Difference in Cognitive Function by First Onset Age of Alcohol Induced Blackout and Its Duration

OBJECTIVE: Alcohol-induced blackout (blackout) is a typical early symptom of cognitive impairment caused by drinking. However, the first onset age of blackout or the duration after onset of blackout has not been directly compared in previous studies. The purpose of this study was to investigate the differences in cognitive function to the first start age of blackouts and their duration. METHODS: Thirty-one male subjects were included in this study. Their age at the first blackout and the duration after the onset of blackout were investigated. Neuropsychological tests were conducted to determine their attention, memory, and executive function. Subjects were divided into three groups according to their age of the first onset blackout (group O1, 40 years). Subjects were also divided into three groups by duration after the onset of blackout (P1, 30 years). We then examined differences in neurocognitive function among these groups. RESULTS: O1 tended to have a lower memory score than O2 (F = 3.28, p = 0.053). Significant differences were observed in attention and executive function between groups P1 and P3 (Digit Span_backward: F = 6.07, p < 0.05; visual span_forward: F = 4.19, p < 0.05; executive intelligence quotient: F = 3.55, p < 0.05). CONCLUSION: Greater memory impairment was detected in subjects having an earlier age of the first blackout. The longer the duration after the onset of blackout, the more impaired their attention and executive function skills.

Human Herpes Virus 6 Encephalitis Following Bone Marrow Transplantation with Uncommon Magnetic Resonance Imaging Findings

BACKGROUND: Human Herpes Virus 6 (HHV6) is commonly associated with encephalitis following bone marrow transplantation. However, hippocampal atrophy and global hypometabolism are rare findings in HHV6 encephalitis. CASE REPORT: A 41-year-old right-handed woman with acute lymphoblastic leukemia presented with fever and mental changes 2 weeks after receiving a sibling bone marrow transplant. The patient's cerebrospinal fluid (CSF) was positive for HHV-6 deoxyribonucleic acid (DNA), but was negative for other viral DNA. Brain magnetic resonance imaging revealed atrophic changes in bilateral medial temporal lobes. Following 4 weeks of ganciclovir therapy, a CSF exam was negative for HHV-6 DNA and the patient's neurological symptoms partially improved. However, she was disoriented and had severe retrograde and anterograde amnesia. 18F-fluorodeoxyglucose-positron emission tomography indicated global hypometabolism in the medial temporal lobes and the fronto-parietal cortices. CONCLUSIONS: This is a rare and unusual case of hippocampal atrophy in the acute stage of HHV6 encephalitis. Our imaging findings may reflect the chronic indolent course of HHV6 encephalitis.

Seasonal Changes in the Incidence of Transient Global Amnesia

BACKGROUND AND PURPOSE: Transient global amnesia (TGA) is a stereotypic condition characterized by anterograde and retrograde amnesia that typically resolves within 24 hours. The pathophysiology of TGA is still unclear. We noted that patients hospitalized with TGA tend to appear in seasonal clusters, and decided to investigate this phenomenon. METHODS: Every patient with acute presentation of amnesia at our medical center is hospitalized for observation and evaluation. We reviewed the monthly occurrence of TGA in our patient population between 2000 and 2014, and compared this to non-TGA hospitalizations during the same time period. RESULTS: During the analysis period, 154 patients who met the criteria for TGA were hospitalized, as well as 259,007 non-TGA hospitalizations. The annual occurrence of TGA ranged from 5 to 16 hospitalizations. There were 91 TGA events in women and 63 in men, in subjects aged 62.8±10.6 years (mean±SD). The incidence was maximal during December [odds ratio (OR)=2.83, 95% confidence interval (CI)=1.20–6.67] and March (OR=2.77, 95% CI=1.17–6.56), and minimal from April to August. The incidence exhibited an increase followed by a decrease from October to February. A seasonal trend was observed as well, with incidence peaks occurring in winter (OR=1.82, 95% CI=1.12–2.96) and spring (OR=1.80, 95% CI=1.10–2.94). CONCLUSIONS: Our findings suggest that the incidence of TGA exhibits seasonal variations. This observation may help to improve the understanding of the pathophysiology underlying TGA.

