Establishing the link between post-concussive symptoms and brain network dysfunction: A systematic scoping review of neuroimaging evidence.

Mild traumatic brain injury (mTBI) is a prevalent condition with symptoms spanning physical, psychological, cognitive, and sleep domains. Altered functional brain networks have been implicated in mTBI, but the relationship between these network changes and post-concussive symptoms remains poorly understood. This study is a systematic scoping review, adhering to PRISMA-ScR guidelines, assessing current literature on the association between brain network dysfunction and mTBI-related symptoms. Searches across ProQuest, Web of Science, and PubMed yielded 41 studies for full review, with most (n = 39) employing resting-state functional magnetic resonance imaging (rs-fMRI) to examine brain networks. The default mode network (DMN) was a primary focus, with studies reporting heterogeneous findings of increased and decreased connectivity both within and outside this network. Over 85% of studies used mTBI-specific symptom measures, and 50% employed detailed questionnaires for emotional and physical symptom assessment. Of these, 23 studies identified significant correlations between symptom scores and network connectivity. However, methodological inconsistencies, including variable analytic approaches, highlight the need for standardization in this field. Key areas for future research include incorporating multimodal imaging techniques, conducting longitudinal studies or extending recruitment time points, and stratifying analyses by sex to optimise identification of connectivity changes. Addressing these gaps is crucial for advancing our understanding of functional network alterations in mTBI and their clinical implications, ultimately supporting improved diagnostic and therapeutic strategies.