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Cerebrospinal fluid myelin basic protein as a prognostic biomarker in dogs with thoracolumbar intervertebral disk
G J Levine1, J M Levine, T H Witsberger
1Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX 77843, USA. gjlevine@cvm.tamu.edu
Background:
Release of myelin basic protein (MBP) into the cerebrospinal fluid (CSF) is associated with active demyelination and correlates with outcome in various neurological diseases.
Hypothesis/Objectives:
To describe associations among CSF MBP concentration, initial neurological dysfunction, and long-term ambulatory outcome in dogs with acute thoracolumbar intervertebral disk herniation (IVDH).
Animals:
Fifty seven [corrected] dogs with acute thoracolumbar IVDH and 16 clinically normal dogs.
Methods:
Prospective case series clinical study. Signalment, initial neurological dysfunction as determined by a modified Frankel score (MFS), and ambulatory outcome at >3-month follow-up were recorded. Cisternal CSF MBP concentration was determined by an ELISA. Associations were estimated between CSF MBP concentration and various clinical parameters.
Results:
Dogs with thoracolumbar IVDH that did not ambulate at follow-up had a higher CSF MBP concentration (median, 3.56 ng/mL; range, 0.59-51.2 ng/mL) compared with control dogs (median, 2.22 ng/mL; range, 0-3.82 ng/mL) (P=.032). A CSF MBP concentration of >or=3 ng/mL had a sensitivity of 78% and specificity of 76% to predict an unsuccessful outcome based on receiver-operating characteristics curve analysis (area under the curve=0.688, P=.079). Affected dogs with a CSF MBP concentration>or=3 ng/mL had 0.09 times the odds of ambulation at follow-up compared with affected dogs with CSF MBP concentration<3 ng/mL when adjusted for initial MFS (95% confidence interval 0.01-0.66, P=.018).
Conclusions And Clinical Importance:
These results would suggest that CSF MBP concentration may be useful as an independent prognostic indicator in dogs with thoracolumbar IVDH.
Insights
Elevated cerebrospinal fluid myelin basic protein (MBP) indicates poor prognosis for dogs with thoracolumbar intervertebral disk herniation (IVDH), suggesting its use as a prognostic indicator.
Area of Science:
- Veterinary Neurology
- Neuroscience
- Biomarker Discovery
Background:
- Myelin basic protein (MBP) release in cerebrospinal fluid (CSF) signifies active demyelination.
- MBP levels correlate with clinical outcomes in various neurological conditions.
Purpose of the Study:
- To investigate the association between CSF MBP concentration and neurological dysfunction.
- To determine the prognostic value of CSF MBP for long-term ambulatory outcome in dogs with acute thoracolumbar intervertebral disk herniation (IVDH).
Main Methods:
- A prospective case series study involved 57 dogs with acute thoracolumbar IVDH and 16 healthy controls.
- CSF MBP concentration was measured using ELISA.
- Neurological dysfunction (modified Frankel score) and ambulatory outcome (>3 months) were assessed.
Main Results:
- Dogs with IVDH who did not recover ambulation had significantly higher CSF MBP concentrations compared to controls.
- CSF MBP levels ≥3 ng/mL demonstrated moderate sensitivity and specificity for predicting poor outcome.
- Elevated CSF MBP independently predicted reduced odds of ambulation in affected dogs.
Conclusions:
- CSF MBP concentration shows potential as an independent prognostic biomarker.
- This finding may aid in predicting recovery and guiding treatment decisions for canine IVDH.
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