{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T19:25:32Z","timestamp":1772220332802,"version":"3.50.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T00:00:00Z","timestamp":1738713600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To systematically review studies relating neuroimaging findings to balance problems resulting from a history of mTBI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Mild traumatic brain injury affects 55.9 million people worldwide every year. These injuries can have persistent symptoms such as maintaining balance which can be life-altering. Difficulties maintaining balance persist months or years after a mild traumatic brain injury in &gt;30% of patients. Neuroimaging modalities, including magnetic resonance imaging, diffusion-weighted imaging, functional magnetic resonance imaging, electroencephalography, and magnetoencephalography, have been associated with presentation or persistence of balance difficulties, but no clinical guidelines are currently in place.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Inclusion criteria<\/jats:title>\n                    <jats:p>Studies will include participants of any age or sex who were diagnosed as having mild traumatic brain injury by a medical professional, excluding studies which by design included patients with other conditions diagnosed using neuroimaging findings. There must be at least one post-injury scan from at one or more of the included neuroimaging modalities, and assessment of balance problems. A comparator must be present in the form of either a control group or longitudinal design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A search will be conducted in Elsevier (Embase), MEDLINE (PubMed), Google Scholar, SportDiscus (EBSCOhost) and ProQuest for studies meeting the inclusion criteria, published 2013-2024, and available in English. Reviews will not be included. The process of study selection, critical assessment, data extraction, and summarizing findings will be conducted by two independent reviewers, with disagreements resolved by a third. The meta-analysis will summarize the strength of association between specific findings related to brain regions using various neuroimaging modalities and the presentation or persistence of balance difficulties. Evidence related to each neuroimaging modality will summarized using the GRADE approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        Systematic review registration number:\n                        <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42024476988\" xlink:type=\"simple\">CRD42024476988<\/jats:ext-link>\n                      <\/jats:bold>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0307339","type":"journal-article","created":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T13:34:41Z","timestamp":1738762481000},"page":"e0307339","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Neuroimaging findings and balance problems after mild traumatic brain injury: A systematic review protocol"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-9967-2221","authenticated-orcid":true,"given":"Todd","family":"Boscarello","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robby","family":"Boparai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Samson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9312-7729","authenticated-orcid":true,"given":"Alan","family":"Rodriguez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0114-4383","authenticated-orcid":true,"given":"Thomas","family":"Knoblauch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cheryl","family":"Vanier","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Travis","family":"Snyder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,2,5]]},"reference":[{"key":"pone.0307339.ref001","doi-asserted-by":"crossref","unstructured":"Silverberg, N. D., Iverson, G. L., Cogan, A., Dams, O. C. K., Delmonico, R., & Members of the American Congress of Rehabilitation Medicine Task Force. (2023). The American Congress of Rehabilitation Medicine diagnostic criteria for mild traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 104(8), 1343\u20131355.","DOI":"10.1016\/j.apmr.2023.03.036"},{"key":"pone.0307339.ref002","volume-title":"In StatPearls.","author":"C. M. Permenter","year":"2024"},{"key":"pone.0307339.ref003","volume-title":"Desk reference to the diagnostic criteria from DSM-5","author":"American Psychiatric Associatio","year":"2013"},{"key":"pone.0307339.ref004","volume-title":"The ICD-10 classification of mental and behavioural disorders: Diagnostic criteria for research","author":"World Health Organization","year":"1993"},{"key":"pone.0307339.ref005","doi-asserted-by":"crossref","first-page":"687197","DOI":"10.3389\/fneur.2021.687197","article-title":"Neurophysiological biomarkers of persistent post-concussive symptoms: A scoping