Cerebrospinal fluid myelin basic protein as a prognostic marker in patients with head injury

Tw, Noseworthy; Bj, Anderson; Af, Noseworthy; Shustack, Allan; Rg, Johnston; Kc, Petruk; Ta, McPherson

doi:10.1097/00003246-198509000-00010

Cited by 18 publications

(16 citation statements)

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“…This may suggest a significant contribution of secondary injury to axonal pathology following TBI, and CSF MBP release may reflect damage more from the evolution of TBI than the initial insult. Despite previous work demonstrating an inverse correlation between outcome and peak serum [13, 14] and CSF [10] MBP concentrations, peak CSF MBP concentrations in this study were not associated with 6-month outcome. Previous study has demonstrated that CSF MBP concentration may correlate with outcome post injury.…”

Section: Discussioncontrasting

confidence: 99%

“…Similar concentrations of CSF MBP have been seen in adults with TBI [3, 9, 11, 15] as well as in serum [10]. …”

Section: Discussionsupporting

confidence: 63%

“…The study of CSF MBP concentrations in neonatal HIE by Garcia-Alix and colleagues [7] found that mean MBP concentration at 12 and 72 h correlated with neuro-cognitive outcome at 1 year of age. Noseworthy and colleagues [10] demonstrated 6-month GOS score correlated with a single peri-operative CSF MBP measurement in adults who underwent surgery within a week of TBI. This study did not demonstrate an association between 6-month GOS score and CSF MBP concentration.…”

Section: Discussionmentioning

confidence: 99%

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Increased CSF Concentrations of Myelin Basic Protein After TBI in Infants and Children: Absence of Significant Effect of Therapeutic Hypothermia

Bell

Kochanek

et al. 2012

Neurocrit Care

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Background The objectives of this study were to determine effects of severe traumatic brain injury (TBI) on cerebrospinal fluid (CSF) concentrations of myelin basic protein (MBP) and to assess relationships between clinical variables and CSF MBP concentrations. Methods We measured serial CSF MBP concentrations in children enrolled in a randomized controlled trial evaluating therapeutic hypothermia (TH) after severe pediatric TBI. Control CSF was obtained from children evaluated, but found not to be having CNS infection. Generalized estimating equation models and Wilcoxon Rank-Sum test were used for comparisons of MBP concentrations. Results There were 27 TBI cases and 57 controls. Overall mean (±SEM) TBI case MBP concentrations for 5 days after injury were markedly greater than controls (50.49 ± 6.97 vs. 0.11 ± 0.01 ng/ml, p < 0.01). Mean MBP concentrations were lower in TBI patients < 1 year versus >1 year (9.18 ± 1.67 vs. 60.22 ± 8.26 ng/ml, p = 0.03), as well as in cases with abusive head trauma (AHT) versus non-abusive TBI (14.46 ± 3.15 vs. 61.17 ± 8.65 ng/ml, p = 0.03). TH did not affect MBP concentrations. Conclusions Mean CSF MBP increases markedly after severe pediatric TBI, but is not affected by TH. Infancy and AHT are associated with low MBP concentrations, suggesting that age-dependent myelination influences MBP concentrations after injury. Given the magnitude of MBP increases, axonal injury likely represents an important therapeutic target in pediatric TBI.

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Section: Discussioncontrasting

confidence: 99%

“…Similar concentrations of CSF MBP have been seen in adults with TBI [3, 9, 11, 15] as well as in serum [10]. …”

Section: Discussionsupporting

confidence: 63%

Section: Discussionmentioning

confidence: 99%

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Increased CSF Concentrations of Myelin Basic Protein After TBI in Infants and Children: Absence of Significant Effect of Therapeutic Hypothermia

Bell

Kochanek

et al. 2012

Neurocrit Care

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“…Myelin basic protein (MBP), an abundant protein in the central nervous system associated with white matter, has not been studied extensively in adults or children [Mukherjee et al, 1985;Noseworthy et al, 1985], but may provide important information in cases of iTBI where there may be a delay in seeking medical care and/or repetitive trauma, since serum MBP concentrations peak 48-72 h after injury and remain increased for up to 2 weeks Thomas et al, 1984].…”

Section: Introductionmentioning

confidence: 99%

Serum Biomarkers after Traumatic and Hypoxemic Brain Injuries: Insight into the Biochemical Response of the Pediatric Brain to Inflicted Brain Injury

et al. 2006

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Inflicted traumatic brain injury (iTBI) involves a combination of mechanical trauma and hypoxemia. Serum biomarker concentrations may provide objective information about their relative importance to the pathophysiology of iTBI. We compared the time course of neuron-specific enolase (NSE), S100B and myelin basic protein after pediatric hypoxic-ischemic brain injury, iTBI and noninflicted TBI (nTBI). The time to reach peak concentrations of all three biomarkers was shorter after nTBI. Initial and peak S100B, initial and peak myelin basic protein and peak NSE concentrations were no different between the three groups. Initial NSE concentration was highest after nTBI. These results suggest that the biochemical response of the brain to iTBI is distinct from the response to nTBI and shares temporal similarities with hypoxic-ischemic brain injury. This may have important implications for the treatment and prognosis of children with iTBI.

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“…An increase in serum S100B is a powerful predictor of intracranial pathological features 43,45 and may be more indicative of intracranial injury than findings on a CT scan, 1,25,26,45 although controversy exists about whether extracerebral injury affects serum S100B concentrations in adults. 2,4 Another serum marker, myelin basic protein, has not been studied extensively in adults 36,37 or children. It is an abundant protein in the CNS associated with white matter.…”

mentioning

confidence: 99%

Serum neuron-specific enolase, S100B, and myelin basic protein concentrations after inflicted and noninflicted traumatic brain injury in children

Berger

Adelson²,

Pierce³

et al. 2005

Journal of Neurosurgery: Pediatrics

167

160

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Serum NSE, S100B, or myelin basic protein are increased in the majority of children with acute nTBI and iTBI, including well-appearing children with iTBI in whom the diagnosis might otherwise have been missed. Differences in the time course of NSE, S100B, and myelin basic protein after nTBI and iTBI may provide insight into the pathophysiology of iTBI. These serum markers should be prospectively evaluated in a target population of infants.

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Cerebrospinal fluid myelin basic protein as a prognostic marker in patients with head injury

Cited by 18 publications

References 0 publications

Increased CSF Concentrations of Myelin Basic Protein After TBI in Infants and Children: Absence of Significant Effect of Therapeutic Hypothermia

Increased CSF Concentrations of Myelin Basic Protein After TBI in Infants and Children: Absence of Significant Effect of Therapeutic Hypothermia

Serum Biomarkers after Traumatic and Hypoxemic Brain Injuries: Insight into the Biochemical Response of the Pediatric Brain to Inflicted Brain Injury

Serum neuron-specific enolase, S100B, and myelin basic protein concentrations after inflicted and noninflicted traumatic brain injury in children

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