ObjectiveTo explore the related factors, responsible lesions, and prognosis of transient global amnesia (TGA).MethodsWe retrospectively collected TGA patients admitted to Zhongshan Hospital Xiamen University between October 1st 2011 and October 31st 2018 and age- and sex-matched health examinees in the Department of Physical Examination in the same period as a control group. We recorded the relevant clinical information of the two groups, such as sex, age, hypertension, diabetes, hyperlipidemia, atrial fibrillation, stroke, migraine, TGA and epilepsy, and the imaging data of the TGA patients. The occurrences of cerebral infarction, cerebral hemorrhage, recurrence of TGA, and myocardial infarction of the two groups were followed up.ResultsA total of 73 TGA patients and 73 age- and sex-matched controls were included. The difference in the history of migraine was statistically significant (χ2=4.000, P=0.038), while there was no significant difference in the history of hypertension, diabetes or other medical history between the two groups (P>0.05). It was found that the responsible focus of TGA was in the hippocampal CA1 region, while the fornix column and the hippocampal CA1 region existed in the same functional loop. The mean follow-up time was (36.0±22.6) months. Sixty-nine TGA patients and 67 healthy controls were followed up. During the follow-up, there was no significant difference in the incidence of cerebral infarction, cerebral hemorrhage, myocardial infarction, or TGA attacks between the two groups (P>0.05). There was no statistically significant difference (P>0.05) in the clinical or follow-up data between the TGA patients with lesion on DWI (n=9) and the ones without lesion on DWI (n=58).ConclusionsMigraine may be a risk factor for TGA. The responsible brain area of TGA may involve a memory loop, including hippocampal CA1 region, fornix column and so on. After the attack of TGA, the long-term prognosis is well.
Objective To explore the correlations of serum levels of matrix metalloproteinase (MMP)-2, MMP-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), and their ratios, with the severity of white matter hyperintensities (WMH) in patients with cerebral small vessel disease (CSVD). Methods This prospective study included patients with CSVD who were treated at Zhongshan Hospital, Xiamen University between January 2022 and February 2024. Qualitative and quantitative analyses of WMH were performed using the Fazekas scale and lesion prediction algorithm. Biomarkers such as MMP-2, MMP-9, and TIMP-1 were measured to explore their correlations with the severity of WMH. Results A total of 144 patients with CSVD were included in this study, comprising 63 males and 81 females, with an average age of (67.60±8.73) years. There were 83 (57.6%), 41 (28.5%), and 20 (13.9%) patients were categorized as Fazekas grade 1, 2, and 3 for WMH, respectively, with an median total WMH volume of 4.31 mL. Multinomial logistic regression analysis for Fazekas grade (grade 1 as the reference level) showed that MMP-2 [grade 2: odds ratio (OR)=1.059, 95% confidence interval (CI) (1.016, 1.105); grade 3: OR=1.463, 95%CI (1.124, 1.905)], TIMP-1 [grade 2: OR=1.019, 95%CI (1.006, 1.032); grade 3: OR=1.048, 95%CI (1.008, 1.090)], and MMP-9/TIMP-1 [grade 3: OR=2.650, 95%CI (1.393, 5.039)] were independently associated with Fazekas grade (P<0.05). Multinomial logistic regression analysis for the quartile group of total WMH volume (group Q1 as the reference level) showed that MMP-2 [group Q2: OR=1.160, 95%CI (1.021, 1.318); group Q3: OR=1.238, 95%CI (1.086, 1.412); group Q4: OR=1.313, 95%CI (1.140, 1.512)] and TIMP-1 [group Q2: OR=1.095, 95%CI (1.054, 1.138); group Q3: OR=1.084, 95%CI (1.045, 1.125); group Q4: OR=1.102, 95%CI (1.057, 1.149)] were independently associated with the quartile group of total WMH volume (P<0.05). Conclusions Serum levels of MMP-2 and TIMP-1 demonstrate significant independent associations with both the Fazekas grade and the total volume of WMH in patients with CSVD. These correlations underscore the potential utility of MMP-2 and TIMP-1 as critical biomarkers for assessing the severity of WMH in CSVD, highlighting their prospective roles in clinical diagnostics and therapeutic monitoring.