Hodges J R, Ward C D
University Department of Clinical Neurology, Radcliffe Infirmary, Oxford.
Brain. 1989 Jun;112 ( Pt 3):595-620. doi: 10.1093/brain/112.3.595.
The clinical and behavioural features of 5 patients examined during transient global amnesia (TGA) are described. All underwent extensive neuropsychological testing during and sequentially after the attack. Our results show that in TGA there is a characteristic neuropsychological deficit which parallels that in the permanent amnesic syndrome. Personality, complex cognition and problem solving, semantic knowledge, language and visuospatial function remained intact. Immediate memory was preserved. Longer-term verbal and nonverbal memory was severely disrupted in all cases. In contrast, the extent of retrograde amnesia was highly variable. A famous faces test showed an extensive deficit in 3 cases, with improvement in all cases following the attack. Analysis of group data confirmed the presence of a reversible temporal gradient, in that more distant memories were relatively spared. On a famous events test, recognition was normal across all decades, but dating of events from the 1960s and 1970s was consistently impaired. The Crovitz test of remote personal episodic memory was given to 3 subjects; all showed impaired uncued autobiographical memory and in contrast to normal controls, had a virtual absence of recent memories. During recovery from TGA there was progressive shrinkage of retrograde amnesia but a permanent short retrograde gap of around 1 h remained in all cases. Although subjectively normal within 24 h, all cases demonstrated persisting impairment of new learning for at least a week post-TGA. The relevance of the neuropsychological data to theories concerning the amnesic syndrome is discussed. We postulate a temporary deficit in retrieval of remote memories which appears to be dissociable from the anterograde amnesia.
本文描述了5例短暂性全面性遗忘症（TGA）患者发作期间及之后的临床和行为特征。所有患者在发作期间及发作后均接受了广泛的神经心理学测试。我们的研究结果表明，TGA存在一种特征性神经心理学缺陷，与永久性遗忘综合征中的缺陷相似。人格、复杂认知和问题解决能力、语义知识、语言和视觉空间功能均保持完好。即刻记忆得以保留。所有病例中，长期言语和非言语记忆均受到严重破坏。相比之下，逆行性遗忘的程度差异很大。一项名人面孔测试显示，3例患者存在广泛缺陷，发作后所有病例均有改善。对分组数据的分析证实了存在可逆的时间梯度，即较远的记忆相对未受影响。在一项著名事件测试中，所有年代的识别能力均正常，但20世纪60年代和70年代事件的时间判断一直受损。对3名受试者进行了远程个人情景记忆的克罗维茨测试；所有受试者均表现出线索性自传体记忆受损，与正常对照组相比，几乎没有近期记忆。在从TGA恢复的过程中，逆行性遗忘逐渐缩小，但所有病例均留下了约1小时的永久性短期逆行性记忆空白。尽管在24小时内主观感觉正常，但所有病例在TGA后至少一周内均表现出新学习能力持续受损。本文讨论了神经心理学数据与遗忘综合征相关理论的相关性。我们推测远程记忆提取存在暂时缺陷，这似乎与顺行性遗忘可分离。
