SYSTEMATIC REVIEW OF FUNCTIONAL MRI IN DIAGNOSING MILD TRAUMATIC BRAIN INJURY
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Keywords
mild traumatic brain injury, functional MRI, brain connectivity, default mode network, diagnostic imaging, neurofunctional assessment.
Abstract
Background: Mild traumatic brain injury (mTBI), often referred to as concussion, represents a significant public health concern due to its subtle neurological consequences that are frequently undetectable by conventional imaging methods such as CT or structural MRI. Functional magnetic resonance imaging (fMRI) has emerged as a promising neuroimaging tool capable of identifying alterations in brain activity, connectivity, and functional networks associated with mTBI. Objective: This systematic review aims to evaluate the diagnostic value of fMRI in detecting functional brain abnormalities in patients with mTBI, highlighting its potential role in improving clinical assessment, prognosis, and management. Methods: A comprehensive literature search was conducted across PubMed, Scopus, and Web of Science databases for studies published between 2010 and 2025. Inclusion criteria consisted of peer-reviewed studies investigating resting-state or task-based fMRI findings in adult or adolescent patients diagnosed with mTBI. Studies without clear diagnostic or functional outcomes were excluded. Data were extracted regarding study design, fMRI paradigms, brain regions affected, and correlations with cognitive or behavioral outcomes. Results: The majority of included studies demonstrated that mTBI patients exhibit altered activation patterns in the prefrontal cortex, posterior cingulate cortex, and default mode network (DMN), along with disrupted functional connectivity within attention and executive control networks. Resting-state fMRI consistently identified abnormal network synchronization and reduced connectivity strength. Task-based fMRI revealed compensatory hyperactivation in regions associated with working memory and attention. Although fMRI showed high sensitivity in detecting subtle changes, variability in protocols and analytical methods limited reproducibility and clinical standardization. Conclusion: fMRI provides valuable insights into the neurofunctional alterations following mild traumatic brain injury and holds promise as an adjunctive diagnostic and prognostic tool. However, heterogeneity in imaging methodologies and lack of standard diagnostic criteria hinder its routine clinical application. Future multicenter studies with standardized fMRI protocols are needed to validate its diagnostic reliability and integrate it into clinical practice for early detection and individualized management of mTBI.
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