The long-term prognosis of Transient Global Amnesia: a systematic review

Ioannis Liampas; Maria Raptopoulou; Vasileios Siokas; Zisis Tsouris; Alexandros Brotis; Athina-Maria Aloizou; Metaxia Dastamani; Efthimios Dardiotis

doi:10.1515/revneuro-2020-0110

Abstract

Transient Global Amnesia (TGA) constitutes an enigmatic amnestic condition. In view of the admittedly limited knowledge regarding the nature of TGA, we decided to systematically review existing evidence for the generally regarded benign course of the disease. MEDLINE, EMBASE, CENTRAL and PsycINFO were searched for relevant articles. Observational (case-control, cross-sectional and cohort) controlled studies were retrieved. TGA diagnosis was made according to the diagnostic criteria of Caplan, validated by Hodges and Warlow. The TGA group was compared with either healthy controls (HC) or/and individuals with transient ischaemic attacks (TIA). The long-term risks of dementia, epilepsy, psychological-emotional disturbances, as well as long-term vascular and (vascular or nonvascular) mortality risks, were evaluated. Quality assessment was based on the Newcastle–Ottawa Scale. Literature search provided 12 eligible articles. Retrospective, prospective or mixed cohort designs were implemented in every study. Five articles registered a high quality, five registered a moderate quality, while two articles were assessed as part of the grey literature (conference abstract, abstract in English-article in Spanish). Overall, retrieved evidence was suggestive of similar vascular and mortality risks in TGA patients and HC, while TIA individuals exhibited elevated risks. Moreover, psychological disturbances were comparable between TGA and healthy individuals. On the other hand, studies for dementia and epilepsy obtained contradictory results, indicating both a similar and an increased risk in the TGA group compared to the HC group. Therefore, additional high-quality studies are warranted for the acquisition of more determining conclusions regarding the long-term risk of dementia and epilepsy in TGA.

Keywords: dementia; depression; epilepsy; stroke; Transient Global Amnesia

Corresponding author: Ioannis Liampas, Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41100 Larissa, Greece; and Kolokotroni 41, 42100 Trikala, Greece, E-mail: liampasioannes@gmail.com

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest statement: None to declare.

References

Agosti, C., Borroni, B., Akkawi, N.M., and Padovani, A. (2010). Cerebrovascular risk factors and triggers in transient global amnesia patients with and without jugular valve incompetence: results from a sample of 243 patients. Eur. Neurol. 63: 291–294. https://doi.org/10.1159/000292502.Search in Google Scholar PubMed

Arena, J.E. and Rabinstein, A.A. (2015). Transient global amnesia. Mayo Clin. Proc. 90: 264–272. https://doi.org/10.1016/j.mayocp.2014.12.001.Search in Google Scholar PubMed

Arena, J.E., Brown, R.D., Mandrekar, J., and Rabinstein, A.A. (2017). Long-term outcome in patients with transient global amnesia: a population-based study. Mayo Clin. Proc. 92: 399–405. https://doi.org/10.1016/j.mayocp.2016.11.015.Search in Google Scholar PubMed PubMed Central

Bartsch, T., Alfke, K., Stingele, R., Rohr, A., Freitag-Wolf, S., Jansen, O., and Deuschl, G. (2006). Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain 129: 2874–2884. https://doi.org/10.1093/brain/awl248.Search in Google Scholar PubMed

Bartsch, T. and Butler, C. (2013). Transient amnesic syndromes. Nat. Rev. Neurol. 9: 86–97. https://doi.org/10.1038/nrneurol.2012.264.Search in Google Scholar PubMed

Caplan, L. (1985). Transient global amnesia. In: Vinken, P.J., Gruyn, G.W., and Klawans, H.L. (Eds.), Handbook of clinical neurology, Vol. 1. Elsevier, Amsterdam, pp. 205–218.Search in Google Scholar

Cattaino, G., Querin, F., Pomes, A., and Piazza, P. (1984). Transient global amnesia. Acta Neurol. Scand. 70: 385–390. https://doi.org/10.1111/j.1600-0404.1984.tb00842.x.Search in Google Scholar PubMed

Cheng, G., Huang, C., Deng, H., and Wang, H. (2012). Diabetes as a risk factor for dementia and mild cognitive impairment: a meta-analysis of longitudinal studies. Intern. Med. J. 42: 484–491. https://doi.org/10.1111/j.1445-5994.2012.02758.x.Search in Google Scholar PubMed

