4.7 Article

Chronobiology of transient global amnesia

Journal

JOURNAL OF NEUROLOGY
Volume 269, Issue 1, Pages 361-367

Publisher

SPRINGER HEIDELBERG
DOI: 10.1007/s00415-021-10639-x

Keywords

Transient global amnesia; Chronobiology; Circadian rhythm; Infradian rhythm; Season; Day-of-week

Funding

  1. Olympia Morata Programme of Heidelberg University
  2. Projekt DEAL

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The study identified a robust circadian rhythm in the occurrence of TGA, with bimodal peaks each day, which was consistent across different study sites and independent of sex and age.
Introduction The etiology of transient global amnesia (TGA) is still a matter of debate. Based, among others, on the observation of a close temporal relation between certain events and subsequent TGA episodes, recent proposals discuss the relevance of stress-associated processes impacting on hippocampal functioning. Circadian, infra- and ultradian rhythmicity has been found to play a relevant role in the multifactorial pathomechanisms of various disorders but has not been thoroughly studied in TGA. Methods Data of patients with a final diagnosis of TGA were collected in Mannheim, Germany (06/1999-01/2018, n = 404), and in the Kansai district, Japan (04/2006-03/2018, n = 261). Chronological patterns of TGA occurrence were determined. Results Significant circadian rhythmicity of TGA occurrence with bimodal peaks (mid-morning, late afternoon) was found for the entire population (p = 0.002) and for either sub-cohort (Mannheim: p = 0.003, Kansai: p = 0.007). This finding was confirmed for either sex (women: p = 0.004, men: p = 0.004) and different age groups (< 65 years: p = 0.0009, >= 65 years: p = 0.003). There was no variation according to day of the week, month or season, but the proportion of patients with a weekday episode was significantly higher in the Mannheim cohort (p = 0.002). Discussion We identified a robust circadian rhythm in TGA occurrence which remarkably applied to either of the two study sites located on different continents and which was independent of sex and age. In light of abundant evidence of circadian rhythmicity of both, components of the human stress response system and memory, chronobiological analyses may provide an opportunity to further uncover the mechanisms underlying TGA.

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