Tao Wang1,2, Yicheng Xu3, Deying Li4,5, Wenjun Tu6, Yanan Li1, Shuai Miao1,2, Jilai Li3, Peifu Wang3, Fei Zhao7, Lingzhong Fan8,9,10, Shengyuan Yu11. 1. Medical School of Chinese PLA, Beijing, 100853, China. 2. Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China. 3. Department of Neurology, Aerospace Center Hospital, Beijing, China. 4. Brainnetome Center, Chinese Academy of Sciences, Beijing, 100190, China. 5. National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. 6. Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China. 7. Department of Radiology, Aerospace Center Hospital, Beijing, China. 8. Brainnetome Center, Chinese Academy of Sciences, Beijing, 100190, China. lingzhong.fan@ia.ac.can. 9. National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. lingzhong.fan@ia.ac.can. 10. CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China. lingzhong.fan@ia.ac.can. 11. Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China. yusy1963@126.com.
Abstract
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.
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.
Authors: Kristina Szabo; Carolin Hoyer; Louis R Caplan; Roland Grassl; Martin Griebe; Anne Ebert; Michael Platten; Achim Gass Journal: Neurology Date: 2020-06-12 Impact factor: 9.910
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