review","volume":"12","author":"S. Mortaheb","year":"2021","journal-title":"Frontiers in Neurology"},{"issue":"8","key":"pone.0307339.ref006","doi-asserted-by":"crossref","first-page":"721","DOI":"10.2340\/16501977-1169","article-title":"Brain pathology after mild traumatic brain injury: An exploratory study by repeated magnetic resonance examination","volume":"45","author":"M. Lannsjo","year":"2013","journal-title":"Journal of Rehabilitation Medicine"},{"issue":"5","key":"pone.0307339.ref007","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1080\/02699052.2017.1283537","article-title":"Longitudinal changes in brain morphology from 4 weeks to 12 months after mild traumatic brain injury: Associations with cognitive functions and clinical variables.","volume":"31","author":"T. Hellstrom","year":"2017","journal-title":"Brain Injury,"},{"key":"pone.0307339.ref008","doi-asserted-by":"crossref","first-page":"836","DOI":"10.3389\/fneur.2018.00836","article-title":"Clinical findings in a multicenter MRI study of mild TBI","volume":"9","author":"T. Shetty","year":"2018","journal-title":"Frontiers in Neurology"},{"issue":"8","key":"pone.0307339.ref009","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/s00234-010-0774-6","article-title":"Microstructural brain injury in post-concussion syndrome after minor head injury","volume":"53","author":"M. Smits","year":"2011","journal-title":"Neuroradiology"},{"key":"pone.0307339.ref010","doi-asserted-by":"crossref","first-page":"156","DOI":"10.3389\/fneur.2016.00156","article-title":"Diffusion tensor imaging findings in post-concussion syndrome patients after mild traumatic brain injury: A systematic review","volume":"7","author":"E. Khong","year":"2016","journal-title":"Frontiers in Neurology"},{"issue":"9","key":"pone.0307339.ref011","doi-asserted-by":"crossref","first-page":"2789","DOI":"10.1002\/hbm.20709","article-title":"Postconcussion syndrome after minor head injury: Brain activation of working memory and attention","volume":"30","author":"M. Smits","year":"2009","journal-title":"Human Brain Mapping"},{"issue":"1","key":"pone.0307339.ref012","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/s11065-020-09474-0","article-title":"Volumetric MRI findings in mild traumatic brain injury (mTBI) and neuropsychological outcome.","volume":"33","author":"E. D. Bigler","year":"2023","journal-title":"Neuropsychology Review"},{"issue":"5","key":"pone.0307339.ref013","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1016\/j.neuron.2013.10.017","article-title":"EEG and MEG: Relevance to neuroscience","volume":"80","author":"F. Lopes da Silva","year":"2013","journal-title":"Neuron"},{"issue":"6","key":"pone.0307339.ref014","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1212\/WNL.0000000000004214","article-title":"The spectrum of mild traumatic brain injury: A review","volume":"89","author":"A. R. Mayer","year":"2017","journal-title":"Neurology"},{"issue":"4","key":"pone.0307339.ref015","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.3171\/2017.10.JNS17352","article-title":"Estimating the global incidence of traumatic brain injury","volume":"130","author":"M. C. Dewan","year":"2018","journal-title":"Journal of Neurosurgery"},{"issue":"1","key":"pone.0307339.ref016","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/00001199-200501000-00003","article-title":"Two decades of advances in understanding of mild traumatic brain injury","volume":"20","author":"R. Ruff","year":"2005","journal-title":"Journal of Head Trauma Rehabilitation"},{"key":"pone.0307339.ref017","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.gaitpost.2019.05.011","article-title":"Balance and the brain: A review of structural brain correlates of postural balance and balance training in humans.","volume":"71","author":"O. J. Surgent","year":"2019","journal-title":"Gait & Posture"},{"issue":"6","key":"pone.0307339.ref018","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1503\/jpn.190156","article-title":"Volumetric brain differences in clinical depression in association with anxiety: A systematic review with meta-analysis","volume":"45","author":"A. E. O. Daniela","year":"2020","journal-title":"Journal of Psychiatry and Neuroscience"},{"issue":"10","key":"pone.0307339.ref019","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.1016\/j.jclinepi.2009.06.005","article-title":"Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement","volume":"62","author":"PRISMA Group","year":"2009","journal-title":"Journal of Clinical Epidemiology"},{"key":"pone.0307339.ref020","volume-title":"JBI manual for evidence synthesis","author":"E. Aromataris","year":"2020"},{"key":"pone.0307339.ref021","doi-asserted-by":"crossref","first-page":"k4597","DOI":"10.1136\/bmj.k4597","article-title":"A guide to systematic review and meta-analysis of prognostic factor