{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T15:36:02Z","timestamp":1789400162856,"version":"build-2803163510"},"reference-count":44,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T00:00:00Z","timestamp":1733443200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100023181","name":"Agencja Bada\u0144 Medycznych","doi-asserted-by":"publisher","award":["S196\/2022"],"award-info":[{"award-number":["S196\/2022"]}],"id":[{"id":"10.13039\/501100023181","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Previous retrospective studies have reported vigabatrin\u2010associated brain abnormalities on magnetic resonance imaging (VABAM), although clinical impact is unknown. We evaluated the association between vigabatrin and predefined brain magnetic resonance imaging (MRI) changes in a large homogenous tuberous sclerosis complex (TSC) cohort and assessed to what extent VABAM\u2010related symptoms were reported in TSC infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Dutch TSC Registry and the EPISTOP cohort provided retrospective and prospective data from 80 TSC patients treated with vigabatrin (VGB) before the age of 2\u2009years and 23 TSC patients without VGB. Twenty\u2010nine age\u2010matched non\u2010TSC epilepsy patients not receiving VGB were included as controls. VABAM, specified as T2\/fluid\u2010attenuated inversion recovery hyperintensity or diffusion restriction in predefined brain areas, were examined on brain MRI before, during, and after VGB, and once in the controls (at approximately age 2\u2009years). Additionally, the presence of VABAM accompanying symptoms was evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prevalence of VABAM in VGB\u2010treated TSC patients was 35.5%. VABAM\u2010like abnormalities were observed in 13.5% of all patients without VGB. VGB was significantly associated with VABAM (risk ratio [RR] =\u20093.57, 95% confidence interval [CI] =\u20091.43\u20136.39), whereas TSC and refractory epilepsy were not. In all 13 VGB\u2010treated patients with VABAM for whom posttreatment MRIs were available, VABAM entirely resolved after VGB discontinuation. The prevalence of symptoms was 11.7% in patients with VABAM or VABAM\u2010like MRI abnormalities and 4.3% in those without, implicating no significant association (RR\u2009=\u20092.76, 95% CI = .68\u20138.77).<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>VABAM are common in VGB\u2010treated TSC infants; however, VABAM\u2010like abnormalities also occurred in children without either VGB or TSC. The cause of these MRI changes is unknown. Possible contributing factors are abnormal myelination, underlying etiology, recurrent seizures, and other antiseizure medication. Furthermore, the presence of VABAM (or VABAM\u2010like abnormalities) did not appear to be associated with clinical symptoms. This study confirms that the well\u2010known antiseizure effects of VGB outweigh the risk of VABAM and related symptoms.<\/jats:p><\/jats:sec>","DOI":"10.1111\/epi.18190","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T16:24:29Z","timestamp":1733502269000},"page":"356-368","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Vigabatrin\u2010associated brain magnetic resonance imaging abnormalities and clinical symptoms in infants with tuberous sclerosis complex"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2294-2344","authenticated-orcid":false,"given":"Carmen","family":"Stevering","sequence":"first","affiliation":[{"name":"Department of Pediatric Neurology University Medical Center Utrecht Brain Center  Utrecht The 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