Migraine in transient global amnesia: a meta-analysis of observational studies

Ioannis Liampas; Athanasios S Siouras; Vasileios Siokas; Zisis Tsouris; Dimitrios Rikos; Alexandros Brotis; Athina-Maria Aloizou; Metaxia Dastamani; Efthimios Dardiotis

doi:10.1007/s00415-020-10363-y

Migraine in transient global amnesia: a meta-analysis of observational studies

J Neurol. 2022 Jan;269(1):184-196. doi: 10.1007/s00415-020-10363-y. Epub 2021 Jan 2.

Authors

Ioannis Liampas¹, Athanasios S Siouras², Vasileios Siokas³, Zisis Tsouris³, Dimitrios Rikos³, Alexandros Brotis⁴, Athina-Maria Aloizou³, Metaxia Dastamani³, Efthimios Dardiotis³

Affiliations

¹ Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Larissa, Greece. liampasioannes@gmail.com.
² Department of Computer Science and Biomedical Informatics, School of Science, University of Thessaly, Lamia, Greece.
³ Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Larissa, Greece.
⁴ Department of Neurosurgery, School of Medicine, University Hospital of Larissa, University of Thessaly, Larissa, Greece.

PMID: 33388926
DOI: 10.1007/s00415-020-10363-y

Abstract

Background: PURPOSE: Although many studies have investigated the relationship between transient global amnesia (TGA) and migraine, to date, no meta-analysis has confirmed the existence and size of their association.

Methodology: Literature search involved MEDLINE, EMBASE, CENTRAL and PsycINFO. Observational controlled studies including TGA patients (Caplan, Hodges and Warlow) were retrieved. Quality evaluation was based on the Newcastle-Ottawa scale. The prevalence of migraine was compared in TGA patients vs. healthy controls (HC), as well as in TGA against TIA individuals. Data from case-control, cross-sectional and cohort studies were pooled separately.

Results: Literature search yielded 1178 articles, 12 of which were included in the present meta-analysis. Results from case-control (ten), cohort (one) and cross-sectional (one) studies were compatible with an association between TGA and migraine. The nationwide inpatient cross-sectional study was of lesser value due to its inpatient orientation. The high-quality, population-based, retrospective cohort (158,301 participants per group) determined a higher relative-risk (RR) of TGA for migraine vs. non-migraine individuals [RR = 2.48, 95%confidence-interval (95% CI) = (1.32, 4.87)]. Sensitivity testing based on stricter diagnostic criteria strengthened the estimated association [RR = 3.84, 95% CI = (1.57, 9.38)]. Additionally, pooled data from eight case-control studies (700 TGA, 746 HC) yielded similar results [Odds-Ratio, OR = 2.51, 95% CI = (1.85, 3.41)], with the association mainly driven by the three high-quality studies, rather than the five articles of moderate quality. Finally, pooled findings from four case-control studies of moderate-quality revealed a higher prevalence of migraine among TGA compared to TIA patients [OR = 1.82, 95% CI = (1.22, 2.73)].

Conclusions: A significant association between TGA and migraine was established. The underlying connecting mechanism remains undetermined, yet.

Keywords: Aura; Migraine; Transient global amnesia; Transient ischemic attack.

Publication types

Meta-Analysis
Review

MeSH terms

Amnesia
Amnesia, Transient Global* / epidemiology
Case-Control Studies
Cross-Sectional Studies
Humans
Migraine Disorders* / epidemiology
Retrospective Studies