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Transdiagnostic MRI-derived Features of Psychopathology Following Traumatic Brain Injury: A Systematic Review
Alexia Samiotis1,2, Amelia J Hicks3,4, Jai Carmichael3,4
1Monash-Epworth Rehabilitation Research Centre, Epworth HealthCare, 181-185 Hoddle St Richmond, Melbourne, VIC, 3121, Australia. alexia.samiotis1@monash.edu.
Neuropsychology Review
|July 25, 2026
Summary
This review found inconsistent MRI-based brain features linked to psychopathology after moderate-severe traumatic brain injury (TBI). However, lower hippocampal volume was associated with depression, anxiety, apathy, and psychosis in TBI patients.
Area of Science:
- Neuroscience
- Psychiatry
- Radiology
Background:
- Understanding the biological underpinnings of psychopathology following moderate-to-severe traumatic brain injury (TBI) is crucial but remains challenging.
- Previous reviews indicate limited consensus on associations between specific brain regions/functions and psychopathology categories like anxiety and depression.
Purpose of the Study:
- To systematically review and evaluate magnetic resonance imaging (MRI)-derived features associated with psychopathology transdiagnostically in moderate-to-severe TBI.
- To identify consistent neurobiological markers across different diagnostic categories of psychopathology in TBI.
Main Methods:
- A systematic literature search was conducted across Embase, PsycINFO, and MEDLINE for studies investigating MRI features (macro-, micro-structure, function) and psychopathology in adults with closed moderate-to-severe TBI.
- Risk of bias was assessed using a customized tool based on Joanna Briggs Institute Critical Appraisal Tools.
- 18 studies met the eligibility criteria out of 7,777 screened records.
Main Results:
- Studies predominantly focused on hippocampal morphology and depression.
- Findings were heterogeneous, but some morphological features, including hippocampus, thalamus, and fronto-temporal regions, showed transdiagnostic convergence.
- Lower hippocampal volume was consistently associated with increased depression, anxiety, apathy, and psychosis.
Conclusions:
- Current evidence on transdiagnostic MRI-derived features of psychopathology in moderate-to-severe TBI is limited and inconsistent, with a predominant focus on structural MRI.
- Limitations include a narrow focus on specific psychopathology categories and a lack of appropriate comparators.
- Adopting transdiagnostic-dimensional frameworks is proposed to better understand shared and distinct biological features of psychopathology in TBI.
Keywords:
Hippocampal morphologyMRI featuresMental healthNeuroimagingTransdiagnostic frameworksTraumatic brain injuryMore Related Videos
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