studies","volume":"364","author":"R. D. Riley","year":"2019","journal-title":"BMJ"},{"issue":"4","key":"pone.0307339.ref022","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s13244-018-0624-3","article-title":"Clinical applications of diffusion weighted imaging in neuroradiology","volume":"9","author":"M. Drake-Perez","year":"2018","journal-title":"Insights Into Imaging"},{"issue":"6","key":"pone.0307339.ref023","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/2012.10.FOCUS12253","article-title":"Evaluating the cognitive consequences of mild traumatic brain injury and concussion by using electrophysiology","volume":"33","author":"N. Gosselin","year":"2012","journal-title":"Neurosurgical Focus"},{"key":"pone.0307339.ref024","first-page":"109","article-title":"Single-subject-based whole-brain MEG slow-wave imaging approach for detecting abnormality in patients with mild traumatic brain injury. NeuroImage","volume":"5","author":"M. X. Huang","year":"2014","journal-title":"Clinical"},{"issue":"5","key":"pone.0307339.ref025","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1007\/s40846-017-0285-6","article-title":"Postural stability assessment in patients with mild traumatic brain injury complaining of dizziness","volume":"37","author":"K.-Y. Chen","year":"2017","journal-title":"Journal of Medical and Biological Engineering"},{"issue":"11","key":"pone.0307339.ref026","doi-asserted-by":"crossref","first-page":"e0288727","DOI":"10.1371\/journal.pone.0288727","article-title":"Associations between white matter integrity and postural control in adults with traumatic brain injury","volume":"18","author":"C. Zampieri","year":"2023","journal-title":"PLoS ONE"},{"issue":"9","key":"pone.0307339.ref027","doi-asserted-by":"crossref","first-page":"788","DOI":"10.3109\/09638288.2011.619624","article-title":"Associations among self-reported balance problems, post-concussion symptoms, and performance-based tests: A longitudinal follow-up study","volume":"34","author":"I. Kleffelgaard","year":"2012","journal-title":"Disability and Rehabilitation"},{"key":"pone.0307339.ref028","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.jclinepi.2016.01.021","article-title":"PRESS peer review of electronic search strategies: 2015 guideline statement","volume":"75","author":"J. McGowan","year":"2016","journal-title":"Journal of Clinical Epidemiology"},{"issue":"1","key":"pone.0307339.ref029","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1186\/s13643-017-0644-y","article-title":"Optimal database combinations for literature searches in systematic reviews: A prospective exploratory study","volume":"6","author":"W. M. Bramer","year":"2017","journal-title":"Systematic Reviews"},{"key":"pone.0307339.ref030","author":"Critical Appraisal Skills Programme (CASP).","year":"2022","journal-title":"CASP systematic review checklist"},{"issue":"4","key":"pone.0307339.ref031","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies.","volume":"61","author":"E. von Elm","year":"2008","journal-title":"Journal of Clinical Epidemiology"},{"key":"pone.0307339.ref032","article-title":"Cochrane handbook for systematic reviews of interventions (Version 5.0.1).","author":"J. P. Higgins","year":"2008","journal-title":"The Cochrane Collaboration"},{"issue":"4","key":"pone.0307339.ref033","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1136\/ebmental-2019-300117","article-title":"How to perform a meta-analysis with R: A practical tutorial","volume":"22","author":"S. Balduzzi","year":"2019","journal-title":"Evidence-Based Mental Health"},{"issue":"3","key":"pone.0307339.ref034","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v036.i03","article-title":"Conducting meta-analyses in R with the metafor package","volume":"36","author":"W. Viechtbauer","year":"2010","journal-title":"Journal of Statistical Software"},{"key":"pone.0307339.ref035","doi-asserted-by":"crossref","DOI":"10.1201\/9781003107347","volume-title":"Doing meta-analysis with R: A hands-on guide","author":"M. Harrer","year":"2021"},{"key":"pone.0307339.ref036","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1186\/2046-4053-2-71","article-title":"Judging the quality of evidence in reviews of prognostic factor research: Adapting the GRADE framework","volume":"2","author":"A. Huguet","year":"2013","journal-title":"Systematic Reviews"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0307339","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,5]],"date-time":"2025-02-05T13:35:00Z","timestamp":1738762500000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0307339"}},"subtitle":[],"editor":[{"given":"Maryam","family":"Bemanalizadeh","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,5]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,5]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0307339","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2024.07.04.24309977","asserted-by":"object"}]},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,5]]}}}