Quantitative MR relaxometry study of effects of vigabatrin on the brains of patients with epilepsy

Neurotoxic changes have been found in the brains of dogs and rats treated with the antiepileptic drug vigabatrin, and these can be demonstrated in vivo by MRI. Quantification of T2 signal by relaxometry is more sensitive than visual assessment of T2-weighted images in revealing changes in T2 signal. We have therefore undertaken a quantitative MR study of 45 patients with refractory partial seizures during a prospective, randomised, double-blind trial of vigabatrin (1.5 g twice daily), followed by open treatment. T2 relaxometry was performed during a baseline period, after 20 weeks vigabatrin or placebo treatment and again in those who continued the drug for at least 35 weeks. Twenty weeks' vigabatrin treatment was not associated with a significant change in T2 relaxation time in any brain area. There were no significant T2 signal changes in the follow-up study and no correlation between change in T2 and duration of vigabatrin treatment. There was no quantitative MR evidence of vigabatrin-related changes in the white matter of these patients similar to those which have been found in animals treated with the drug.