Predictive Utility of Diffusion MRI After Mild Traumatic Brain Injury in Civilian Populations: A Systematic Review

Area of Science:

• Neuroscience
• Radiology
• Neurology

Background:

• Persistent symptoms and functional limitations are common after mild traumatic brain injury (mTBI).
• The role of subtle white matter changes in these long-term effects remains unclear.
• This review focuses on uncomplicated mTBI, excluding blast, sports-related, or multiple injuries.

Approach:

• Systematic review of advanced MRI techniques, including Diffusion Tensor Imaging (DTI) and Susceptibility-Weighted Imaging (SWI).
• Extracted microstructural white matter indices and clinical outcomes (cognitive, neuropsychiatric, functional) from 13 studies.
• Included studies with uncomplicated mTBI patients and healthy controls, excluding specific injury types.

Key Points:

• Five of seven DTI studies found correlations between reduced white matter integrity and cognitive deficits (attention, processing speed, executive function) 6-12 months post-injury.
• Four studies linked DTI metrics to persistent postconcussive symptoms 3-12 months after injury.
• Two SWI studies showed conflicting results regarding microbleeds and symptom persistence.

Conclusions:

• Microstructural white matter integrity may correlate with clinical presentation 3-12 months after uncomplicated mTBI.
• Variability in analysis methods and brain regions studied necessitates further research.
• Future studies should investigate regional white matter indices and symptom persistence beyond 12 months.