Skip to main content
Top
Published in: Neuroradiology 4/2012

01-04-2012 | Diagnostic Neuroradiology

Lesion detectability on diffusion-weighted imaging in transient global amnesia: the influence of imaging timing and magnetic field strength

Authors: Inseon Ryoo, Jae Hyoung Kim, SangYun Kim, Byung Se Choi, Cheolkyu Jung, Sung Il Hwang

Published in: Neuroradiology | Issue 4/2012

Login to get access

Abstract

Introduction

Transient global amnesia (TGA) is a benign disease with a sudden-onset, transient memory disturbance. Characteristic punctate high-signal intensity lesions in the hippocampus on diffusion-weighted imaging (DWI) have been reported in variable frequencies. We investigated the influence of the timing of DWI and the magnetic field strength on the lesion detectability in TGA.

Methods

Seventy-three patients diagnosed with TGA underwent DWI within 24 h after the symptom onset and again on day 3 at either 1.5 (n = 31) or 3 T (n = 42). The patients were divided into three subgroups according to the time lapse after the symptom onset to the first DWI (0–6 h, 6–12 h, and 12–24 h).

Results

The detection rate of the lesions during the first 24 h rose statistically significantly with increased time lapse after the symptom onset (34% in 0–6 h, 62% in 6–12 h, and 67% in 12–24 h). It increased up to 75% on day 3. The detection rate was higher at 3 T than at 1.5 T in all time points (41% vs. 27% in 0–6 h, 70% vs. 44% in 6–12 h, 80% vs. 57% in 12–24 h, and 86% vs. 61% on day 3), but the statistical significance was achieved only on day 3.

