Abstract
Background: Transient global amnesia (TGA) is defined by an acute memory disturbance of unclear etiology for a period of less than 24 h. TGA occurs as a single event in most cases. Prevalence rates of recurrent TGA vary widely from 5.4 to 27.1%. This retrospective study aimed to determine predictors for TGA recurrence.Methods: Cardiovascular risk profile and magnetic resonance imaging (MRI) of 340 hospitalized TGA patients between 2011 and 2020 were retrospectively analyzed. The median follow-up period amounted to 4.5 ± 2.7 years. Comparisons were made between TGA patients with and without subsequent recurrence.Results: TGA patients with subsequent recurrence were significantly younger (recurrent vs. single episode, 63.6 ± 8.6 years vs. 67.3 ± 10.5 years, p = 0.032) and showed a lower degree of cerebral microangiopathy compared to TGA patients without recurrence. The mean latency to recurrence was 3.0 years ± 2.1 years after the first episode. In a subgroup analysis, patients with at least five years of follow-up (N = 160, median follow-up period 7.0 ± 1.4 years) had a recurrence rate of 11.3%. A 24.5% risk of subsequent TGA recurrence in the following five years was determined for TGA patients up to 70 years of age without microangiopathic changes on MRI (Fazekas' score 0).Conclusion: Younger TGA patients without significant microangiopathy do have an increased recurrence risk. In turn, pre-existing cerebrovascular pathology, in the form of chronic hypertension and cerebral microangiopathy, seems to counteract TGA recurrence.
Highlights
Transient global amnesia (TGA), first described in 1956 [1], is an acute disturbance of memory function for a period of less than 24 h that usually occurs in middle-aged and elderly individuals
TGA patients with subsequent recurrence were significantly younger and showed a lower extent of cerebral microangiopathy compared to TGA patients without recurrence
It is known that TGA patients are less likely to have chronic hypertension compared to acute stroke patients, which is reflected in lower levels of consecutive hypertensive disorders such as the extent of cerebral microangiopathy
Summary
Transient global amnesia (TGA), first described in 1956 [1], is an acute disturbance of memory function for a period of less than 24 h that usually occurs in middle-aged and elderly individuals. The cause of this neuropsychological syndrome with foreground anterograde and retrograde amnesia without focal neurological deficits is thought to reflect a transient deficit in hippocampal function [2] and a reversible disturbance in the functional connectivity of the broader episodic memory network including the medial temporal sub-network, as well as the orbitofrontalcingulate, medial occipital, inferior temporal and deep-structure sub-networks [3, 4]. This retrospective study aimed to determine predictors for TGA recurrence
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