Hybrid Evidence-Informed Synthesis of Resting-State Functional Connectivity Alterations in Mild Traumatic Brain Injury. [Review]

Abstract

BACKGROUND: Mild traumatic brain injury (mTBI) is frequently followed by persistent cognitive, affective, and sensory complaints despite unremarkable conventional structural imaging. Resting-state functional MRI (rs-fMRI) has been increasingly employed to detect subtle alterations in large-scale brain networks. However, variability in analytical approaches and the potential influence of neurovascular factors complicate interpretation of BOLD-derived connectivity findings.

OBJECTIVE: This study provides a focused, evidence-informed synthesis integrating umbrella review principles with a targeted narrative analysis of recent high-quality rs-fMRI studies in mild traumatic brain injury (mTBI). Rather than a comprehensive systematic review, the aim was to identify convergent patterns of network dysfunction while critically examining methodological constraints, including neurovascular confounds and variability in analytical approaches.

CONCLUSIONS: This synthesis supports a network-level model of mTBI characterized by distributed connectivity disturbances. However, given the limited number of eligible studies and substantial methodological heterogeneity, findings should be interpreted as qualitative convergence rather than quantitative generalization. Future longitudinal, multimodal, and standardized imaging approaches are required to clarify the translational relevance of rs-fMRI findings.