Conclusion

Awareness of the different lesion detectability on DWI according to the time lapse after the symptom onset can help in diagnosing the patients with suspected TGA. High field strength is another important factor to increase the lesion detectability on DWI.
Literature
1.
go back to reference Fisher CM, Adams RD (1964) Transient global amnesia. Acta Neurol Scand Suppl 40(SUPPL 9):1–83PubMed Fisher CM, Adams RD (1964) Transient global amnesia. Acta Neurol Scand Suppl 40(SUPPL 9):1–83PubMed
2.
go back to reference Berli RHA, Waespe W, Bachli EB (2009) Transient global amnesia - not so rare after all. Swiss Med Wkly 139:288–292PubMed Berli RHA, Waespe W, Bachli EB (2009) Transient global amnesia - not so rare after all. Swiss Med Wkly 139:288–292PubMed
3.
go back to reference Hodges JR, Warlow CP (1990) The aetiology of transient global amnesia. A case-control study of 114 cases with prospective follow-up. Brain 113:639–657PubMedCrossRef Hodges JR, Warlow CP (1990) The aetiology of transient global amnesia. A case-control study of 114 cases with prospective follow-up. Brain 113:639–657PubMedCrossRef
4.
go back to reference Miller JW, Petersen RC, Metter EJ, Millikan CH, Yanagihara T (1987) Transient global amnesia: clinical characteristics and prognosis. Neurology 37(5):733–737PubMed Miller JW, Petersen RC, Metter EJ, Millikan CH, Yanagihara T (1987) Transient global amnesia: clinical characteristics and prognosis. Neurology 37(5):733–737PubMed
5.
go back to reference Quinette P, Guillery-Girard B, Dayan J, de la Sayette V, Marquis S, Viader F, Desgranges B, Eustache F (2006) What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 129:1640–1658PubMedCrossRef Quinette P, Guillery-Girard B, Dayan J, de la Sayette V, Marquis S, Viader F, Desgranges B, Eustache F (2006) What does transient global amnesia really mean? Review of the literature and thorough study of 142 cases. Brain 129:1640–1658PubMedCrossRef
6.
go back to reference Bartsch T, Deuschl G (2010) Transient global amnesia: functional anatomy and clinical implications. Lancet Neurol 9(2):205–214PubMedCrossRef Bartsch T, Deuschl G (2010) Transient global amnesia: functional anatomy and clinical implications. Lancet Neurol 9(2):205–214PubMedCrossRef
7.
go back to reference Lee HY, Kim JH, Weon YC, Lee JS, Kim SY, Youn SW, Kim SH (2007) Diffusion-weighted imaging in transient global amnesia exposes the CA1 region of the hippocampus. Neuroradiology 49(6):481–487PubMedCrossRef Lee HY, Kim JH, Weon YC, Lee JS, Kim SY, Youn SW, Kim SH (2007) Diffusion-weighted imaging in transient global amnesia exposes the CA1 region of the hippocampus. Neuroradiology 49(6):481–487PubMedCrossRef
8.
go back to reference Sander K, Sander D (2005) New insights into transient global amnesia: recent imaging and clinical findings. Lancet Neurol 4(7):437–444PubMedCrossRef Sander K, Sander D (2005) New insights into transient global amnesia: recent imaging and clinical findings. Lancet Neurol 4(7):437–444PubMedCrossRef
9.
go back to reference Sedlaczek O, Hirsch JG, Grips E, Peters CN, Gass A, Wohrle J, Hennerici M (2004) Detection of delayed focal MR changes in the lateral hippocampus in transient global amnesia. Neurology 62(12):2165–2170PubMed Sedlaczek O, Hirsch JG, Grips E, Peters CN, Gass A, Wohrle J, Hennerici M (2004) Detection of delayed focal MR changes in the lateral hippocampus in transient global amnesia. Neurology 62(12):2165–2170PubMed
10.
go back to reference Weon YC, Kim JH, Lee JS, Kim SY (2008) Optimal diffusion-weighted imaging protocol for lesion detection in transient global amnesia. AJNR Am J Neuroradiol 29(7):1324–1328PubMedCrossRef Weon YC, Kim JH, Lee JS, Kim SY (2008) Optimal diffusion-weighted imaging protocol for lesion detection in transient global amnesia. AJNR Am J Neuroradiol 29(7):1324–1328PubMedCrossRef
11.
go back to reference Butler CR, Graham KS, Hodges JR, Kapur N, Wardlaw JM, Zeman AZ (2007) The syndrome of transient epileptic amnesia. Ann Neurol 61(6):587–598PubMedCrossRef Butler CR, Graham KS, Hodges JR, Kapur N, Wardlaw JM, Zeman AZ (2007) The syndrome of transient epileptic amnesia. Ann Neurol 61(6):587–598PubMedCrossRef
