Serum myelin basic protein as a marker of brain injury in aneurysmal subarachnoid haemorrhage
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Norbert Wąsik1, Bartosz Sokół2, Marcin Hołysz3
1Department of Neurosurgery, Poznan University of Medical Sciences, 49 Przybyszewskiego Street, 60-355, Poznan, Poland. nwasik@ump.edu.pl.
Background:
Myelin basic protein (MBP) is the second most abundant protein in central nervous system myelin. Since the 1980s, it has been regarded as a marker of brain tissue injury in both trauma and disease. There have been no recent reports regarding MBP in aneurysmal subarachnoid haemorrhage (SAH).
Methods:
One hundred four SAH patients with ruptured aneurysms underwent endovascular treatment within 24 h of rupture, and 156 blood samples were collected: 104 on days 0-3, 32 on days 4-6 and 20 on days 9-12 post-SAH. MBP levels were assayed using ELISA and compared with the clinical status on admission, laboratory results, imaging findings and treatment outcome at 3 months.
Results:
MBP levels on days 0-3 post-SAH were significantly higher among poor outcome patients (p < 0.001), non-survivors (p = 0.005), patients who underwent intracranial intervention (p < 0.001) and patients with intracerebral haemorrhage (ICH; p < 0.001). On days 4-6 post-SAH, significantly higher levels were found following intracranial intervention (p = 0.009) and ICH (p = 0.039). There was clinically relevant correlation between MBP levels on days 0-3 post-SAH and 3-month Glasgow Outcome Scale (cc = - 0.42) and also ICH volume (cc = 0.48). All patients who made a full recovery had MBP levels below detection limit on days 0-3 post-SAH. Following endovascular aneurysm occlusion, there was no increase in MBP in 86 of the 104 patients investigated (83%).
Conclusions:
The concentration of MBP in peripheral blood after intracranial aneurysm rupture reflects the severity of the brain tissue injury (due to surgery or ICH) and correlates with the treatment outcome. Endovascular aneurysm occlusion was not followed by a rise in MBP in most cases, suggesting the safety of this technique.
Insights
Myelin basic protein (MBP) levels in blood indicate brain injury severity after aneurysmal subarachnoid hemorrhage (SAH). Higher MBP correlates with poor outcomes, suggesting its utility as a prognostic biomarker.
Area of Science:
- Neuroscience
- Biochemistry
- Clinical Neurology
Background:
- Myelin basic protein (MBP) is a well-established marker for central nervous system myelin damage.
- Recent studies on MBP in aneurysmal subarachnoid hemorrhage (SAH) are limited.
- MBP's role in SAH pathophysiology and prognosis requires further investigation.
Purpose of the Study:
- To investigate MBP levels in patients with aneurysmal subarachnoid hemorrhage (SAH).
- To correlate MBP concentrations with clinical status, imaging findings, and treatment outcomes.
- To assess the potential of MBP as a biomarker for brain tissue injury and prognosis following SAH.
Main Methods:
- 104 SAH patients undergoing endovascular treatment were enrolled.
- Blood samples were collected at multiple time points post-SAH (days 0-3, 4-6, 9-12).
- MBP levels were measured using ELISA and correlated with clinical and imaging data.
Main Results:
- Elevated MBP levels on days 0-3 post-SAH were associated with poor outcomes, non-survival, intracranial intervention, and intracerebral hemorrhage (ICH).
- MBP levels correlated with 3-month Glasgow Outcome Scale and ICH volume.
- Full recovery was associated with undetectable MBP levels, and endovascular treatment did not increase MBP in most patients.
Conclusions:
- MBP concentration in peripheral blood reflects brain tissue injury severity after SAH.
- MBP serves as a potential biomarker for predicting treatment outcomes in SAH patients.
- Endovascular aneurysm occlusion appears safe, with no significant MBP elevation observed in most cases.
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