Fisher, C.M. and Adams, R.D. (1958). Transient global amnesia. Trans. Am. Neurol. Assoc. 83: 143–146.10.1001/archneur.1982.00510220003001Search in Google Scholar PubMed

Fisher, C.M. and Adams, R.D. (1964). Transient global amnesia. Acta Neurol. Scand. 40(Suppl. 9): 1–83.10.1001/archneur.1982.00510220003001Search in Google Scholar

Förster, A., Griebe, M., Gass, A., Kern, R., Hennerici, M.G., and Szabo, K. (2012). Diffusion-weighted imaging for the differential diagnosis of disorders affecting the hippocampus. Cerebrovasc. Dis. 33: 104–115. https://doi.org/10.1159/000332036.Search in Google Scholar PubMed

Förster, A., Al-Zghloul, M., Wenz, H., Böhme, J., Groden, C., and Neumaier-Probst, E. (2017). Isolated punctuate hippocampal infarction and transient global amnesia are indistinguishable by means of MRI. Int. J. Stroke 12: 292–296. https://doi.org/10.1177/1747493016676613.Search in Google Scholar PubMed

Gandolfo, C., Caponnetto, C., Conti, M., Dagnino, N., Del Sette, M., and Primavera, A. (1992). Prognosis of transient global amnesia: a long-term follow-up study. Eur. Neurol. 32: 52–57. https://doi.org/10.1159/000116787.Search in Google Scholar PubMed

Herzog, R., Álvarez-Pasquin, M.J., Díaz, C., Del Barrio, J.L., Estrada, J.M., and Gil, Á. (2013). Are healthcare workers’ intentions to vaccinate related to their knowledge, beliefs and attitudes? A systematic review. BMC Publ. Health 13: 154. https://doi.org/10.1186/1471-2458-13-154.Search in Google Scholar PubMed PubMed Central

Higashida, K., Okazaki, S., Todo, K., Sasaki, T., Ohara, N., Kohara, N., Yamamoto, S., Yamagami, H., Hashikawa, K., Yoshimoto, T., et al.. (2020). A multicenter study of transient global amnesia for the better detection of magnetic resonance imaging abnormalities. Eur. J. Neurol. 27: 2117–2124. https://doi.org/10.1111/ene.14408.Search in Google Scholar PubMed

Himeno, T., Kuriyama, M., Takemaru, M., Kanaya, Y., Shiga, Y., Takeshima, S., Takamatsu, K., Shimoe, Y., Fukushima, T., and Matsubara, E. (2017). Vascular risk factors and internal jugular venous flow in transient global amnesia: a study of 165 Japanese patients. J. Stroke Cerebrovasc. Dis. 26: 2272–2278. https://doi.org/10.1016/j.jstrokecerebrovasdis.2017.05.010.Search in Google Scholar PubMed

Hinge, H.H., Jensen, T.S., Kjaer, M., Marquardsen, J., and de Fine Olivarius, B. (1986). The prognosis of transient global amnesia. Results of a multicenter study. Arch. Neurol. 43: 673–676. https://doi.org/10.1001/archneur.1986.00520070031013.Search in Google Scholar PubMed

Hodges, J.R. and Warlow, C.P. (1990a). Syndromes of transient amnesia: towards a classification: a study of 153 cases. J. Neurol. Neurosurg. Psychiatr. 53: 834–843. https://doi.org/10.1136/jnnp.53.10.834.Search in Google Scholar PubMed PubMed Central

Hodges, J.R. and Warlow, C.P. (1990b). The aetiology of transient global amnesia. A case-control study of 114 cases with prospective follow-up. Brain 113: 639–657. https://doi.org/10.1093/brain/113.3.639.Search in Google Scholar PubMed

Howe, C.J., Cole, S.R., Lau, B., Napravnik, S., and Eron, J.J.Jr (2016). Selection bias due to loss to follow up in cohort studies. Epidemiology 27: 91–97. https://doi.org/10.1097/ede.0000000000000409.Search in Google Scholar

Hsieh, S.W., Chen, C.H., Huang, P., Li, C.H., Yang, S.T., and Yang, Y.H. (2019). The long-term risk of dementia after transient global amnesia: a population-based cohort study in Taiwan. Neuroepidemiology 53: 201–208. https://doi.org/10.1159/000501910.Search in Google Scholar PubMed

