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Network localization of transient global amnesia beyond the hippocampus

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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.

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Author information

Author notes

  1. Tao Wang, Yicheng Xu, and Deying Li contributed equally to this work

Authors and Affiliations

  1. Medical School of Chinese PLA, Beijing, 100853, China

    Tao Wang, Yanan Li & Shuai Miao

  2. Department of Neurology, Chinese PLA General Hospital, Beijing, 100853, China

    Tao Wang, Shuai Miao & Shengyuan Yu

  3. Department of Neurology, Aerospace Center Hospital, Beijing, China

    Yicheng Xu, Jilai Li & Peifu Wang

  4. Brainnetome Center, Chinese Academy of Sciences, Beijing, 100190, China

    Deying Li & Lingzhong Fan

  5. National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China

    Deying Li & Lingzhong Fan

  6. Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China

    Wenjun Tu

  7. Department of Radiology, Aerospace Center Hospital, Beijing, China

    Fei Zhao

  8. CAS Center for Excellence in Brain Science and Intelligence Technology, Institute of Automation, Chinese Academy of Sciences, Beijing, 100190, China

    Lingzhong Fan

Authors
  1. Tao Wang
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  2. Yicheng Xu
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  5. Yanan Li
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Contributions

Tao Wang: conceptualization (equal); data curation (lead); investigation (lead); writing—original draft preparation (lead). Yicheng Xu: conceptualization (lead); investigation (equal); writing—review and editing (equal). Deying Li: formal analysis (equal); methodology (equal). Wenjun Tu: conceptualization (equal); writing—review and editing (equal). Shuai Miao: investigation (equal); writing—review and editing (equal). Jilai Li: conceptualization (equal); writing—review and editing (equal). Peifu Wang: writing—review and editing (equal); supervision (equal). Fei Zhao: resources; data curation (equal). Lingzhong Fan: formal analysis (lead); methodology (lead); visualization (lead); writing—review and editing (equal). Shengyuan Yu: conceptualization (equal); writing—review and editing (lead); supervision (lead).

Corresponding authors

Correspondence to Lingzhong Fan or Shengyuan Yu.

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Wang, T., Xu, Y., Li, D. et al. Network localization of transient global amnesia beyond the hippocampus. Neurol Sci 44, 649–657 (2023). https://doi.org/10.1007/s10072-022-06439-4

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