Login Register Cart 0
Generic placeholder image

Current Neurovascular Research

Editor-in-Chief

ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe
Research Article

Cerebral Small Vessel Disease Burden in Patients with Transient Global Amnesia and its Relationship with Recurrence

In Press, (this is not the final "Version of Record"). Available online 27 March, 2024
Author(s): Zhi-li Wang, Simeng Wang, Dongtao Liu, Yuelei Lyu, Wei Qin* and Wenli Hu*
Published on: 27 March, 2024

DOI: 10.2174/0115672026309418240322060729

Price: $95

Abstract

Objective: Cerebral Small Vessel Disease (CSVD) has not been systematically studied in patients with Transient Global Amnesia (TGA). We aimed to investigate the CSVD burden in patients with TGA and its relationship with TGA recurrence.

Methods: We retrospectively examined 69 patients diagnosed with TGA in a single center between January 2015 and November 2023. The overall CSVD burden and single CSVD imaging markers, including enlarged perivascular spaces in the hippocampus (H-EPVS), were measured in each patient and compared with those in 69 age- and sex-matched healthy controls. Multivariate logistic regression was performed to determine independent predictors of recurrence.

Results: Of the 69 included patients, 40 (58%) were female, and the median age was 67 years (range 42-83 years). Twenty-one patients (30.4%) showed dot-like hippocampal hyperintensities on diffusion-weighted imaging (DWI). The mean follow-up was 51 months. Sixteen patients (23.2%) experienced TGA recurrence. The burden of overall CSVD, lacunes, WMH, EPVS, and extensive H-EPVS was higher in TGA patients than in controls. TGA patients who experienced recurrence had a heavier overall CSVD burden, lower frequency of hippocampal DWI hyperintensities, and longer follow-up duration than those who had with single episode. In the multivariate analysis, only follow-up duration was an independent predictor of TGA recurrence.

Conclusion: The overall CSVD burden and extensive H-EPVS burden were higher in patients with TGA than healthy controls. Follow-up duration but not overall CSVD burden may predict TGA recurrence.