Recurrent Transient Global Amnesia in a Hot and Humid Machinery Room

Transient global amnesia (TGA) is characterized by abrupt onset temporary dysfunction of anterograde and retrograde amnesia without other neurologic deficits. We encountered a 53-year-old man who developed recurrent TGA while working in a hot and humid machinery room (33degrees C and 64% relative humidity). Heat exposure and physical exertion may facilitate the leakage of cytokines into the systemic circulation so as to cause a cerebral endothelial insult. Functional insufficiency of the hippocampus and its connections caused by physical and environmental factors may be related to recurrent attacks.

Amnesia retrógrada aislada: descripción clínica y neuroimágenesde un caso / Isolated retrograde amnesia: clinical description and neuroimages of a case

La amnesia retrógrada aislada es un déficit neuropsicológico poco común y sus características clínicas, etiológicas,imagenológicas y de recuperación han sido poco documentadas. El presente artículo reporta el casoclínico de una paciente de 28 años de edad, residente en Medellín, Colombia, quien posterior a un secuestro,sufre pérdida de la memoria remota. Se le practicó una evaluación neuropsicológica, además se le realizaronestudios de neuroimagen estructural y funcional, con el fin de caracterizar un posible daño neurológico...

Rehabilitación neuropsicológica en un caso de amnesia retrógrada aislada / Neuropsychological rehabilitation in an isolated case of retrograde amnesia

La amnesia retrógrada aislada es un déficit neuropsicológico poco común y el empleo de terapia de rehabilitación neuropsicológica no ha sido estudiado ni planteado para estos pacientes. El presente artículo documenta el caso clínico de CE, una paciente de 28 años de edad, residente en Medellín, Colombia, quien posterior a un secuestro, sufre pérdida de la memoria remota. Se le practicó una evaluación neuropsicológica, y estudios de neuroimagen estructural. Posteriormente, se propuso e implementó un plan de rehabilitación neuropsicológica enfocado en la recuperación de la memoria semántica. Al terminar la intervención se encontró mejoría a nivel cognitivo y funcional, con incremento significativo en las habilidades mnésicas y neurolingüísticas, en la comprensión de su entorno y el desempeño en las actividades cotidianas.

Isolated retrograde amnesia is a rare neuropsychological deficit and neuropsychological rehabilitation therapy has not been studied or proposed for these patients. This article documents the case of CE, a 28-year-old female patient, resident in Medellin, Colombia, who suffers remote memory loss after being kidnapped. Neuropsychological assessment and structural neuroimaging studies was performed. Then, a neuropsychological rehabilitation plan focused on semantic memory retrieval was planned and implemented. After the intervention, cognitive and functional improvement was found, with significant increase in mnemonic and neurolinguistic skills, also in understanding of her environment and her performance in daily activities.

Spectral characteristics of the hippocampal LFP during contextual fear conditioning / Características espectrais da atividade elétrica hipocampal durante o medo condicionado ao contexto

Objective: The hippocampus has an important role in the acquisition and recall of aversive memories. The objective of this study was to investigate the relationship among hippocampal rhythms. Methods: Microeletrodes arrays were implanted in the hippocampus of Wistar rats. The animals were trained and tested in a contextual fear conditioning task. The training consisted in applying shocks in the legs. The memory test was performed 1 day (recent memory) or 18 days (remote memory) after training. We proposed a measure based on the FFT power spectrum, denominated "delta-theta ratio", to characterize the different behaviors (active exploration and freezing) and the memories types. Results: The delta-theta ratio was able to distinguish recent and remote memories. In this study, the ratio for the 18-day group was smaller than for the 1-day group. Moreover, this measure was useful to distinguish the different behavior states - active exploration and freezing. Conclusions: The results suggest delta-theta oscillations could reflect the demands on information processing during recent and remote memory recalls.