12.
13.
go back to reference Kopelman MD, Panayiotopoulos CP, Lewis P (1994) Transient epileptic amnesia differentiated from psychogenic "fugue": neuropsychological, EEG, and PET findings. J Neurol Neurosurg Psychiatry 57(8):1002–1004PubMedCrossRef Kopelman MD, Panayiotopoulos CP, Lewis P (1994) Transient epileptic amnesia differentiated from psychogenic "fugue": neuropsychological, EEG, and PET findings. J Neurol Neurosurg Psychiatry 57(8):1002–1004PubMedCrossRef
14.
go back to reference Szabo K, Forster A, Jager T, Kern R, Griebe M, Hennerici MG, Gass A (2009) Hippocampal lesion patterns in acute posterior cerebral artery stroke: clinical and MRI findings. Stroke 40(6):2042–2045PubMedCrossRef Szabo K, Forster A, Jager T, Kern R, Griebe M, Hennerici MG, Gass A (2009) Hippocampal lesion patterns in acute posterior cerebral artery stroke: clinical and MRI findings. Stroke 40(6):2042–2045PubMedCrossRef
15.
go back to reference Gass A, Gaa J, Hirsch J, Schwartz A, Hennerici MG (1999) Lack of evidence of acute ischemic tissue change in transient global amnesia on single-shot echo-planar diffusion-weighted MRI. Stroke 30(10):2070–2072PubMedCrossRef Gass A, Gaa J, Hirsch J, Schwartz A, Hennerici MG (1999) Lack of evidence of acute ischemic tissue change in transient global amnesia on single-shot echo-planar diffusion-weighted MRI. Stroke 30(10):2070–2072PubMedCrossRef
16.
go back to reference Strupp M, Bruning R, Wu RH, Deimling M, Reiser M, Brandt T (1998) Diffusion-weighted MRI in transient global amnesia: elevated signal intensity in the left mesial temporal lobe in 7 of 10 patients. Ann Neurol 43(2):164–170PubMedCrossRef Strupp M, Bruning R, Wu RH, Deimling M, Reiser M, Brandt T (1998) Diffusion-weighted MRI in transient global amnesia: elevated signal intensity in the left mesial temporal lobe in 7 of 10 patients. Ann Neurol 43(2):164–170PubMedCrossRef
17.
go back to reference Winbeck K, Etgen T, von Einsiedel HG, Rottinger M, Sander D (2005) DWI in transient global amnesia and TIA: proposal for an ischaemic origin of TGA. J Neurol Neurosurg Psychiatry 76(3):438–441PubMedCrossRef Winbeck K, Etgen T, von Einsiedel HG, Rottinger M, Sander D (2005) DWI in transient global amnesia and TIA: proposal for an ischaemic origin of TGA. J Neurol Neurosurg Psychiatry 76(3):438–441PubMedCrossRef
18.
go back to reference Bartsch T, Alfke K, Stingele R, Rohr A, Freitag-Wolf S, Jansen O, Deuschl G (2006) Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain 129:2874–2884PubMedCrossRef Bartsch T, Alfke K, Stingele R, Rohr A, Freitag-Wolf S, Jansen O, Deuschl G (2006) Selective affection of hippocampal CA-1 neurons in patients with transient global amnesia without long-term sequelae. Brain 129:2874–2884PubMedCrossRef
19.
go back to reference Ba-Ssalamah A, Nobauer-Huhmann IM, Pinker K, Schibany N, Prokesch R, Mehrain S, Mlynarik V, Fog A, Heimberger K, Trattnig S (2003) Effect of contrast dose and field strength in the magnetic resonance detection of brain metastases. Invest Radiol 38(7):415–422PubMed Ba-Ssalamah A, Nobauer-Huhmann IM, Pinker K, Schibany N, Prokesch R, Mehrain S, Mlynarik V, Fog A, Heimberger K, Trattnig S (2003) Effect of contrast dose and field strength in the magnetic resonance detection of brain metastases. Invest Radiol 38(7):415–422PubMed
20.
go back to reference Wattjes MP, Harzheim M, Kuhl CK, Gieseke J, Schmidt S, Klotz L, Klockgether T, Schild HH, Lutterbey GG (2006) Does high-field MR imaging have an influence on the classification of patients with clinically isolated syndromes according to current diagnostic MR imaging criteria for multiple sclerosis? AJNR Am J Neuroradiol 27(8):1794–1798PubMed Wattjes MP, Harzheim M, Kuhl CK, Gieseke J, Schmidt S, Klotz L, Klockgether T, Schild HH, Lutterbey GG (2006) Does high-field MR imaging have an influence on the classification of patients with clinically isolated syndromes according to current diagnostic MR imaging criteria for multiple sclerosis? AJNR Am J Neuroradiol 27(8):1794–1798PubMed
