Journal article
Neuroimaging correlates of symptom burden and functional recovery following mild traumatic brain injury: A systematic review
NeuroImage clinical, Vol.49, 103910
2026
DOI: 10.1016/j.nicl.2025.103910
PMCID: PMC12811548
PMID: 41496379
Abstract
•Divergent neuroimaging findings in mTBI patients with incomplete vs. full recovery.•Thalamus, SLF, and cingulate disruptions linked to mTBI symptom burden and recovery.•Opportunity to guide neuroimaging analysis by clinically driven phenotypes.•Opportunity to embrace multimodal analytical frameworks to advance understanding.•Significant methodological heterogeneity across studies.
Mild traumatic brain injury (mTBI) represents 95% of all traumatic brain injuries. Despite being classified as “mild,” mTBI can lead to persistent symptoms that impact quality of life. Diagnostic and management strategies rely heavily on subjective symptom reporting due to a lack of validated biomarkers. Identifying neuroimaging biomarkers to characterise the pathophysiological features underlying symptom burden and poor recovery is critical for improving mTBI management.
To synthesise evidence on cross-sectional, longitudinal, and prognostic links between Magnetic Resonance Imaging (MRI) features and mTBI symptom burden and functional recovery.
The review followed PRISMA guidelines. Systematic searches of MEDLINE, SCOPUS, and Cochrane Library identified mTBI studies with acute MRI data, measures of symptom burden or functional recovery, and at least one follow-up clinical timepoint, covering publications to July 18, 2025. Risk of bias was evaluated using the Quality in Prognostic Studies tool, and findings were synthesised narratively.
Sixty-two of 7,232 articles were included. The review identified heterogeneous evidence across MRI modalities. Structural MRI findings showed limited correlation with clinical outcomes, while changes in white matter and functional connectivity were more strongly associated with symptom burden and recovery. Disruptions of integrative regions and association pathways such as the thalamus, superior longitudinal fasciculus, and cingulate cortex were linked to worse symptom burden and recovery outcomes.
Acute MRI, when contextualised with clinical data, helps delineate correlates of mTBI symptom burden and functional recovery. To strengthen inference, future neuroimaging studies should prespecify and report symptom burden and functional recovery as core endpoints.
Details
- Title: Subtitle
- Neuroimaging correlates of symptom burden and functional recovery following mild traumatic brain injury: A systematic review
- Creators
- Joshua P. McGeown - Mātai Medical Research InstituteMangor Pedersen - Auckland University of TechnologyRemika Mito - The University of MelbourneAlice Theadom - Auckland University of TechnologyJerome J. Maller - Monash UniversityPaul Condron - Mātai Medical Research InstituteSamantha J. Holdsworth - Mātai Medical Research Institute
- Resource Type
- Journal article
- Publication Details
- NeuroImage clinical, Vol.49, 103910
- DOI
- 10.1016/j.nicl.2025.103910
- PMID
- 41496379
- PMCID
- PMC12811548
- NLM abbreviation
- Neuroimage Clin
- ISSN
- 2213-1582
- eISSN
- 2213-1582
- Publisher
- Elsevier Inc; London
- Grant note
- Neurological Foundation of New Zealand First FellowshipAustralian Research Council Discovery Early Career Researcher Award (ARC DECRA) - Australian Government: DE240101035
JPM acknowledges funding support provided by the Neurological Foundation of New Zealand First Fellowship. RM is supported by an Australian Research Council Discovery Early Career Researcher Award (ARC DECRA; project number DE240101035) funded by the Australian Government.
- Language
- English
- Electronic publication date
- 11/19/2025
- Date published
- 2026
- Academic Unit
- Radiology
- Record Identifier
- 9985064771202771
Metrics
8 Record Views