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KMID : 1100220060050020056
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Dementia and Neurocognitive Disorders
2006 Volume.5 No. 2 p.56 ~ p.62
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Neuropsychological and Cerebral Blood Flow Analysis in Acute and Recovery Phase in Transient Global Amnesia
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Lee Jung-Seok
Kim Sang-Yun
Baek Min-Jae
Kim Yu-Kyeong
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Abstract
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Background: Transient global amnesia (TGA), a selective memory disorder without any accompanying neurological deficit, is characterized by sudden onset of anterograde amnesia and variable retrograde amnesia. Despite several new hypothesis concerning TGA pathogenesis, there is no consensus about the cause. The aim of this study is to investigate the change in clinical findings and functional imaging during and after amnestic period.
Method: Six patients with amnestic episodes were included in this study who fulfilled the criteria for TGA, as published by Hodges and Warlow. These patients were divided into two subgroups according to the presence of encoding failure on declarative memory. Acute phase group was defined as patients having encoding failure on declarative memory. Recovery phase group was defined as patients recovering from amnestic period. Three patients belonged to the acute phase group and the remaining three patients to recovery phase group. All the subjects except one, underwent brain perfusion single photon emission computed tomography (SPECT). Cognitive functions were rated with neuropsychological test and Voxel-based SPM analysis was used for the evaluation of cerebral blood flow change.
Result: In acute phase group, the neuropsychological test (n=3) showed encoding failure on verbal and visuospatial memory, and one of them had frontal lobe dysfunction. SPM analysis (n=2) revealed hypoperfusion in left temporal, temporo- occipitl, occipital and cerebellum. In recovery phase group (n=3), the neuropsychological test demonstrated frontal lobe dysfunction (n=2). One of them had encoding failure on visuospatial memory. SPM analysis showed hypoperfusion in both frontal, temporal and cerebellum.
Conclusion: Our findings revealed that there are mismatching results between the neuropsychological test and cerebral perfusion. More severe hypoperfusion at variable cortical areas was noted in recovery phase group. These results suggests that hypoperfusion may not be the primary event in TGA.
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KEYWORD
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Transient global amnesia, Anterograde amnesia, SPECT
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