background and purpose: Opioid‐associated amnestic syndrome (OAS) and transient global amnesia (TGA) are conditions with clinical overlap. We therefore sought to determine whether opioid use might be associated with TGA. Methods: Data from the Massachusetts Department of Public Health Syndromic Surveillance program were queried to ascertain the frequency of opioid use among emergency department (ED) encounters for TGA compared to that for all other ED visits between January 2019 and June 2023. Results: A total of 13,188,630 ED visits were identified during the study period. Of 1417 visits for TGA, one visit met the exposure definition for opioid use. There were 13,187,213 visits for other indications, 57,638 of which were considered opioid‐exposed. The odds ratio for the relationship between opioid use and TGA was 0.16 (95% confidence interval 0.02, 1.14). Conclusion: Despite the clinical overlap between OAS and TGA, surveillance data from ED visits in Massachusetts do not suggest that opioid use is a risk factor for TGA, indicating that OAS and TGA are distinct entities. [ABSTRACT FROM AUTHOR]

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Introduction: Transient global amnesia (TGA) is a spontaneously resolving, anterograde amnesia that lasts mostly <24 h and often occurs with retrograde amnesia. The etiology of TGA remains unclear, although in recent decades, many risk factors and preceding events have been identified. There are few up-to-date reports on the TGA incidence in Northern Europe. In this study, we report the incidence and risk factors associated with TGA in Finland. Materials and Methods: The study included all patients with suspected TGA that were referred to Kuopio University Hospital (KUH) in 2017. The hospital catchment area included 246,653 individuals. Risk factors and demographic data were collected from medical records. The TGA incidence rates were calculated as the number of patients with TGA divided by the number of individuals at risk in different age groups. Results: In 2017, 56 patients were treated for TGA at KUH. Of these, 46 had a first-ever TGA. The most common event preceding TGA was physical effort (n = 28, 50%), followed by emotional stress (n = 11, 19.6%) and water contact or a temperature change (n = 11, 19.6%). The most common comorbidities were hypercholesterolemia (n = 22, 39.3%), hypertensive disease (n = 21, 37.5%), hypothyroidism (n = 11, 19.6%), coronary artery disease (n = 8, 14.3%), and migraine (n = 7, 12.5%). TGA occurred most often in December (n = 9, 16.0%), March (n = 8, 14.3%), or October (n = 8, 14.3%), and least often in November and May (n = 2, 3.6% in both months). The crude incidence of a first TGA in Eastern Finland was 18.6/100,000 inhabitants, and when standardized to the European population in 2010, it was 14.3/100,000 inhabitants. Therefore, the TGA incidence was higher than previously reported in European countries. Discussion: The most common precipitating factors for TGA were physical effort, emotional stress, and water contact/temperature change. The incidence of TGA was high in the Eastern Finnish population. [ABSTRACT FROM AUTHOR]

Introduction: Transient global amnesia (TGA) is a sudden loss of memory without definite etiology. Some cardiac conditions like myocardial infarction, mitral valve prolapse, takotsubo syndrome, and arrhythmias have been described in the literature as offenders. To our knowledge, there is no report of an association between TGA and endocarditis or even septicemia.Case presentation: The patient was a 52-year-old man with a history of hypertension and aortic valve surgery which was presented to the emergency department with TGA. On brain CT scan and MRI there was not any pathological finding and EEG revealed normal features without any epileptiform discharge. During evaluations, the diagnosis of acute bacterial endocarditis has been established by the presence of positive blood culture and vegetation on the aortic valve in trans-esophageal echocardiography. At 6 months follow-up, and after receiving appropriate antibiotic therapy and cardiac surgery, he was symptom-free.Conclusion: Association between TGA and cardiovascular disorders like myocardial infarction and takotsubo syndrome has been described. Neurological complications occur in about one-fourth of patients with infective endocarditis, but there is not any report of the association between TGA and acute bacterial endocarditis. Cardiovascular disorder studies are just limited to case reports without any clarification of mechanism and pathophysiology.