Hsieh, S.W., Chen, C.H., Ho, B., Yang, S.T., and Yang, Y.H. (2020a). Long-term risk of depression after transient global amnesia: a population-based study. Psychiatr. Clin. Neurosci. 74: 413–414. https://doi.org/10.1111/pcn.13014.Search in Google Scholar PubMed

Hsieh, S.W., Yang, Y.H., Ho, B.L., Yang, S.T., and Chen, C.H. (2020b). The long-term risk of epilepsy after transient global amnesia: a population-based cohort study. Clin. Neurol. Neurosurg. 197: 106086, https://doi.org/10.1016/j.clineuro.2020.106086.Search in Google Scholar PubMed

Jensen, T.S. and de Fine Olivarius, B. (1981). Transient global amnesia – its clinical and pathophysiological basis and prognosis. Acta Neurol. Scand. 63: 220–230. https://doi.org/10.1111/j.1600-0404.1981.tb00775.x.Search in Google Scholar PubMed

Kirshner, H.S. (2011). Transient global amnesia: a brief review and update. Curr. Neurol. Neurosci. Rep. 11: 578–582. https://doi.org/10.1007/s11910-011-0224-9.Search in Google Scholar PubMed

Kitamura, T., Ogawa, S.K., Roy, D.S., Okuyama, T., Morrissey, M.D., Smith, L.M., Redondo, R.L., and Tonegawa, S. (2017). Engrams and circuits crucial for systems consolidation of a memory. Science 356: 73–78. https://doi.org/10.1126/science.aam6808.Search in Google Scholar PubMed PubMed Central

Kodounis, M., Liampas, I.N., Constantinidis, T.S., Siokas, V., Mentis, A.A., Aloizou, A.M., Xiromerisiou, G., Zintzaras, E., Hadjigeorgiou, G.M., and Dardiotis, E. (2020). Assessment of the reporting quality of double-blind RCTs for ischemic stroke based on the CONSORT statement. J. Neurol. Sci. 415: 116938. https://doi.org/10.1016/j.jns.2020.116938.Search in Google Scholar PubMed

Lanzone, J., Ricci, L., Assenza, G., Ulivi, M., Di Lazzaro, V., and Tombini, M. (2018). Transient epileptic and global amnesia: real-life differential diagnosis. Epilepsy Behav. 88: 205–211. https://doi.org/10.1016/j.yebeh.2018.07.015.Search in Google Scholar PubMed

Liampas, I., Chlinos, A., Siokas, V., Brotis, A., and Dardiotis, E. (2019). Assessment of the reporting quality of RCTs for novel oral anticoagulants in venous thromboembolic disease based on the CONSORT statement. J. Thromb. Thrombolysis 48: 542–553. https://doi.org/10.1007/s11239-019-01931-9.Search in Google Scholar PubMed

Liampas, I., Siokas, V., Brotis, A., and Dardiotis, E. (2020a). Vitamin D serum levels in patients with migraine: a meta-analysis. Rev. Neurol. (Paris) 176: 560–570. https://doi.org/10.1016/j.neurol.2019.12.008.Search in Google Scholar PubMed

Liampas, I., Siokas, V., Mentis, A.A., Aloizou, A.M., Dastamani, M., Tsouris, Z., Aslanidou, P., Brotis, A., and Dardiotis, E. (2020b). Serum homocysteine, pyridoxine, folate, and vitamin B12 levels in migraine: systematic review and meta-analysis. Headache 60: 1508–1534. https://doi.org/10.1111/head.13892.Search in Google Scholar PubMed

Liampas, I., Siokas, V., Brotis, A., Vikelis, M., and Dardiotis, E. (2020c). Endogenous melatonin levels and therapeutic use of exogenous melatonin in migraine: systematic review and meta-analysis. Headache 60: 1273–1299. https://doi.org/10.1111/head.13828.Search in Google Scholar PubMed

Liampas, I., Siokas, V., Aloizou, A.M., Tsouris, Z., Dastamani, M., Aslanidou, P., Brotis, A., and Dardiotis, E. (2020d). Pyridoxine, folate and cobalamin for migraine: a systematic review. Acta Neurol. Scand. 142: 108–120. https://doi.org/10.1111/ane.13251.Search in Google Scholar PubMed

Liampas, I., Siokas, V., Brotis, A., Aloizou, A.M., Mentis, A.A., Vikelis, M., and Dardiotis, E. (2020e). Meta-analysis of melatonin levels in cluster headache-review of clinical implications. Acta Neurol. Scand. 142: 356–367. https://doi.org/10.1111/ane.13317.Search in Google Scholar PubMed

