ABSTRACT NUMBER: ESOC2026LB86 PERFORMANCE OF SERUM MYELIN BASIC PROTEIN FOR ACUTE ISCHEMIC STROKE DETECTION

Abstract Background and aims Early identification of acute ischemic stroke remains difficult during first clinical assessment. Blood markers that reflect myelin injury may assist early triage. Myelin basic protein (MBP) is released after myelin disruption and can be quantified in serum. Methods This cross-sectional diagnostic study included forty-nine adults evaluated for suspected stroke. Blood was drawn at presentation, before definitive diagnosis. Serum MBP was measured using a validated immunoassay. Final classification was based on clinical assessment and neuroimaging. Group comparisons used nonparametric testing. Diagnostic accuracy was evaluated using ROC analysis. Cutoff selection followed the Youden index. Sensitivity, specificity, predictive values, and likelihood ratios were calculated. Results Median serum MBP was higher in ischemic stroke cases at 92.98 ng/mL (interquartile range 160.26) compared with 10.08 ng/mL (interquartile range 16.22) in non-stroke controls (p < 0.001). The ROC area under the curve was 0.885 (95% confidence interval 0.787 to 0.982). At a cutoff above 35.07 ng/mL, sensitivity reached 86.4% and specificity 85.2%. Positive predictive value was 82.6%. Negative predictive value was 88.5%. In this cohort, MBP separated diagnostic groups more clearly than neuron-specific enolase and BDNF. Conclusions These findings indicate that serum MBP identifies acute ischemic stroke with good accuracy at presentation. External validation is required. Assay dependence remains uncertain. The cohort was limited in size. End. Conflict of interest