Objetivo: O hipocampo tem um importante papel na aquisição e evocação das memórias aversivas. Pretendeu-se, neste trabalho, investigar a dinâmica entre os ritmos hipocampais durante a evocação das memórias aversivas recente e remota. Métodos: Foram implantadas matrizes de microeletrodos em ratos Wistar. Os animais foram treinados e testados numa tarefa de condicionamento contextual de medo. O treino consistiu em aplicações de choques nas patas. O teste de memória foi realizado 1 dia (memória recente) ou 18 dias (memória remota) após o treino. Nesse trabalho, foi proposta uma medida baseada no espectro de potências, denominada "razão delta-theta", para caracterização dos diferentes comportamentos observados (vigília exploratória e congelamento) e tipos de memórias. Resultados: A razão delta-theta mostrou-se capaz de distinguir os grupos testados para as memórias recente e remota. Neste caso, observou-se, para o grupo testado 18 dias após, um valor menor do que para o grupo testado 1 dia após. Além disso, essa medida mostrou-se útil para distinguir os diferentes estados comportamentais. Conclusões: Os resultados sugerem que a dinâmica entre os ritmos delta e theta pode refletir o processamento da informação durante a evocação das memórias recente e remota.

Retrograde Amnesia as a Predominant Symptom of Transient Global Amnesia

Transient global amnesia (TGA) causes retrograde amnesia, but there have been few reports of retrograde amnesia as a presenting symptom in TGA. A 52-year-old male who had acute amnesia for the past 4 years presented with TGA and recovered within 1 day. Brain magnetic resonance imaging revealed a lesion in the left hippocampus, and brain single-photon emission computed tomography revealed decreased blood flow in the left temporal and frontal areas. We speculated that hippocampal lesion with a frontal perfusion defect can be a cause of TGA.

Pure Retrograde Amnesia: Is This Real Organic or Psychogenic?

Cases showing memory disturbances with isolated retrograde memory without any definitive brain lesions are classified as dissociative amnesia. Improvements in imaging techniques have allowed the organic causes of this disease to be identified in several recent cases. Several studies have diagnosed cases of memory disorders as pure retrograde amnesia (PRA). The patient reported here had no psychiatric disorder and had normal MRI results, but showed hypometabolism in PET that met the criteria for PRA.

Compreensão e memorização de notícias de rádio apresentadas serialmente por idosos sadios / Comprehension and storage of sequentially presented radio news items by healthy elderly

In the normal aging processes, complaints of memory loss and auditory comprehension are not uncommon, principally in complex and cognitively demanding situations. Objective: The objective of this study was to investigate skills of discourse comprehension and retention in a natural situation, by healthy aged in relation to variables such as age, schooling and cognitive screening measurement. Methods: Thirty healthy elderly participated in the study (mean age=73.56 yrs; SD=6.26 and mean schooling=8.6 yrs; SD=4.41). Twelve news items were recorded and presented in three sequences of four news-groups. Participants were instructed to listen to the four news items, and upon completion were questioned about one of them. Results: We found no age or schooling effect on the performance of the subjects. The participants achieved almost full scores on all answers (ceiling effect). Discussion: The heterogeneity of elderly and cognitive compensation in natural situations could explain these results of elderly behavior.

No processo de envelhecimento, queixas sobre declínio de memória e dificuldades de compreensão auditiva não são raras, principalmente em situações complexas e com maior demanda cognitiva. Objetivos: O objetivo do estudo foi investigar habilidades de compreensão e retenção de discurso por idosos, em situações naturais, considerando as variáveis: idade, escolaridade e medida cognitiva. Métodos: 30 idosos participaram do estudo (média de idade=73,56; desvio padrão=6,26 e média de escolaridade=8,6; desvio padrão=4.41). Doze noticias foram gravadas e apresentadas em três seqüências de quatro grupos cada. Os participantes foram instruídos a ouvir as seqüências e ao final foram questionados sobre uma das notícias. Resultados: Não foram encontrados efeitos de idade ou escolaridade na perfórmance dos participantes. Notou-se efeito teto em todos os escores. Discussão: A heterogeneidade do envelhecimento e compensações cognitivas em situações naturais poderiam explicar o comportamento dos idosos da amostra.

