title: Longitudinal Cerebral Perfusion Change in Transient Global Amnesia Related to Left Posterior Medial Network Disruption.
abstract: BACKGROUND
  The pathophysiology of transient global amnesia (TGA) is not fully understood. Previous studies using single photon emission computed tomography (SPECT) have reported inconclusive results regarding cerebral perfusion. This study was conducted to identify the patterns of regional cerebral blood flow (rCBF) in TGA patients via longitudinal SPECT analysis. An association between the observed SPECT patterns and a pathophysiological mechanism was considered.
  
  
  METHODS
  Based on the TGA registry database of Seoul National University Bundang Hospital, 22 TGA patients were retrospectively identified. The subjects underwent initial Tc-99m-ethyl cysteinate dimer (ECD) SPECT within 4 days of an amnestic event and underwent follow-up scans approximately 6 months later. The difference in ECD uptake between the two scans was measured via voxel-based whole brain analysis, and the quantified ECD uptake was tested using a paired t-test.
  
  
  RESULTS
  The TGA patients had significantly decreased cerebral perfusion at the left precuneus (P<0.001, uncorrected) and at the left superior parietal and inferior temporal gyrus according to the voxel-based whole brain analysis (P<0.005, uncorrected). A difference in the quantified ECD uptake between the 2 scans was also found at the left precuneus among the 62 cortical volumes of interest (P = 0.018, Cohen's d = -0.25).
  
  
  CONCLUSIONS
  We identified left hemispheric lateralized hypoperfusion that may be related to posterior medial network disruption. These findings may be a contributing factor to the pathophysiology of TGA.
authors.affiliation: Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea.
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Jang
authors.affiliation: Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.|Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Park
authors.affiliation: Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.|Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Park
authors.affiliation: Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.|Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Min Jeong
authors.initials: MJ
authors.lastname: Wang
authors.affiliation: Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.|Department of Neurology, Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Jae-Sung
authors.initials: JS
authors.lastname: Lim
authors.affiliation: Department of Neurology, Kangwon National University Hospital, Chuncheon, Republic of Korea.
authors.forename: Sung-Hun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Nuclear Medicine, Kangwon National University Hospital, Chuncheon, Republic of Korea.
authors.forename: In KooK
authors.initials: IK
authors.lastname: Chun
authors.affiliation: Department of Neurology, Seoul Veterans Hospital, Seoul, Korea.
authors.forename: Youngsoon
authors.initials: Y
authors.lastname: Yang
authors.affiliation: Clinical Neuroscience Center, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.|Department of Neurology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: SangYun
authors.initials: S
authors.lastname: Kim
mesh_terms: D020236:Amnesia, Transient Global / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D003545:Cysteine / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015609:Organotechnetium Compounds; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; C059659:technetium Tc 99m bicisate; D003545:Cysteine