Background: Transient global amnesia is common in the older adult, but the cause and mechanism remain unclear. Focal brain lesions allow for causal links between the lesion location and resulting symptoms, and we based on the reported TGA-causing lesions and used lesion network mapping to explore the causal neuroanatomical substrate of TGA. Methods: Fifty-one cases of transient global amnesias with DWI lesions from the literature were identified, and clinical data were extracted and analyzed. Next, we mapped each lesion volume onto a reference brain and computed the network of regions functionally connected to each lesion location using a large normative connectome dataset. Results: Lesions primarily occurred in the hippocampus, and in addition to the hippocampus, there are also other locations of TGA-causing lesions such as the cingulate gyrus, anterior thalamic nucleus (ATN), putamen, caudate nucleus, corpus callosum, fornix. More than 90% of TGA-causing lesions inside the hippocampus were functionally connected with the default mode network (DMN). Conclusion: Structural abnormality in the hippocampus was the most consistently reported in TGA, and besides the hippocampus, lesions occurring at several other brain locations also could cause TGA. The DMN may also be involved in the pathophysiology of TGA. According to the clinical and neuroimaging characteristics, TGA may be a syndrome with multiple causes and cannot be treated simply as a subtype of TIA. [ABSTRACT FROM AUTHOR]

Reversible cerebral vasoconstriction syndrome (RCVS) and transient global amnesia (TGA) are acute and self‐limiting intra‐cerebral conditions. Although previously studied as independent phenomena, there are increasing reports of co‐occurrence of these two pathologies. We report a 55‐year‐old male who presented to the hospital with recurrent thunderclap headaches over the course of 1 week with sudden onset of anterograde memory loss. His medications included a selective serotonin reuptake inhibitor and intermittent use of pseudoephedrine. On examination he was amnestic to recent events and notably perseverating. Magnetic resonance imaging of the brain without contrast showed a small, punctate focus of restricted diffusion in the left hippocampus. He was diagnosed with TGA based on his clinical presentation. His headaches and amnesia resolved over the next 12 h throughout the course of his stay with acetaminophen and oral verapamil and he was discharged. Repeat computed tomography angiogram at 2 weeks revealed diffuse and segmental narrowing of the anterior and posterior intracranial circulation, which resolved on follow‐up imaging at 3 months, confirming RCVS. The acute and reversible nature of these conditions and increasing reports of co‐occurrence suggests a common pathophysiologic link. We review the literature highlighting similar cases and the presumed pathophysiology. [ABSTRACT FROM AUTHOR]

Background: Transient epileptic amnesia (TEA) is a rare phenomenon in temporal lobe epilepsy that is often unrecognized or misdiagnosed as transient global amnesia (TGA). It is postulated that TEA is due to both ictal and postictal disturbances. Response to antiseizure medication underlines its epileptic nature. In view of the increasing incidence of new-onset epilepsies in old age, an increase in TEA can be expected in the future. Objective: Analysis of TEA features in a monocentric case series. Material and methods: A search in our electronic patient data base yielded 10 patients with TEA out of 7899 patients over a period of 8 years. Clinical and paraclinical features as well as findings of additional examinations were retrospectively collected. Data are given as mean ± SD. Results: All 10 patients were diagnosed with temporal lobe epilepsy. The mean age at manifestation of TEA was 59.1 ± 6.7 years, the diagnosis was made with a delay of 21.9 ± 26.3 months. The TEA lasted on average 56 ± 37 min, and 16 ± 9.9 TEA episodes per year were reported by the patients; out of the 10 patients 6 reported that TEA usually occurred upon awakening. In 9 of 10 patients, there was evidence of typical seizure symptoms or other semiological elements during TEA. Interictal neuropsychological disturbances of temporal functions were seen in 8 of 10 patients and evidence of depressive disorder in 6 of 10 patients. Video EEG recordings revealed epileptiform activity during sleep in 4 patients over the left and in 2 patients over both temporal regions. In 3 patients, magnetic resonance imaging displayed typical alterations of the temporomesial structures (in 2 patients on the left and in 1 the right side). Antiseizure medication improved seizure control in 7 of 10 patients (seizure freedom in 6 patients), 3 patients were lost to follow-up. Discussion: TEA is rare, occurs in older adults and is correctly diagnosed after about 2 years. Thorough assessment of additional symptoms and circumstances, the recurrent occurrence as well as typical EEG and imaging findings of temporal lobe epilepsy enables the distinction between TEA and TGA. [ABSTRACT FROM AUTHOR]

Cerebral infarction is an uncommon and unusual cause of acute amnesia. The fornix is a white matter tract bundle that plays an important function in memory. We present the case of a 60-year-old male presenting with altered mental status and acute onset amnesia with CT and MR imaging demonstrating an acute left fornix infarct. This case serves to further illuminate the findings associated with this uncommon clinical event. In addition, it highlights the importance for physicians across multiple subspecialities to maintain an index of suspicion for fornix infarct in the evaluation of acute onset amnesia.