Cerebellar Hypoperfusion during Transient Global Amnesia: An MRI and Oculographic Study

BACKGROUND AND PURPOSE: Transient global amnesia (TGA) is characterized by sudden anterograde and retrograde amnesia lasting for up to 24 hours. Diffusion-weighted magnetic resonance imaging (DWI) in cases of TGA and ischemia demonstrates a high frequency of high signal intensities restricted to the hippocampus, and this has been proposed as an etiology of TGA. The aims of this study were to characterize the DWI and single-photon-emission computed tomography (SPECT) findings during the acute and recovered phases of TGA and to correlate the findings with oculomotor abnormalities. METHODS: Five consecutive patients with a clinical diagnosis of TGA underwent DWI and SPECT of the brain within 24 hours after symptom onset and again 3 days later. Eye movements were also recorded using three-dimensional video-oculography. RESULTS: In all patients, DWI disclosed small punctuate (1-3 mm), high-signal lesions in the lateral portion of the hippocampus. The initial SPECT also revealed hypoperfusion in the cerebellar vermis, which had recovered by the follow-up examination. Three patients showed saccadic hypermetria or impaired smooth pursuit only during the acute phase. CONCLUSIONS: Our patients with TGA showed cerebellar vermian hypoperfusion in addition to ischemic insults to the lateral hippocampus. The oculomotor abnormalities observed in our patients support the occurrence of cerebellar dysfunction during the TGA attack.

Amnésia retrógrada funcional grave: relato de caso / Severe functional retrograde amnesia: case report

CONTEXTO: Uma síndrome amnésica clássica caracteriza-se por evidente prejuízo da memória anterógrada, variável e temporária amnésia retrógrada, sendo as formas não-declarativas da memória poupadas. Entretanto, publicações recentes relataram casos de prejuízo desproporcional da memória retrógrada em relação à anterógrada. OBJETIVOS: Relatar o caso de um paciente de 26 anos de idade com um quadro grave de amnésia retrógrada, aparentemente sem fatores desencadeantes. MÉTODOS: Entrevista psiquiátrica e avaliação neuropsicológica. RESULTADOS: A perda de memória do paciente se estendia por toda sua vida, mas ele era capaz de adquirir e reter novas informações. Ele também apresentava prejuízos na produção e na compreensão de palavras, assim como no reconhecimento e no uso de objetos. CONCLUSÃO: A formulação diagnóstica final do caso é difícil, apontando possivelmente o contínuo existente entre a amnésia retrógrada psicogênica e a orgânica.

BACKGROUND: A classic amnestic syndrome is characterized by a significant impairment of the anterograde memory, a variable and transitory retrograde amnesia with preserved non-declarative memory. However, case reports of patients with disproportionate compromise of the retrograde memory have been described in the recent literature. OBJECTIVES: To report a 26-year-old patient with a severe global retrograde amnesia with no evident triggering factor. METHODS: Psychiatric interview and neuropsychological evaluation. RESULTS: His memory loss compromised all domains of his life, although he could acquire and retain new information. He also exhibited prominent deficits in production and comprehension of common words as well as in recognition and use of objects. DISCUSSION: The final diagnostic formulation of the present case is difficult possibly indicating a continuum between psychogenic and organic retrograde amnesia.

