Despite decades of intense investigation, the etiology and pathomechanism of the disorder remain enigmatic. Transient global amnesia (TGA) is a neurological disorder characterized by an acute onset of dense anterograde amnesia, which is often accompanied by retrograde amnesia of varying extent, but an otherwise normal neurological status. In light of abundant evidence of circadian rhythmicity of both, components of the human stress response system and memory, chronobiological analyses may provide an opportunity to further uncover the mechanisms underlying TGA. We identified a robust circadian rhythm in TGA occurrence which remarkably applied to either of the two study sites located on different continents and which was independent of sex and age. There was no variation according to day of the week, month or season, but the proportion of patients with a weekday episode was significantly higher in the Mannheim cohort ( p = 0.002). Significant circadian rhythmicity of TGA occurrence with bimodal peaks (mid-morning, late afternoon) was found for the entire population ( p = 0.002) and for either sub-cohort (Mannheim: p = 0.003, Kansai: p = 0.007). Chronological patterns of TGA occurrence were determined. Methodsĭata of patients with a final diagnosis of TGA were collected in Mannheim, Germany (06/1999–01/2018, n = 404), and in the Kansai district, Japan (04/2006–03/2018, n = 261). Circadian, infra- and ultradian rhythmicity has been found to play a relevant role in the multifactorial pathomechanisms of various disorders but has not been thoroughly studied in TGA. Based, among others, on the observation of a close temporal relation between certain events and subsequent TGA episodes, recent proposals discuss the relevance of stress-associated processes impacting on hippocampal functioning. The etiology of transient global amnesia (TGA) is still a matter of debate.
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