Transient global amnesia (TGA) is a self-limiting neurological condition that temporarily affects patients’ ability to access and store memories. So far, its etiology is unknown; however, ischemic origin has been discussed in the past. We present the case of a 61-year-old female with clinical appearance of TGA. MRI and duplex scan revealed punctiform and patchy ischemic lesions in both temporal lobes and right vertebral artery dissection, suggesting basilar artery embolism as the underlying cause. Our case report shows that TGA can be a symptom of ischemic lesions in the hippocampus and patients with presentation of additional focal neurologic symptoms or atypical distribution or appearance of the diffusion-weighted image (multiple/patchy) lesions should get ischemic stroke diagnosis and treatment.

Transient global amnesia (TGA) is an uncommon clinical syndrome characterized by short‐term memory loss and disorientation that resolves in 24 h. Here, we report a 60‐year‐old male patient who presented with a sudden onset of disorientation and short‐term memory loss and started to ask about his whereabouts and what happened. He had no significant past medical or psychiatric disorder. Likewise, the patient did not have a recent history of head trauma, substance abuse, loss of consciousness, seizure disorder, or migraine. Neurologic examination was normal except for mild disorientation and short‐term memory impairment. He had a score of 18/30 on the mini‐mental state examination. Extensive laboratory investigations did not show any abnormal findings. Brain MRI and EEG were normal. His memory improved and returned to a normal baseline within 24 h from the onset. After the exclusion of potential causes and the patient returned to a normal state of memory, the diagnosis of transient global amnesia was made. At the follow‐up visit, the patient was in a state of normal function without a recurrence of memory impairment. Here, we presented this interesting case of transient global amnesia. TGA is a diagnosis of exclusion and is essential to keep in mind when evaluating a patient with acute onset of short‐term memory impairment, especially when etiological investigations reveal no potential cause. [ABSTRACT FROM AUTHOR]

An episode of temporary memory loss which is recovered within 24 hours is called transient global amnesia. The etiology and triggering factors are unclear but hippocampal lesions may contribute to this condition. Diffusion-weighted magnetic resonance imaging is used to detect these lesions. In this case report, two cases with transient global amnesia who had hippocampal lesions are presented. [ABSTRACT FROM AUTHOR]

Background: Transient global amnesia (TGA) is a sudden-onset transient memory impairment along with intact neurologic examinations. Even though it is a benign neurologic condition with many differential diagnoses, the incidence rate of TGA is reported to have increased since the onset of the pandemic. Therefore, this systematic scoping review aims to investigate TGA in that context. Methods: MEDLINE, Scopus, and Google Scholar databases were systematically searched for relevant articles with a string of specified keywords. Results: The primary search yielded 90 studies. After all the necessary screening rounds were carried out, we were left with six included studies. One study was also identified through a search in other relatively relevant databases. Finally, seven case reports were accepted including three TGA patients with positive and one with negative test for coronavirus disease- 2019 (COVID-19), respectively. COVID-19 status was unclear in the others. Conclusion: The reported COVID-19 positive cases had presentations similar to those with TGA before the pandemic. Therefore, we think that TGA might occur concomitantly with the COVID-19 infection or due to the psychological impact of the pandemic. In the confirmed cases of TGA and COVID-19, the abnormal findings may be due to COVID-19 infection. However, the reports were not as complete as desired. Therefore, providing the readers with more detailed reports in future cases is recommended. [ABSTRACT FROM AUTHOR]

Transient global amnesia (TGA) is defined by an acute memory disturbance of unclear aetiology for a period of less than 24 h. Observed psychological, neuroanatomical and hormonal differences between the sexes in episodic memory suggest sex-specific differences in memory disorders such as TGA. The aim of this study was to determine sex-specific differences in cardiovascular risk profiles, recurrences and magnetic resonance imaging (MRI). In total, 372 hospitalised TGA patients between 01/2011 and 10/2021 were retrospectively analysed. Comparisons were made between female and male TGA patients and compared to 216 patients with acute stroke. In our sample, women were overrepresented (61.8%), especially compared to the general population in the 65–74 age category (χ2 = 10.6, p < 0.02). On admission, female TGA patients had significantly higher systolic blood pressure values and a higher degree of cerebral microangiopathy compared to male TGA patients, whereas acute stroke patients did not. No sex-specific differences were observed with respect to recurrences or hippocampal DWI lesions. Our data demonstrate sex-specific differences in TGA. The higher blood pressure on admission and different degree of cerebral microangiopathy in female TGA patients supports the theory of blood pressure dysregulation as a disease trigger. Distinct precipitating events in female and male patients could lead to differences in the severity and duration of blood pressure abnormalities, possibly explaining the higher incidence in female patients. [ABSTRACT FROM AUTHOR]

