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We investigate the sensitivity of MAP-MRI-derived quantitative imaging biomarkers to detect previously unseen microstructural damage in patients with mild traumatic brain injuries (mTBI), whose clinical scans otherwise appeared normal. We developed and validated an MAP-MRI data processing pipeline for analyzing diffusion-weighted images for use in healthy controls and mTBI patients whose longitudinal scans were obtained from the GE\/NFL\/mTBI MRI database. A regional outlier analysis of longitudinal tissue changes in a pilot cohort during a 90-day period of observation showed that several MAP-MRI-derived parameters had increased intersession variability in white matter tracts and deep gray matter nuclei of mTBI patients relative to healthy controls. In summary, longitudinal monitoring of changes in MAP-MRI metrics may provide a comprehensive means to study pathological mTBI alterations that evolve at different timescales, while current image-based biomarkers lack the sensitivity and specificity and are unable to predict patient outcome.<\/jats:p>","DOI":"10.1177\/08977151251377449","type":"journal-article","created":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T00:57:47Z","timestamp":1757552267000},"page":"1923-1935","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Quantifying Longitudinal Microstructural Changes in Mild Traumatic Brain Injury Patients with Mean Apparent Propagator MRI"],"prefix":"10.1177","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8764-4313","authenticated-orcid":false,"given":"Mihika","family":"Gangolli","sequence":"first","affiliation":[{"name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland, USA."},{"name":"Military Traumatic Brain Injury Initiative (MTBI2), Bethesda, Maryland, USA."},{"name":"Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."},{"name":"The Henry M. 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