Neuroimaging as a Biomarker for Mild Traumatic Brain Injury
A common point-of-view about mild traumatic brain injury, or concussion, is that its effects are short-lived, and that the patient will return to normal without intervention. Although most people may indeed spontaneously recover fully after a mild traumatic brain injury, it is also becoming clear that neurological changes may persist in the brain-even after the patient is no longer experiencing outward symptoms or complications.
In a recent review of structural neuroimaging techniques that are more sensitive to subtle brain changes, a recent research review outlined the potential to show the long-term effects of mild traumatic brain injury using neuroimaging. For instance, magnetic resonance imaging (MRI) can show abnormalities in white matter or in levels of hemosiderin (a blood byproduct), and diffusion tensor imaging (DTI) can illustrate changes in white matter tracts. However, in order for these biomarkers to be clinically useful, there needs to be an understanding of the underlying pathologies that they represent, and an ability to analyze them appropriately.
The common perception that mild traumatic brain injury effects are short-lived, and that any complications that a person may experience are suspect of malingering behavior, is likely to be a misguided one. Just as there has been a slow shift in perception about the complications and neuropathology (and therefore the diagnosis and treatment) of multiple sclerosis, the understanding of mild traumatic brain injury may likewise shift towards an acceptance of its long-term effects.
Bigler E. Neuroimaging biomarkers in mild traumatic brain injury (mTBI). Neuropsychology Review. (September 2013).