Introduction: Current clinical diagnostic criteria of transient global amnesia (TGA) require the episode to completely resolve within 24 h. Small case series investigating the neuropsychological profiles obtained during the first days after TGA are inconclusive, with some suggesting the persistence of memory deficits. Methods: In this retrospective observational study, neuropsychological data of 185 TGA patients obtained during the first days following an attack were analysed. Data of cognitive functions assessed in at least 50 patients were evaluated and dichotomised according to z-values as "impaired" or "unimpaired". Moreover, the results of magnetic resonance imaging (MRI) were collected. Results: Neuropsychological assessment was performed within the first 3 days after TGA in 158 (85.4%) of all patients. The majority of patients showed no significant neuropsychological sequelae in the postacute phase of TGA. However, Mini-Mental Status Examination showed impairment in 22.6% of 159 patients, and we found subtle reductions of patients' performance in tests of verbal long-term memory and executive function in 16.3–24.6% of patients. Patients with hippocampal diffusion-weighted imaging (DWI) lesions performed significantly worse in a verbal recognition task than those without DWI lesions. Discussion: Our findings reflect subtle performance reductions in different cognitive domains in a small subgroup of TGA patients. This implies that the gradual resolution of subclinical symptoms may take longer than the 24 h required as maximum episode duration by current diagnostic criteria. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Transient global amnesia (TGA), which is described as short-term amnesia, may be influenced by some dietary components involved in brain function. The aim of the present study was to assess the connection between TGA and dietary intake of vitamin B12., Methods: This cross-sectional study was conducted on 258 people with TGA and 520 people without TGA in Sabzevar, Iran. All participants were screened for TGA (ICD-10 code: G45.4). A validated Food Frequency Questionnaire (FFQ) was utilized to estimate the dietary intake of vitamin B12. Different models of logistic regression were used to determine the association between TGA and dietary intake of vitamin B12 after adjusting the confounders., Results: There was an inverse association between the risk of TGA and the intake of vitamin B12 (OR = 0.94, CI 95%: 0.89-0.99, p = .02, effect size: -0.04). The result did not change after adjustment for age, gender, education, job, and marital status (OR = 0.93, CI 95%: 0.88-0.98, p = .01, effect size: -0.03). The result remained significant after additional adjustments for body mass index (BMI) and physical activity (OR = 0.94, CI 95%: 0.89-0.99, p = .03, effect size: -0.04), and after further adjustments for the underlying diseases, including diabetes, hypertension, and stroke (OR = 0.86, CI 95%: 0.81-0.92, p < .01, effect size: -0.10)., Conclusion: Vitamin B12 deficiency may increase the risk of TGA and should be considered as a potential concern for people at risk for TGA. Further studies are needed to validate these findings and to discover the underlying mechanisms of the effects of vitamin B12 on TGA., (© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Transient global amnesia is not rare, but its etiology remains unknown. Cerebral ischemia is a suspected cause because high signal intensity is observed on diffusion-weighted brain magnetic resonance imaging; however, previous studies have not established it as a cause. Of the 128 patients (114 females) enrolled in this study, 82 (64.6%) experienced extreme stress before transient global amnesia. The number of female patients with patent foramen ovale was more than that of males. The patent foramen ovale-positive group had fewer vascular risk factors and fewer old ischemic lesions on fluid-attenuated inversion recovery magnetic resonance imaging than the patent foramen ovale-negative group. Brain magnetic resonance imaging confirmed that high signal intensity was more likely to be detected on the initial diffusion-weighted imaging when there was an old lesion detected by fluid-attenuated inversion recovery. Furthermore, a longer period from symptom onset to brain magnetic resonance imaging was associated with a positive initial diffusion-weighted imaging result. It is difficult to attribute one underlying mechanism to all the transient global amnesia cases. This study confirmed that transient global amnesia patients with patent foramen ovale had lesser vascular risk factors and showed fewer old lesions on fluid-attenuated inversion recovery magnetic resonance imaging than those without. These results suggest that transient global amnesia may be caused by a paradoxical embolus rather than ischemia due to traditional vascular risk factors in patients with patent foramen ovale.

