Abstract:
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 between CSF MBP concentration,
initial neurological dysfunction, and long-term ambulatory outcome in dogs with acute
thoracolumbar intervertebral disk herniation (IVDH).
ANIMALS: 574 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 using an enzyme-linked immunosorbent assay (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 to
control dogs (median, 2.22 ng/ml; range, 0-3.82 ng/ml) (P = 0.032). A CSF MBP
concentration of ≥ 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=0.079). Affected dogs with a CSF MBP concentration ≥ 3
ng/ml had 0.09 times the odds of ambulation at follow-up compared to affected dogs with
CSF MBP concentration <3 ng/ml when adjusted for initial MFS (95% CI 0.01-0.66, P =
0.018).
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.