21.
go back to reference Wattjes MP, Lutterbey GG, Harzheim M, Gieseke J, Traber F, Klotz L, Klockgether T, Schild HH (2006) Higher sensitivity in the detection of inflammatory brain lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis using high field MRI: an intraindividual comparison of 1.5 T with 3.0 T. Eur Radiol 16(9):2067–2073PubMedCrossRef Wattjes MP, Lutterbey GG, Harzheim M, Gieseke J, Traber F, Klotz L, Klockgether T, Schild HH (2006) Higher sensitivity in the detection of inflammatory brain lesions in patients with clinically isolated syndromes suggestive of multiple sclerosis using high field MRI: an intraindividual comparison of 1.5 T with 3.0 T. Eur Radiol 16(9):2067–2073PubMedCrossRef
22.
go back to reference Caplan L (1985) Transient global amnesia. In: Vinken PJ, Bruyn GW, Klawans HL (eds) Handbook of clinical neurology. Elsevier Science, Amsterdam, pp 205–218 Caplan L (1985) Transient global amnesia. In: Vinken PJ, Bruyn GW, Klawans HL (eds) Handbook of clinical neurology. Elsevier Science, Amsterdam, pp 205–218
23.
go back to reference Bendor MB (1956) Syndrome of isolated episode of confusion with amnesia. J Hillside Hosp 5:212–215 Bendor MB (1956) Syndrome of isolated episode of confusion with amnesia. J Hillside Hosp 5:212–215
24.
go back to reference Guyotat M, Courjon J (1956) Les ictus amnesiques. J Méd Lyon 37:697–701PubMed Guyotat M, Courjon J (1956) Les ictus amnesiques. J Méd Lyon 37:697–701PubMed
25.
go back to reference Zorzon M, Antonutti L, Mase G, Biasutti E, Vitrani B, Cazzato G (1995) Transient global amnesia and transient ischemic attack. Natural history, vascular risk factors, and associated conditions. Stroke 26(9):1536–1542PubMedCrossRef Zorzon M, Antonutti L, Mase G, Biasutti E, Vitrani B, Cazzato G (1995) Transient global amnesia and transient ischemic attack. Natural history, vascular risk factors, and associated conditions. Stroke 26(9):1536–1542PubMedCrossRef
26.
go back to reference Howland JG, Wang YT (2008) Synaptic plasticity in learning and memory: stress effects in the hippocampus. Prog Brain Res 169:145–158PubMedCrossRef Howland JG, Wang YT (2008) Synaptic plasticity in learning and memory: stress effects in the hippocampus. Prog Brain Res 169:145–158PubMedCrossRef
27.
go back to reference Yang CH, Huang CC, Hsu KS (2005) Behavioral stress enhances hippocampal CA1 long-term depression through the blockade of the glutamate uptake. J Neurosci 25(17):4288–4293PubMedCrossRef Yang CH, Huang CC, Hsu KS (2005) Behavioral stress enhances hippocampal CA1 long-term depression through the blockade of the glutamate uptake. J Neurosci 25(17):4288–4293PubMedCrossRef
29.
go back to reference Nakada T, Kwee IL, Fujii Y, Knight RT (2005) High-field, T2 reversed MRI of the hippocampus in transient global amnesia. Neurology 64(7):1170–1174PubMedCrossRef Nakada T, Kwee IL, Fujii Y, Knight RT (2005) High-field, T2 reversed MRI of the hippocampus in transient global amnesia. Neurology 64(7):1170–1174PubMedCrossRef
30.
go back to reference Lee SY, Kim WJ, Suh SH, Oh SH, Lee KY (2009) Higher lesion detection by 3.0 T MRI in patient with transient global amnesia. Yonsei Med J 50(2):211–214PubMedCrossRef Lee SY, Kim WJ, Suh SH, Oh SH, Lee KY (2009) Higher lesion detection by 3.0 T MRI in patient with transient global amnesia. Yonsei Med J 50(2):211–214PubMedCrossRef
Metadata
Title
Lesion detectability on diffusion-weighted imaging in transient global amnesia: the influence of imaging timing and magnetic field strength
Authors
Inseon Ryoo
Jae Hyoung Kim
SangYun Kim
Byung Se Choi
Cheolkyu Jung
Sung Il Hwang
Publication date
01-04-2012
Publisher
Springer-Verlag
Published in
Neuroradiology / Issue 4/2012
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-011-0889-4

Other articles of this Issue 4/2012

Neuroradiology 4/2012 Go to the issue