• Stefania Mondello, Andrea Gabrielli, Sheila Catani, Mariagrazia D'Ippolito, Andreas Jeromin, Antonio Ciaramella, Paola Bossù, Kara Schmid, Frank Tortella, Kevin K W Wang, Ronald L Hayes, and Rita Formisano.
• University of Florida, Department of Anesthesiology, Gainesville, FL, USA. stm_mondello@hotmail.com
• Brain Inj. 2012 Jan 1;26(13-14):1629-35.

ObjectiveTo 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.MethodsSerum 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.ResultsSevere 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.ConclusionsSevere 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.

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