Abstract Transient global amnesia (TGA) is an uncommon clinical syndrome characterized by short‐term memory loss and disorientation that resolves in 24 h. Here, we report a 60‐year‐old male patient who presented with a sudden onset of disorientation and short‐term memory loss and started to ask about his whereabouts and what happened. He had no significant past medical or psychiatric disorder. Likewise, the patient did not have a recent history of head trauma, substance abuse, loss of consciousness, seizure disorder, or migraine. Neurologic examination was normal except for mild disorientation and short‐term memory impairment. He had a score of 18/30 on the mini‐mental state examination. Extensive laboratory investigations did not show any abnormal findings. Brain MRI and EEG were normal. His memory improved and returned to a normal baseline within 24 h from the onset. After the exclusion of potential causes and the patient returned to a normal state of memory, the diagnosis of transient global amnesia was made. At the follow‐up visit, the patient was in a state of normal function without a recurrence of memory impairment. Here, we presented this interesting case of transient global amnesia. TGA is a diagnosis of exclusion and is essential to keep in mind when evaluating a patient with acute onset of short‐term memory impairment, especially when etiological investigations reveal no potential cause.

Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of a temporary memory disorder with profound anterograde amnesia and a variable impairment of the past memory. Usually, the attacks are preceded by a precipitating event, last up to 24 h and are not associated with other neurological deficits. Diagnosis can be challenging because the identification of TGA requires the exclusion of some acute amnestic syndromes that occur in emergency situations and share structural or functional alterations of memory circuits. Magnetic Resonance Imaging (MRI) studies performed 24–96 h after symptom onset can help to confirm the diagnosis by identifying lesions in the CA1 field of the hippocampal cornu ammonis, but their practical utility in changing the management of patients is a matter of discussion. In this review, we aim to provide a practical approach to early recognition of this condition in daily practice, highlighting both the lights and the shadows of the diagnostic criteria. For this purpose, we summarize current knowledge about the clinical presentation, diagnostic pathways, differential diagnosis, and the expected long-term outcome of TGA. [ABSTRACT FROM AUTHOR]

Background and aims: Transient global amnesia (TGA) is a clinical syndrome characterized by sudden anterograde amnesia not accompanied by other neurological symptoms. There is no consensus on the underlying pathophysiological mechanism. However, diffusion-weighted imaging (DWI) of the magnetic resonance imaging (MRI) has demonstrated hippocampal lesions in as many as 50% of cases. This paper describes a series of patients with TGA and hippocampal lesions. Methods: This study assessed vascular risk factors in patients older than age 18 admitted to the Hospital Universitario San Ignacio, Bogota, Colombia, from May 2017 to June 2020 with a diagnosis of TGA and evidence of hippocampal ischemic lesion on 3 Tesla brain MRI. Results: The authors identified 36 patients, 72.2% female, with mean age 62 years. Cardiovascular risk factors, most frequently high blood pressure, carotid disease, and dyslipidemia, were present in 75% of these patients. Hippocampal lesions were unilateral in 80% of cases, with median size 2.5 mm, most frequently located at the hippocampal body. Approximately 14% of patients also presented acute ischemic lesions in locations other than the hippocampus. Conclusions: TGA is a clinical entity previously considered to have undetermined etiology. The present study used brain MRI to identify a group of patients with hippocampal ischemic lesions, finding associated vascular risk factors in a high proportion of them. [ABSTRACT FROM AUTHOR]

Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of a temporary memory disorder with a profound anterograde amnesia and a variable impairment of the past memory. Since the first description, dating back over 60 years, several cases have beenreported in the literature. Nevertheless, TGA remains one of the most mysterious diseases in clinical neurology. The debate regarding the etiology of this disease has focused mainly on three different mechanisms: vascular (due to venous flow changes or focal arterial ischemia), epileptic, and migraine related. However, to date there is no scientific proof of any of these mechanisms. Furthermore, the demonstration by diffusion-weighted MRI of lesions in the CA1 field of the hippocampus cornu ammonis led us to hypothesize that the selective vulnerability of CA1 neurons to metabolic stress could play a role in the pathophysiology of TGA. In this review, we summarize current knowledge on the anatomy, vascularization and function of the hippocampus. Furthermore, we discuss the emerging theories on the etiology and the pathophysiological cascade leading to an impairment of hippocampal function during the attacks. [ABSTRACT FROM AUTHOR]