Nakada Tsutomu, Kwee Ingrid L, Fujii Yukihiko, Knight Robert T
Center for Integrated Human Brain Science, Brain Research Institute, University of Niigata, 1 Asahimachi, Niigata 951, Japan.
Neurology. 2005 Apr 12;64(7):1170-4. doi: 10.1212/01.WNL.0000156158.48587.EA.
To investigate the fine structural integrity of the hippocampus in patients with transient global amnesia (TGA) using high-resolution T2 reversed (T2R) MRI.
The authors performed detailed structural analysis of the hippocampus in 15 patients who had recovered from an episode of TGA and 150 randomly recruited normal volunteers across the adult age spectrum using high-resolution T2R MRI obtained on a 3.0-T system. An additional 100 subjects, with stroke or tumor, were similarly studied and served as disease controls.
The overall incidence of hippocampal cavities detected in normal volunteers increased with age but never exceeded 40%, whereas the incidence in disease control group was 31%. They were always unilateral. In contrast, cavities were found in all 15 patients with TGA (100%), an incidence higher than in normal or disease controls (p < 0.05; Ryan's multiple comparison test), and were bilateral in eight patients (53%). The cavities in all but one of the normal volunteers (99%) and all disease controls (100%) were crescent shaped and < or =2 mm in width. The cavities in 14 of 15 patients with TGA (93%) were considerably larger (>3 mm in width), and five of the patients had giant cavities (>5 mm in width). Most of the cavities in patients with TGA had a rounded shape and resembled pathologic cavities described in specimens of hypoxia-related CA1 necrosis.
The data indicate that transient global amnesia may not be a benign entity. Delayed neuronal loss within CA1 area of Lorente de No may represent its important sequel.
使用高分辨率T2反转（T2R）磁共振成像（MRI）研究短暂性全面性遗忘症（TGA）患者海马的精细结构完整性。
作者使用在3.0-T系统上获得的高分辨率T2R MRI，对15例已从TGA发作中恢复的患者以及150名随机招募的各年龄段正常志愿者的海马进行了详细的结构分析。另外100名患有中风或肿瘤的受试者也进行了类似研究，并作为疾病对照组。
正常志愿者中检测到的海马腔总体发生率随年龄增加，但从未超过40%，而疾病对照组的发生率为31%。它们总是单侧的。相比之下，15例TGA患者均发现有腔隙（100%），其发生率高于正常或疾病对照组（p<0.05；Ryan多重比较检验），且8例患者（53%）为双侧。除1名正常志愿者（99%）和所有疾病对照组（100%）外，其余的腔隙均为新月形，宽度≤2 mm。15例TGA患者中有14例（93%）的腔隙明显更大（宽度>3 mm），其中5例患者有巨大腔隙（宽度>5 mm）。TGA患者的大多数腔隙呈圆形，类似于缺氧相关CA1坏死标本中描述的病理性腔隙。
数据表明短暂性全面性遗忘症可能并非良性疾病。Lorente de No的CA1区域延迟性神经元丢失可能是其重要的后遗症。
