David Alexander1, Alex Kaizer2, Gary Luckasen3, Sean Pauzauskie1
1University of Colorado School of Medicine, 2Colorado School of Public Health Department of Biostatistics & Informatics, 3Heart Center of the Rockies
Objective:
Report risk factors and incidence for transient global amnesia (TGA) in Northern Colorado. Compare vascular health of Colorado TGA patients with the broader TGA patient population. Discuss altitude-related hypoxia as a potential contributor to TGA pathophysiology.
Background:
TGA is a rare syndrome of sudden onset anterograde amnesia with occasional retrograde amnesia that resolves within 24 hours without neurologic deficits. Its mechanism remains unknown. In Northern Colorado, the incidence of TGA is 2.65 times greater than the national average, providing an ideal setting to confirm risk factors and explore a pathophysiologic role for altitude-related hypoxia.
Design/Methods:
We conducted a retrospective cross-sectional study in Northern Colorado (2019–2023), enrolling 246 patients with TGA. We assessed single vs recurrent episodes and captured demographics, vascular risk factors, emotional stress risk factors, and other variables. Sample prevalences were tested against U.S. estimates using one-sample, two-sided proportion tests. De-identified Epic Cosmos data compared Colorado TGA prevalence with the broader population and contrasted comorbidities (hypertension, hyperlipidemia) among TGA patients.
Results:
The Northern Colorado TGA group had mean age 69.8 years and BMI 27.6. Compared with U.S. prevalence, hypertension, hyperlipidemia, coronary artery disease, anxiety, depression, and seizure disorder were higher (all p<0.001). Lifetime recurrence was 15.8% (national 5.8–13.7%). Epic Cosmos showed TGA was more prevalent in Colorado than in the broader population (p<0.0001). Among TGA patients, Colorado cases had lower comorbidity burden for hypertension (ages 40–85, p<0.005) and hyperlipidemia (ages 50–85, p<0.0005).
Conclusions:
Significant differences in vascular and emotional risk factors between TGA patients and the general population support vascular and catecholamine-stress mechanisms. The higher seizure-disorder prevalence in Northern Colorado supports EEG monitoring to exclude transient epileptic amnesia. Despite a lower vascular comorbidity burden, TGA was more prevalent in Colorado than in the broader population, indicating a mechanistic gap, possibly suggesting that altitude-related hypoxia may unmask TGA in susceptible individuals.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.