Abstract
Working memory impairment is one of the most troubling and persistent symptoms after mild traumatic brain injury (MTBI) that often negatively affects quality of life. This comes as no surprise, as working memory is at the core of critical cognitive functions necessary for successful daily life functioning. It is important to know how working memory impairment relates to detectable brain injuries in order to discover robust biomarkers that allow for early identification of MTBI patients at highest risk of working memory impairments. Remarkable advances have been achieved to provide more information on brain microstructural alterations in the study of MTBI over the past decade with the use of diffusion-weighted magnetic resonance imaging (dMRI), particularly using multi-shell protocols and advanced diffusion modeling with improved specificity. Overall, the results of this growing body of work support a real potential of dMRI not only to identify microstructural changes after injury, but also have the potential to parse out the meaning and impact of such changes. Important future areas of discovery include longitudinal studies focusing on the effect of time-since-injury on clinical status including working memory performance to better understand the temporal dynamics of injury after MTBI and unravel the biophysical meaning of the detected changes in dMRI.
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