Research of the effects of myelin basic protein (MBP) and ischemia modified albumin (IMA) levels in blood and cerebrospinal fluid on vasospasm, clinical progress and outcome in patients with non-traumatic subarachnoid hemorrhage

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BACKGROUND: Non-traumatic subarachnoid hemorrhage (SAH) is associated with high morbidity and mortality, mainly due to secondary brain injury mechanisms such as cerebral vasospasm and delayed cerebral ischemia. Reliable biochemical biomarkers for monitoring disease progression and early outcome assessment remain limited. OBJECTIVE: To investigate temporal changes in serum and cerebrospinal fluid (CSF) levels of myelin basic protein (MBP) and ischemia-modified albumin (IMA) in patients with non-traumatic SAH and to evaluate their associations with clinical severity and functional outcome. METHODS: In this prospective single-center study, 20 patients with non-traumatic SAH were included. Serum and CSF MBP and IMA levels were measured on days 1, 5, and 10 after admission. Clinical severity was assessed using the Modified Fisher scale, Glasgow Coma Scale (GCS), Hunt-Hess scale (HHS), and World Federation of Neurosurgical Societies (WFNS) scale. Functional outcome was evaluated at discharge using the Glasgow Outcome Scale (GOS). Temporal changes and correlations between biomarkers and clinical parameters were analyzed. RESULTS: Serum and CSF MBP levels increased significantly over time (p<0.001), reflecting progressive tissue injury, but showed no consistent association with clinical scores or functional outcome. Serum IMA levels remained elevated without significant temporal variation. In contrast, CSF IMA levels demonstrated a late-phase increase and were significantly associated with clinical deterioration. On day 10, CSF IMA levels correlated negatively with GCS and GOS scores and positively with WFNS scores. CONCLUSION: MBP reflects cumulative brain injury following SAH, whereas CSF IMA is more closely associated with late-phase neurological deterioration and early functional outcome. CSF IMA may represent a complementary biomarker for prognostic assessment in non-traumatic SAH.

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