The diagnostic utility of cerebrospinal fluid creatine kinase activity in the horse.

This study investigated the effectiveness of creatine kinase (CK) activity in the cerebrospinal fluid (CSF) as a diagnostic measure for various neurological disorders in horses. The researchers found that it had higher sensitivity and specificity for diagnosing protozoal myelitis compared to other conditions, but overall was not a reliable indicator for diagnosing neurological diseases in horses.

Research Methodology

• The research was carried out on 128 horses that were suffering from different neurological disorders. This involved measuring the level of CK activity in the CSF.
• Researchers also considered other factors like CSF red blood cell count, CSF nucleated cell count, CSF total protein concentration, and serum CK activity, and attempted to find a linkage with CSF CK activity.
• They also accounted for potential contamination of the CSF with whole blood, hemolyzed red blood cells, or serum, which could possibly increase the CSF CK activity.

Findings

• No notable association was found between the CK activity in the CSF and the other parameters studied.
• The CSF CK activity demonstrated higher sensitivity (61%) and specificity (56%) for protozoal myelitis compared to cervical stenotic myelopathy, degenerative myelopathy, or motor neuron disease. However, this was still deemed inadequate for reliable diagnostics.
• Contamination of CSF with whole blood, hemolyzed red blood cells, or serum did not see a significant increase in CSF CK activity.
• The presence of epidural fat or dura in the CSF notably increased CSF CK activity.

Conclusion

• The researchers concluded that the use of CSF CK activity as a diagnostic marker for neurological conditions in horses is unreliable.
• They noted that the presence of epidural fat or dura in the CSF during collection can falsely inflate the CSF CK activity, which might mislead the interpretation of the results.

This research indicates that while CK activity within CSF may have some predictive value for certain conditions (like protozoal myelitis), overall it is not a reliable measure for diagnosing various horse neurological conditions. It also highlights the importance of minimizing contamination during CSF collection to avoid skewed results.