Increased levels of serum MAP-2 at 6-months correlate with improved outcome in survivors of severe traumatic brain injury.
OBJECTIVE
To evaluate microtubule-associated proteins (MAP-2), a dendritic marker of both acute damage and chronic neuronal regeneration after injury, in serum of survivors after severe TBI and examine the association with long-term outcome.


METHODS
Serum concentrations of MAP-2 were evaluated in 16 patients with severe TBI (Glasgow Coma Scale score [GCS] ≤ 8) 6 months post-injury and in 16 controls. Physical and cognitive outcomes were assessed, using the Glasgow Outcome Scale Extended (GOSE) and Levels of Cognitive Functioning Scale (LCFS), respectively.


RESULTS
Severe TBI patients had significantly higher serum MAP-2 concentrations than normal controls with no history of TBI (p = 0.008) at 6 months post-injury. MAP-2 levels correlated with the GOSE (r = 0.58, p = 0.02) and LCFS (r = 0.65, p = 0.007) at month 6. Significantly lower serum levels of MAP-2 were observed in patients in a vegetative state (VS) compared to non-VS patients (p < 0.05). A trend tracking the level of consciousness was observed.


CONCLUSIONS
Severe TBI results in a chronic release of MAP-2 into the peripheral circulation in patients with higher levels of consciousness, suggesting that remodelling of synaptic junctions and neuroplasticity processes occur several months after injury. The data indicate MAP-2 as a potential marker for emergence to higher levels of cognitive function.
University of Florida, Department of Anesthesiology, Gainesville, FL, USA. stm_mondello@hotmail.com
Stefania
S
Mondello
Andrea
A
Gabrielli
Sheila
S
Catani
Mariagrazia
M
D'Ippolito
Andreas
A
Jeromin
Antonio
A
Ciaramella
Paola
P
Bossù
Kara
K
Schmid
Frank
F
Tortella
Kevin K W
KK
Wang
Ronald L
RL
Hayes
Rita
R
Formisano
D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001930:Brain Injuries / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D008297:Male; D008869:Microtubule-Associated Proteins / Q000097:blood*; D008875:Middle Aged; D018458:Persistent Vegetative State / Q000097:blood* / Q000453:epidemiology / Q000503:physiopathology; D010865:Pilot Projects; D011379:Prognosis; D020127:Recovery of Function; D017741:Survivors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult
D015415:Biomarkers; D008869:Microtubule-Associated Proteins