[1]
Ropper AH. Transient global amnesia. N Engl J Med 2023; 388(7): 635-40.
[http://dx.doi.org/10.1056/NEJMra2213867] [PMID: 36791163]
[2]
Quinette P, Guillery-Girard B, Dayan J, et al. What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 2006; 129(7): 1640-58.
[http://dx.doi.org/10.1093/brain/awl105] [PMID: 16670178]
[3]
Barash JA, Parikh M, Ergas R, DeMaria A Jr. Is there a relationship between opioid use and Transient Global Amnesia? Eur J Neurol 2024; 31(2): e16134.
[http://dx.doi.org/10.1111/ene.16134] [PMID: 37955550]
[4]
Mangla A, Navi BB, Layton K, Kamel H. Transient global amnesia and the risk of ischemic stroke. Stroke 2014; 45(2): 389-93.
[http://dx.doi.org/10.1161/STROKEAHA.113.003916] [PMID: 24309586]
[5]
Sander D, Bartsch T, Connolly F, et al. Guideline “Transient Global Amnesia (TGA)” of the German Society of Neurology (Deutsche Gesellschaft für Neurologie): S1-guideline. Neurol Res Prac 2023; 5(1): 15.
[http://dx.doi.org/10.1186/s42466-023-00240-0] [PMID: 37076927]
[6]
Sander K, Sander D. New insights into transient global amnesia: Recent imaging and clinical findings. Lancet Neurol 2005; 4(7): 437-44.
[http://dx.doi.org/10.1016/S1474-4422(05)70121-6] [PMID: 15963447]
[7]
Enzinger C, Thimary F, Kapeller P, et al. Transient global amnesia: Diffusion-weighted imaging lesions and cerebrovascular disease. Stroke 2008; 39(8): 2219-25.
[http://dx.doi.org/10.1161/STROKEAHA.107.508655] [PMID: 18583561]
[8]
Rogalewski A, Beyer A, Friedrich A, et al. Transient Global Amnesia (TGA): Sex-specific differences in blood pressure and cerebral microangiopathy in patients with TGA. J Clin Med 2022; 11(19): 5803.
[http://dx.doi.org/10.3390/jcm11195803] [PMID: 36233669]
[9]
Rogalewski A, Beyer A, Friedrich A, et al. Transient Global Amnesia (TGA): Younger age and absence of cerebral microangiopathy are potentially predisposing factors for TGA recurrence. Front Neurol 2021; 12: 736563.
[http://dx.doi.org/10.3389/fneur.2021.736563] [PMID: 34777205]
[10]
Noh SM, Kang HG. Clinical manifestation and imaging characteristics of transient global amnesia: Patent foramen ovale as an underlying factor. J Integr Neurosci 2021; 20(3): 719-25.
[http://dx.doi.org/10.31083/j.jin2003077] [PMID: 34645106]
[11]
ter Telgte A, Duering M. Cerebral small vessel disease: Advancing knowledge with neuroimaging. Stroke 2024; 2024: 044294.
[http://dx.doi.org/10.1161/STROKEAHA.123.044294] [PMID: 38328947]
[12]
Libecap TJ, Bauer CE, Zachariou V, et al. Association of baseline cerebrovascular reactivity and longitudinal development of enlarged perivascular spaces in the Basal Ganglia. Stroke 2023; 54(11): 2785-93.
[http://dx.doi.org/10.1161/STROKEAHA.123.043882] [PMID: 37712232]
[13]
Evans TE, Knol MJ, Schwingenschuh P, et al. Determinants of perivascular spaces in the general population. Neurology 2023; 100(2): e107-22.
[http://dx.doi.org/10.1212/WNL.0000000000201349] [PMID: 36253103]
[14]
Yang XL, Guo Y, Chen SF, et al. Cerebral small vessel disease is associated with motor, cognitive, and emotional dysfunction in multiple system atrophy. J Parkinsons Dis 2023; 13(7): 1239-52.
[http://dx.doi.org/10.3233/JPD-230166] [PMID: 37742661]
[15]
Pantoni L, Lamassa M, Inzitari D. Transient global amnesia: A review emphasizing pathogenic aspects. Acta Neurol Scand 2000; 102(5): 275-83.
[http://dx.doi.org/10.1034/j.1600-0404.2000.102005275.x] [PMID: 11083503]
[16]
Morris KA, Rabinstein AA, Young NP. Factors associated with risk of recurrent transient global amnesia. JAMA Neurol 2020; 77(12): 1551-8.
[http://dx.doi.org/10.1001/jamaneurol.2020.2943] [PMID: 32865551]
[17]
Hernández MA, Arena JE, Alessandro L, Allegri RF, Calandri IL. Transient global amnesia recurrence. Neurol Clin Pract 2022; 12(4): e35-48.
[http://dx.doi.org/10.1212/CPJ.0000000000001181] [PMID: 36382126]
[18]
Auyeung M, Tsoi TH, Cheung CM, et al. Association of diffusion weighted imaging abnormalities and recurrence in transient global amnesia. J Clin Neurosci 2011; 18(4): 531-4.
[http://dx.doi.org/10.1016/j.jocn.2010.08.019] [PMID: 21316242]
[19]