Ischemic Evidence of Transient Global Amnesia: Location of the Lesion in the Hippocampus

Background and purpose: Transient global amnesia (TGA) is a rare amnestic syndrome characterized by the sudden onset of a selective anterograde and retrograde amnesia with a time course of up to 24 hours. Recent studies have found a high frequency of small high-signal abnormalities in the hippocampus on diffusion-weighted imaging (DWI), and accordingly ischemia has been proposed as an etiology of TGA. We hypothesized that TGA lesions occur preferentially in the CA1 region of the hippocampus, which is known to be susceptible to ischemia. Methods: Twenty consecutive patients with a clinical diagnosis of TGA underwent DWI both within 24 hours of symptom onset and 3 days later. Twenty patients with high-signal abnormalities in the hippocampus on the initial DWI underwent subsequent DWI and T2-weighted imaging in the coronal plane to precisely localize the lesions. Results: Seventeen patients had small high-signal abnormalities (with diameters of 1-3 mm) in the hippocampus unilaterally on DWI. One of these patients had two lesions in one hippocampus. Three of the 20 patients had lesions bilaterally in the hippocampus, 1 of whom had 3 bilateral lesions. A total of 25 lesions were identified: 5 in the hippocampal head, 19 in the body, and 1 in the tail. Six patients had unilateral lesions on the left,11 patients had them on the right, and 3 patients had bilateral lesions. Conclusions: In this study, lesions associated with TGA were localized mostly to the lateral portion of the hippocampus, corresponding to CA1. This finding supports the ischemic etiology of TGA, but the underlying pathophysiologic mechanism requires further investigation.

A Case of Limbic Encephalitis Developed after Allogeneic Stem Cell Transplantation / 대한혈액학회지

Limbic encephalitis is a rare neurological syndrome, which develops after stem cell transplantation, and is characterized by a series of neurological symptoms, including retrograde amnesia, behavioral disturbance, and progressive intellectual deterioration and high signal intensity in the hippocampus on magnetic resonance imaging (MRI). Herein is described the case of a patient with limbic encephalitis, which developed after allogeneic bone marrow transplantation, and was possibly due to HHV-6 infection. An 18-year-old man, with acute lymphoid leukemia, who underwent HLA-matched unrelated donor bone marrow transplantation, developed a fever and chill accompanied by neurological symptoms, including behavioral disturbance and retrograde amnesia, during the bone marrow recovery phase. A brain MRI revealed bright signal-intensity in both hippocampi. Examination of his cerebrospinal fluid suggested viral encephalitis. Based on these findings, a diagnosis of viral limbic encephalitis was highly suspected. Tests for casual causes of viral limbic encephalitis, including the CMV, HZV and HSV-1 and 2, in serum or CSF were all negative. The encephalitis responded well to ganciclovir therapy.

Comparison of retrograde amnesia changes within different injury levels of cerebral concussion in rats / 法医学杂志

OBJECTIVE@#To investigate the retrograde amnesia changes within different injury levels of cerebral concussion in rats.@*METHODS@#A metallic pendulum striker device of brain injury was deployed to duplicate CC models of different injury levels within Sprague-Dawley (S-D) rats. The investigated animals were divided into two groups according to classification standard, that is, Pure Cerebral Concussion (PCC) group and Complicated Cerebral Concussion (CCC) group. One control group was used, and each group included 8 animals. The retrograde amnesia of each group was assessed by Morris Water Maze (MWM) Test from 3 days preinjury to 7 days postconcussion.@*RESULTS@#Compared with the control group, the retrograde amnesia was detected within 3 days in PCC group, and 5 days in CCC group after injury. At the same time, the two groups both manifested space recognition deficit.@*CONCLUSION@#The retrograde amnesia existed in both pure cerebral concussion group and complicated cerebral concussion. Furthermore, the lasting time of retrograde amnesia in animals correlates to the injury level of brain concussion.