Lin, K.H., Chen, Y.T., Fuh, J.L., Li, S.Y., Chen, T.J., Tang, C.H., and Wang, S.J. (2014). Migraine is associated with a higher risk of transient global amnesia: a nationwide cohort study. Eur. J. Neurol. 21: 718–724. https://doi.org/10.1111/ene.12346.Search in Google Scholar PubMed

Man, M.A.Y. and Tsoi, T.H. (2005). Transient global amnesia in Hong Kong (Poster Abstract of the XVIII World Congress of Neurology). J. Neurol. Sci. 238(Suppl. 1): 504.10.1016/S0022-510X(05)81948-3Search in Google Scholar

Mangla, A., Navi, B.B., Layton, K., and Kamel, H. (2014). Transient global amnesia and the risk of ischemic stroke. Stroke 45: 389–393. https://doi.org/10.1161/strokeaha.113.003916.Search in Google Scholar PubMed PubMed Central

Mathew, N.T. and Meyer, J.S. (1974). Pathogenesis and natural history of transient global amnesia. Stroke 5: 303–311. https://doi.org/10.1161/01.str.5.3.303.Search in Google Scholar PubMed

Michel, P., Beaud, V., Eskandari, A., Maeder, P., Demonet, J.F., and Eskioglou, E. (2017). Ischemic amnesia: causes and outcome. Stroke 48: 2270–2273. https://doi.org/10.1161/strokeaha.117.017420.Search in Google Scholar

Mijajlović, M.D., Pavlović, A., Brainin, M., Heiss, W.D., Quinn, T.J., Ihle-Hansen, H.B., Hermann, D.M., Assayag, E.B., Richard, E., Thiel, A., et al.. (2017). Post-stroke dementia – a comprehensive review. BMC Med. 15: 11. https://doi.org/10.1186/s12916-017-0779-7.Search in Google Scholar PubMed PubMed Central

Miller, J.W., Petersen, R.C., Metter, E.J., Millikan, C.H., and Yanagihara, T. (1987). Transient global amnesia: clinical characteristics and prognosis. Neurology 37: 733–737. https://doi.org/10.1212/wnl.37.5.733.Search in Google Scholar PubMed

Modabbernia, A., Taslimi, S., Ashrafi, M., Modabbernia, M.J., and Hu, H.H. (2012). Internal jugular vein reflux in patients with transient global amnesia: a meta-analysis of case-control studies. Acta Neurol. Belg. 112: 237–244. https://doi.org/10.1007/s13760-012-0072-7.Search in Google Scholar PubMed

Naldi, F., Baiardi, S., Guarino, M., Spinardi, L., Cirignotta, F., and Stracciari, A. (2017). Posterior hippocampal stroke presenting with transient global amnesia. Neurocase 23: 22–25. https://doi.org/10.1080/13554794.2016.1270329.Search in Google Scholar PubMed

Nausieda, P.A. and Sherman, I.V. (1979). Long-term prognosis in transient global amnesia. J. Am. Med. Assoc. 241: 392–393. https://doi.org/10.1001/jama.241.4.392.Search in Google Scholar

Noël, A., Quinette, P., Guillery-Girard, B., Dayan, J., Piolino, P., Marquis, S., de la Sayette, V., Viader, F., Desgranges, B., and Eustache, F. (2008). Psychopathological factors, memory disorders and transient global amnesia. Br. J. Psychiatr. 193: 145–151. https://doi.org/10.1192/bjp.bp.107.045716.Search in Google Scholar PubMed

Pantoni, L., Lamassa, M., and Inzitari, D. (2000). Transient global amnesia: a review emphasizing pathogenic aspects. Acta Neurol. Scand. 102: 275–283. https://doi.org/10.1034/j.1600-0404.2000.102005275.x.Search in Google Scholar PubMed

Pantoni, L., Bertini, E., Lamassa, M., Pracucci, G., and Inzitari, D. (2005). Clinical features, risk factors, and prognosis in transient global amnesia: a follow-up study. Eur. J. Neurol. 12: 350–356. https://doi.org/10.1111/j.1468-1331.2004.00982.x.Search in Google Scholar PubMed

Pantoni, L. (2019). Transient global amnesia: an intriguing yet benign disturbance. Arq. Neuropsiquiatr. 77: 1–2. https://doi.org/10.1590/0004-282x20180151.Search in Google Scholar PubMed

