Reversible functional connectivity disturbances during transient global amnesia

• Published in: Annals of neurology Vol. 75; no. 5; pp. 634 - 643
• Main Authors: Peer, Michael, Nitzan, Mor, Goldberg, Ilan, Katz, Judith, Gomori, J. Moshe, Ben-Hur, Tamir, Arzy, Shahar
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2014; Wiley Subscription Services, Inc
• Subjects: Aged; Amnesia; Amnesia, Transient Global - diagnosis; Amnesia, Transient Global - physiopathology; Cluster Analysis; Female; fMRI; Hippocampus - pathology; Hippocampus - physiopathology; Humans; Magnetic Resonance Imaging - methods; Male; Medical imaging; Memory; Memory, Episodic; Middle Aged; Nerve Net - pathology; Nerve Net - physiopathology; Neural Pathways - pathology; Neural Pathways - physiopathology; Resting-state; fMRI; Resting-state; Amnesia; Memory
• ISSN: 0364-5134; 1531-8249
• DOI: 10.1002/ana.24137

Objective Transient global amnesia (TGA), an abrupt occurrence of severe anterograde episodic amnesia accompanied by repetitive questioning, has been known for more than 50 years. Despite extensive research, there is no clear evidence for the underlying pathophysiological basis of TGA. Moreover, there is no neuroimaging method to evaluate TGA in real time. Methods Here we used resting‐state functional magnetic resonance imaging recorded in 12 patients during the acute phase of TGA together with connectivity and cluster analyses to detect changes in the episodic memory network in TGA. Results Our results show a significant reduction in functional connectivity of the episodic memory network during TGA, which is more pronounced in the hyperacute phase than in the postacute phase. This disturbance is bilateral, and reversible after recovery. Although the hippocampus and its connections are significantly impaired, other parts of the episodic memory network are also impaired. Similar results were obtained for the analysis of the episodic memory network whether it was defined in a data‐driven or literature‐based manner. Interpretation These results suggest that TGA is related to a functional disturbance in the episodic memory network, and supply a neuroimaging correlate of TGA during the acute phase. Ann Neurol 2014;75:634–643