Caplan LR. Transient global amnesia. What’s in a name? J Neurol Sci 2022; 441: 120348.
[http://dx.doi.org/10.1016/j.jns.2022.120348] [PMID: 35940029]
[20]
Hodges JR, Warlow CP. Syndromes of transient amnesia: Towards a classification. A study of 153 cases. J Neurol Neurosurg Psychiatry 1990; 53(10): 834-43.
[http://dx.doi.org/10.1136/jnnp.53.10.834] [PMID: 2266362]
[21]
Duering M, Biessels GJ, Brodtmann A, et al. Neuroimaging standards for research into small vessel disease—advances since 2013. Lancet Neurol 2023; 22(7): 602-18.
[http://dx.doi.org/10.1016/S1474-4422(23)00131-X] [PMID: 37236211]
[22]
Fazekas F, Chawluk JB, Alavi A, Hurtig HI, Zimmerman RA. MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR Am J Roentgenol 1987; 149(2): 351-6.
[http://dx.doi.org/10.2214/ajr.149.2.351] [PMID: 3496763]
[23]
Doubal FN, MacLullich AMJ, Ferguson KJ, Dennis MS, Wardlaw JM. Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease. Stroke 2010; 41(3): 450-4.
[http://dx.doi.org/10.1161/STROKEAHA.109.564914] [PMID: 20056930]
[24]
Jiménez-Balado J, Riba-Llena I, Garde E, et al. Prevalence of hippocampal enlarged perivascular spaces in a sample of patients with hypertension and their relation with vascular risk factors and cognitive function. J Neurol Neurosurg Psychiatry 2018; 89(6): 651-6.
[http://dx.doi.org/10.1136/jnnp-2017-316724] [PMID: 29326289]
[25]
Jeong SH, Cha J, Park M, et al. Association of enlarged perivascular spaces with amyloid burden and cognitive decline in alzheimer disease continuum. Neurology 2022; 99(16): e1791-802.
[http://dx.doi.org/10.1212/WNL.0000000000200989] [PMID: 35985826]
[26]
Staals J, Makin SDJ, Doubal FN, Dennis MS, Wardlaw JM. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology 2014; 83(14): 1228-34.
[http://dx.doi.org/10.1212/WNL.0000000000000837] [PMID: 25165388]
[27]
Tynas R, Panegyres PK. Factors determining recurrence in transient global amnesia. BMC Neurol 2020; 20(1): 83.
[http://dx.doi.org/10.1186/s12883-020-01658-8] [PMID: 32143587]
[28]
Rogalewski A, Beyer A, Friedrich A, et al. Transient Global Amnesia (TGA): Influence of acute hypertension in patients not adapted to chronic hypertension. Front Neurol 2021; 12: 666632.
[http://dx.doi.org/10.3389/fneur.2021.666632] [PMID: 34305782]
[29]
Lau KK, Li L, Schulz U, et al. Total small vessel disease score and risk of recurrent stroke. Neurology 2017; 88(24): 2260-7.
[http://dx.doi.org/10.1212/WNL.0000000000004042] [PMID: 28515266]
[30]
Szabo K, Hoyer C, Caplan LR, et al. Diffusion-weighted MRI in transient global amnesia and its diagnostic implications. Neurology 2020; 95(2): e206-12.
[http://dx.doi.org/10.1212/WNL.0000000000009783] [PMID: 32532848]
[31]
Talmasov D, Masurkar AV. Journal club: Diffusion-weighted MRI in transient global amnesia and its diagnostic implications. Neurology 2021; 96(16): e2138-40.
[http://dx.doi.org/10.1212/WNL.0000000000011352] [PMID: 33310875]
[32]
Sparaco M, Pascarella R, Muccio CF, Zedde M. Forgetting the unforgettable: Transient Global Amnesia part I: Pathophysiology and Etiology. J Clin Med 2022; 11(12): 3373.
[http://dx.doi.org/10.3390/jcm11123373] [PMID: 35743444]
[33]
Oliveira R, Teodoro T, Marques IB. Risk factors predicting recurrence of transient global amnesia. Neurol Sci 2021; 42(5): 2039-43.
[http://dx.doi.org/10.1007/s10072-020-04788-6] [PMID: 33033897]
[34]
Alessandro L, Calandri IL, Suarez MF, et al. Transient global amnesia: clinical features and prognostic factors suggesting recurrence. Arq Neuropsiquiatr 2019; 77(1): 3-9.
[http://dx.doi.org/10.1590/0004-282x20180157] [PMID: 30758436]
[35]
Paech D, Kuder TA, Roßmanith C, et al. What remains after transient global amnesia (TGA)? An ultra‐high field 7 T magnetic resonance imaging study of the hippocampus. Eur J Neurol 2020; 27(2): 406-9.
[http://dx.doi.org/10.1111/ene.14099] [PMID: 31573112]
[36]
Taheri S, Peters N, Zietz A, et al. Clinical course and recurrence in Transient Global Amnesia: A study from the TEMPiS Telestroke Network. J Clin Neurol 2023; 19(6): 530-8.
[http://dx.doi.org/10.3988/jcn.2022.0368] [PMID: 37455507]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy