Abstract

BackgroundThe pathophysiology of transient global amnesia (TGA) is not fully understood. Previous studies using single photon emission computed tomography (SPECT) have reported inconclusive results regarding cerebral perfusion. This study was conducted to identify the patterns of regional cerebral blood flow (rCBF) in TGA patients via longitudinal SPECT analysis. An association between the observed SPECT patterns and a pathophysiological mechanism was considered.MethodsBased on the TGA registry database of Seoul National University Bundang Hospital, 22 TGA patients were retrospectively identified. The subjects underwent initial Tc-99m-ethyl cysteinate dimer (ECD) SPECT within 4 days of an amnestic event and underwent follow-up scans approximately 6 months later. The difference in ECD uptake between the two scans was measured via voxel-based whole brain analysis, and the quantified ECD uptake was tested using a paired t-test.ResultsThe TGA patients had significantly decreased cerebral perfusion at the left precuneus (P<0.001, uncorrected) and at the left superior parietal and inferior temporal gyrus according to the voxel-based whole brain analysis (P<0.005, uncorrected). A difference in the quantified ECD uptake between the 2 scans was also found at the left precuneus among the 62 cortical volumes of interest (P = 0.018, Cohen’s d = -0.25).ConclusionWe identified left hemispheric lateralized hypoperfusion that may be related to posterior medial network disruption. These findings may be a contributing factor to the pathophysiology of TGA.

Highlights

  • Transient global amnesia (TGA) refers to the sudden onset of anterograde and retrograde amnesia, which lasts up to 24 hours with no other cognitive impairment

  • The TGA patients had significantly decreased cerebral perfusion at the left precuneus (P

  • We identified left hemispheric lateralized hypoperfusion that may be related to posterior medial network disruption

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Summary

Introduction

Transient global amnesia (TGA) refers to the sudden onset of anterograde and retrograde amnesia, which lasts up to 24 hours with no other cognitive impairment. Previous studies of cerebral hypoperfusion using single photon emission computed tomography (SPECT) have shown inconclusive results, as some describe medial temporal flow change [16, 22,23,24,25] and others report decreased or increased flow changes in various structures [24, 26,27,28]. This variability may be derived from the differences in the study designs, including imaging protocol and the latency of scanning. An association between the observed SPECT patterns and a pathophysiological mechanism was considered

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