Myelin Basic Protein (MBP), Cerebrospinal Fluid

CPT: 83873
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  • MBP

Expected Turnaround Time

4 - 7 days

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Specimen Requirements


Cerebrospinal fluid (CSF)


1 mL

Minimum Volume

0.8 mL; when oligoclonal banding is ordered along with myelin basic protein, the minimum volume of CSF is 0.9 mL.


Plastic transport tube


Centrifuge CSF at 1500xg for 20 minutes and place the supernatant in a separate tube. Ensure that residual fibrin and cellular matter have been removed prior to transport.

Storage Instructions

Room temperature

Stability Requirements



Room temperature

14 days


14 days


14 days

Freeze/thaw cycles

Stable x3

Patient Preparation

Lumbar puncture should be performed within five days of onset of neurologic symptoms suggestive of multiple sclerosis.

Causes for Rejection

Lipemic, hemolyzed, or icteric specimen; CSF should be free from contamination with blood. Hemolysis is associated with falsely-elevated levels of MBP.

Test Details


Assist in diagnosing multiple sclerosis; determine whether an MS patient is having an active demyelinating episode; determine whether active demyelination is occurring in patients being treated by intrathecal chemotherapy or radiation therapy for neoplastic diseases involving the central nervous system; diagnose acute brain tissue destruction in children, including newborns; assess the efficacy of potential treatments for MS


Multiple sclerosis is often episodic. The MBP level may be low to undetectable between attacks. Patients in remission usually have no detectable MBP in their spinal fluid. Results for this test are for research purposes only by the assay's manufacturer. The performance characteristics of this product have not been established. Results should not be used as a diagnostic procedure without confirmation of the diagnosis by another medically established diagnostic product or procedure.


Enzyme-linked immunosorbent assay (ELISA)

Reference Interval

See table.


Male (ng/mL)

Female (ng/mL)

0 to 5 y

Not established

Not established

6 to 12 y



13 to 30 y



31 to 40 y



41 to 60 y



61 to 70 y



71 to 80 y



>80 y



Additional Information

This test provides a measure of myelin fragments released into the spinal fluid as a result of the breakdown of myelin during acute phases in the course of demyelinating disease of the CNS (most common example of which is multiple sclerosis). MBP is a 169 amino acid peptide that comprises 30% of the protein of the myelin sheath. While MBP is a useful test in the diagnosis of active MS, some patients with this disorder will have normal limits, especially during remissions, and elevations may be seen in other disorders as well. Therefore, tests such as CSF oligoclonal bands and IgG index, which are positive in 90% of MS patients during active disease or remission, are preferred for the initial diagnosis. However, MBP is useful for providing objective evidence of disease activity.

CSF MBP levels were found to decrease to the level of controls in a group of 11 cases of chronic progressive multiple sclerosis patients receiving immunosuppressive therapy (cyclophosphamide and prednisone). These findings suggest that MBP might be used to monitor the hoped for beneficial effect of such therapy in some cases of MS.

It has been suggested that MBP levels in the CSF might be used in the assessment of radiation-induced myelopathy. MS patients in relapse have been shown to have increased interleukin 1 and interleukin 2 production as the result of MBP stimulated peripheral blood mononuclear cells.


Antel JP, Arnason BG, Medof ME. Suppressor cell function in multiple sclerosis: Correlation with clinical disease activity. Ann Neurol. 1979 Apr; 5(4):338-342. 312620
Barna BP, Valenzuela R, Gupta MK. Laboratory analyses of cerebrospinal fluid. In: Barna BP, ed. Laboratory Handbook of Neuroimmunologic Disease. Chicago, Ill: American Society of Clinical Pathologists Press;1987:65-104,chap 5.
Cohen SR, Herndon RM, McKhann GM. Radioimmunoassay of myelin basic protein in spinal fluid. An index of active demyelination. N Engl J Med. 1976 Dec 23; 295(26):1455-1457. 995142
Lamers KJ, Uitdehaag BM, Hommes OR, Doesburg W, Wevers RA, von Geel WJ. The short-term effect of an immunosuppressive treatment on CSF myelin basic protein in chronic progressive multiple sclerosis. J Neurol Neurosurg Psychiatry. 1988 Oct; 51(10):1334-1337. 2465387
Marshall DW, Brey RL, Butzin CA. Lack of cerebrospinal fluid myelin basic protein in HIV-infected asymptomatic individuals with intrathecal synthesis of IgG. Neurology. 1989 Aug; 39(8):1127-1129. 2474773
Mukherjee A, Vogt RF, Linthicum DS. Measurement of myelin basic protein by radioimmunoassay in closed head trauma, multiple sclerosis and other neurological diseases. Clin Biochem. 1985 Oct; 18(5):304-307. 2414035
Panitch HS, Hooper CJ, Johnson KP. CSF antibody to myelin basic protein. Measurement in patients with multiple sclerosis and subacute sclerosing panencephalitis. Arch Neurol. 1980 Apr; 37(4):206-209. 6153890


Order Code Order Code Name Order Loinc Result Code Result Code Name UofM Result LOINC
123377 Myelin Basic Protein, CSF 2638-5 123378 Myelin Basic Protein, CSF ng/mL 2638-5

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