Transient Global Amnesia Developed in Recovery Room following General Anesthesia: A case report / 대한마취과학회지

Transient global amnesia is characterized by a sudden inability to form new memories (anterograde amnesia) that usually last for minutes to several hours but never longer than 24 hours. and there are no other focal neurologic signs or symptoms. Retrograde amnesia from a few hours to many years may also be associated with this condition. We report a case of a 56-year-old female patient who experienced transient global amnesia in the recovery room after general anesthesia. She repeated the same queries several times to persons nearby and appeared perplexed. A detailed neurologic examination was otherwise entirely normal. Her symptoms resolved completely the next day.

A Case with Viral Encephalitis presenting a Dissociations in the Retrograde Amnesia

We describe a case of anterograde and retrograde amnesia resulting from probable herpes simplex encephalitis. In retrograde amnesia, dissociations not only between episodic and semantic memories, but also between semantic memories for personal and public things were observed. We postulated, using FDG-PET, that the former was caused by mesial temporal lesions, based on `multiple trace theory', and the latter, by bilateral lateral temporal lesions, which were probably related to the retrieval of semantic memory, especially for public things.

Functional MR Imaging of Psychogenic Amnesia: A Case Report

We present here a case in which functional MR imaging (fMRI) was done for a patient who developed retrograde psychogenic amnesia for a four year period of her life history after a severe stressful event. We performed the fMRI study for a face recognition task using stimulation with three kinds of face photographs: recognizable familiar faces, unrecognizable friends' faces due to the psychogenic amnesia, and unfamiliar control faces. Different activation patterns between the recognizable faces and unrecognizable faces were found in the limbic area, and especially in the amygdala and hippocampus.

Neuronas inmunoreactivas a parvalbúmina y calbindina en la corteza prefrontal dorsolateral de sujetos humanos / Neurons inmunoreaction to parvalbúmine and calbindine in the bark prefrontal of human fellows

Introducción. La regiones intermedias de los giros superior y frontal medio o corteza frontal dorso lateral, correspondientes con las áreas 9,46 y 9/46 de Brodman, desempeñan un papel sustancial en la memoria operativa. Estas zonas evolucionan en su composición celular, involucrando tipos neuronales característicos, asociados con aspectos particulares del procesamiento de la información. Objetivo. Presentar algunos resultados del programa de investigación sobre corteza prefrontal realizado por el centro de estudios cerebrales de la Universidad del valle. Material y Métodos. Después de una revisión sucinta sobre la organización y función de la región prefrontal de la corteza cerebral; se realizó un estudio inmuno-histológico para las proteínas ligadoras de calcio calbindina y parvalbumina en biopsias de corteza cerebral prefrontal de 10 sujetos. Se utilizó un registro fotográfico digital de imágenes a través del microscopía de luz y en él un conteo semiautomático para las células marcadas. Se analizaron los resultados según edad, localización laminar y hemisferio cerebral (derecho-izquierdo). Resultados. Las muestras procesadas para calbindina mostraron una mayor densidad de células, en comparación con la marcadas para parvalbúmina, éstas a su vez mostraron un marcación mas uniforme. La marcación fue más regular e intensa en la capas supragranulares. Existe una mayor frecuencia de células reactivas para parvalbúmina en la región supragranular derecha y para calbindina en la infragranular derecha. Conclusiones. La región prefrontal del hemisferio cerebral derecho presenta mayor frecuencia y densidad celular que su homólogo izquierdo para las células reactivas a los dos marcadores. Esta asimetría correspondería a las diferencias en el procesamiento de información y a una mayor capacidad del hemisferio izquierdo para procesar información organizada en forma semántica

A Case of Viral Encephalitis with Disproportionate Retrograde Amnesia

A 44-year-old man showed recurrent paroxysmal amnesic attacks following viral encephalitis which, despite antiepileptic treatment, developed into status epilepticus. Interestingly, the amnesic attacks mainly consisted of amnesia for retrograde events. After recovery from status, he showed a persistent amnesia which was characterized as disproportionate retrograde amnesia for the past 20 years. We attribute the amnesic attacks in the acute stage to a transient epileptic amnesia and the profound retrograde amnesia in the chronic stage to status- or infection-related focal brain damage.