Romero, J.R., Mercado, M., Beiser, A.S., Pikula, A., Seshadri, S., Kelly-Hayes, M., Wolf, P.A., and Kase, C.S. (2013). Transient global amnesia and neurological events: the framingham heart study. Front. Neurol. 4: 47. https://doi.org/10.3389/fneur.2013.00047.Search in Google Scholar PubMed PubMed Central

Romoli, M., Tuna, M.A., McGurgan, I., Li, L., Giannandrea, D., Eusebi, P., Tordo Caprioli, F., Lotti, A., Salvadori, N., Sarchielli, P., et al.. (2019). Long-term risk of stroke after transient global amnesia in two prospective cohorts. Stroke 50: 2555–2557. https://doi.org/10.1161/strokeaha.119.025720.Search in Google Scholar

Romoli, M., Tuna, M.A., Li, L., Paciaroni, M., Giannandrea, D., Tordo Caprioli, F., Lotti, A., Eusebi, P., Mosconi, M.G., Pellizzaro Venti, M., et al.. (2020). Time trends, frequency, characteristics and prognosis of short-duration transient global amnesia. Eur. J. Neurol. 27: 887–893. https://doi.org/10.1111/ene.14163.Search in Google Scholar PubMed PubMed Central

Shuping, J.R., Rollinson, R.D., and Toole, J.F. (1980). Transient global amnesia. Ann. Neurol. 7: 281–285. https://doi.org/10.1002/ana.410070313.Search in Google Scholar PubMed

Spiegel, D.R., Smith, J., Wade, R.R., Cherukuru, N., Ursani, A., Dobruskina, Y., Crist, T., Busch, R.F., Dhanani, R.M., and Dreyer, N. (2017). Transient global amnesia: current perspectives. Neuropsychiatr. Dis. Treat. 13: 2691–2703. https://doi.org/10.2147/ndt.s130710.Search in Google Scholar

Szabo, K., Hoyer, C., Caplan, L.R., Grassl, R., Griebe, M., Ebert, A., Platten, M., and Gass, A. (2020). Diffusion-weighted MRI in transient global amnesia and its diagnostic implications. Neurology 95: e206–e212. https://doi.org/10.1212/wnl.0000000000009783.Search in Google Scholar

Toledo, M., Pujadas, F., Purroy, F., Lara, N., Quintana, M., and Alvarez-Sabin, J. (2005). La amnesia global transitoria recurrente, una manifestación de la enfermedad isquémica cerebrovascular [Recurrent Transient Global Amnesia, a manifestation of ischemic cerebrovascular disease]. Med. Clin. (Barc) 125: 361–365. https://doi.org/10.1157/13079167.Search in Google Scholar PubMed

Tynas, R. and Panegyres, P.K. (2020). Factors determining recurrence in transient global amnesia. BMC Neurol. 20: 83. https://doi.org/10.1186/s12883-020-01658-8.Search in Google Scholar PubMed PubMed Central

Yi, M., Sherzai, A.Z., Ani, C., Shavlik, D., Ghamsary, M., Lazar, E., and Sherzai, D. (2019). Strong association between migraine and transient global amnesia: a national inpatient sample analysis. J. Neuropsychiatry Clin. Neurosci. 31: 43–48. https://doi.org/10.1176/appi.neuropsych.17120353.Search in Google Scholar PubMed

Zeman, A.Z., Boniface, S.J., and Hodges, J.R. (1998). Transient epileptic amnesia: a description of the clinical and neuropsychological features in 10 cases and a review of the literature. J. Neurol. Neurosurg. Psychiatr. 64: 435–443. https://doi.org/10.1136/jnnp.64.4.435.Search in Google Scholar PubMed PubMed Central

Zorzon, M., Antonutti, L., Masè, G., Biasutti, E., Vitrani, B., and Cazzato, G. (1995). Transient global amnesia and transient ischemic attack. Natural history, vascular risk factors, and associated conditions. Stroke 26: 1536–1542. https://doi.org/10.1161/01.str.26.9.1536.Search in Google Scholar PubMed

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The online version of this article offers supplementary material (https://doi.org/10.1515/revneuro-2020-0110).

Received: 2020-09-25

Accepted: 2020-10-25

Published Online: 2021-02-01

Published in Print: 2021-07-27

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The long-term prognosis of Transient Global Amnesia: a systematic review

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