Current and prospective roles of magnetic resonance imaging in mild traumatic brain injury
Sassani, Matilde Ghafari, Tara Arachchige, Pradeepa R W Idrees, Iman Gao, Yidian Waitt, Alice Weaver, Samuel R C Mazaheri, Ali Lyons, Hannah S Grech, Olivia
Sassani, Matilde
Ghafari, Tara
Arachchige, Pradeepa R W
Idrees, Iman
Gao, Yidian
Waitt, Alice
Weaver, Samuel R C
Mazaheri, Ali
Lyons, Hannah S
Grech, Olivia
Abstract
There is unmet clinical need for biomarkers to predict recovery or the development of long-term sequelae of mild traumatic brain injury, a highly prevalent condition causing a constellation of disabling symptoms. A substantial proportion of patients live with long-lasting sequelae affecting their quality of life and ability to work. At present, symptoms can be assessed through clinical tests; however, there are no imaging or laboratory tests fully reflective of pathophysiology routinely used by clinicians to characterize post-concussive symptoms. Magnetic resonance imaging has potential to link subtle pathophysiological alterations to clinical outcomes. Here, we review the state of the art of MRI research in adults with mild traumatic brain injury and provide recommendations to facilitate transition into clinical practice. Studies utilizing MRI can inform on pathophysiology of mild traumatic brain injury. They suggest presence of early cytotoxic and vasogenic oedema. They also show that mild traumatic brain injury results in cellular injury and microbleeds affecting the integrity of myelin and white matter tracts, all processes that appear to induce delayed vascular reactions and functional changes. Crucially, correlates between MRI parameters and post-concussive symptoms are emerging. Clinical sequences such as T1-weighted MRI, susceptibility-weighted MRI or fluid attenuation inversion recovery could be easily implementable in clinical practice, but are not sufficient, in isolation for prognostication. Diffusion sequences have shown promises and, although in need of analysis standardization, are a research priority. Lastly, arterial spin labelling is emerging as a high-utility research as it could become useful to assess delayed neurovascular response and possible long-term symptoms.
Affiliations
University of Birmingham; Birmingham Health Partners; University Hospitals Birmingham NHS Foundation Trust; University of Nottingham; Aston University
Date
2025-03-25
Type
Journal Article
Collections
Citation
Sassani M, Ghafari T, Arachchige PRW, Idrees I, Gao Y, Waitt A, Weaver SRC, Mazaheri A, Lyons HS, Grech O, Thaller M, Witton C, Bagshaw AP, Wilson M, Park H, Brookes M, Novak J, Mollan SP, Hill LJ, Lucas SJE, Mitchell JL; UK mTBI Predict Consortium; Sinclair AJ, Mullinger K, Fernández-Espejo D. Current and prospective roles of magnetic resonance imaging in mild traumatic brain injury. Brain Commun. 2025 Mar 25;7(2):fcaf120. doi: 10.1093/braincomms/fcaf120.