短暂性全面遗忘症发病相关因素、影像学特征及预后研究

Transient global amnesia:related factors,imaging features,and prognosis

目的探讨短暂性全面遗忘症(transient global amnesia,TGA)发病相关因素、责任病灶及预后。方法回顾性收集2011年10月1日-2018年10月31日厦门大学附属中山医院收治的TGA患者,并在该院体检部收集年龄、性别匹配的健康体检者作为对照组,记录两组相关临床信息和TGA患者影像学检查等,随访两组的心脑血管事件。结果共纳入73例TGA患者与73例年龄、性别匹配的体检者。两组临床信息比较,TGA组和对照组分别有9例和2例患者有偏头痛病史,差异有统计学意义(χ^2=4.000,P=0.038),其余指标组间比较差异均无统计学意义(P>0.05)。TGA患者的责任病灶在海马CA1区,而穹窿柱与海马CA1区存在于同一个功能环路。研究平均随访时间(36.0±22.6)个月;TGA患者完成随访69例,失访4例;对照组完成随访67例,失访6例。随访期间,两组在死亡、脑梗死、脑出血、心肌梗死和TGA发作发生率方面比较,差异均无统计学意义(P>0.05)。弥散加权成像有病灶(n=9)和无病灶(n=58)的TGA组患者各指标比较,差异均无统计学意义(P>0.05)。结论偏头痛是TGA的可能危险因素;TGA的责任脑区可能包含海马CA1区、穹窿柱等。TGA发作后,预后较为良好。

Objective To explore the related factors,responsible lesions,and prognosis of transient global amnesia(TGA).Methods We retrospectively collected TGA patients admitted to Zhongshan Hospital Xiamen University between October 1 st 2011 and October 31 st 2018 and age-and sex-matched health examinees in the Department of Physical Examination in the same period as a control group.We recorded the relevant clinical information of the two groups,such as sex,age,hypertension,diabetes,hyperlipidemia,atrial fibrillation,stroke,migraine,TGA and epilepsy,and the imaging data of the TGA patients.The occurrences of cerebral infarction,cerebral hemorrhage,recurrence of TGA,and myocardial infarction of the two groups were followed up.Results A total of 73 TGA patients and 73 age-and sex-matched controls were included.The difference in the history of migraine was statistically significant(χ^2=4.000,P=0.038),while there was no significant difference in the history of hypertension,diabetes or other medical history between the two groups(P>0.05).It was found that the responsible focus of TGA was in the hippocampal CA1 region,while the fornix column and the hippocampal CA1 region existed in the same functional loop.The mean follow-up time was(36.0±22.6)months.Sixty-nine TGA patients and 67 healthy controls were followed up.During the follow-up,there was no significant difference in the incidence of cerebral infarction,cerebral hemorrhage,myocardial infarction,or TGA attacks between the two groups(P>0.05).There was no statistically significant difference(P>0.05)in the clinical or follow-up data between the TGA patients with lesion on DWI(n=9)and the ones without lesion on DWI(n=58).Conclusions Migraine may be a risk factor for TGA.The responsible brain area of TGA may involve a memory loop,including hippocampal CA1 region,fornix column and so on.After the attack of TGA,the long-term prognosis is well.