{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:04:19Z","timestamp":1789470259439,"version":"build-2803163510"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Hum. Neurosci."],"abstract":"<jats:p>Stroke is currently one of the leading causes of death and disability worldwide among neurological diseases. Although traditional imaging techniques can clearly delineate lesion extent and hemorrhagic patterns, they are limited in quantifying microscopic structural changes and repair processes in early-stage brain tissue damage. Neurite Orientation Dispersion and Density Imaging (NODDI), an advanced diffusion-weighted MRI technique, enables accurate, non-invasive quantification of post-stroke microstructural changes in brain tissue. NODDI objectively quantifies neurite damage and remodeling, providing crucial imaging evidence for stroke severity, prognosis, and rehabilitation outcome evaluation. This review critically synthesizes NODDI\u2019s biophysical principles, evaluates its expanding applications in both ischemic and hemorrhagic stroke\u2014highlighting recent advancements in modeling and clinical translation\u2014discusses persistent limitations, and proposes a roadmap for future research to maximize its clinical utility and address current challenges. Importantly, this review focuses exclusively on magnetic resonance imaging (MRI)-based techniques and does not cover non-MRI modalities such as computed tomography (CT) or positron emission tomography (PET). Notably, post-stroke depression (PSD) affects approximately one-third of stroke survivors and represents a major neuropsychiatric complication that impedes functional recovery and reduces quality of life. Emerging evidence demonstrates that NODDI-derived metrics\u2014particularly ODI and ISO\u2014can identify microstructural disruptions in emotion-related white matter pathways that are specific to PSD, offering potential neuroimaging biomarkers that surpass conventional DTI parameters. These findings position NODDI as a promising tool not only for stroke characterization but also for bridging the gap between focal brain injury and subsequent psychiatric manifestations.<\/jats:p>","DOI":"10.3389\/fnhum.2026.1924031","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:21:22Z","timestamp":1789467682000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Neurite orientation dispersion and density imaging in stroke: current applications, limitations, and future directions"],"prefix":"10.3389","volume":"20","author":[{"given":"Wanxia","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Rehabilitation Medicine, Shaoguan University Affiliated Hospital (Shaoguan First People\u2019s Hospital)","place":["Shaoguan, China"]},{"name":"School of Rehabilitation Medicine, Gannan Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Therapy Teaching and Research, Gannan Healthcare Vocational College","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shaoguan University Affiliated Hospital (Shaoguan First People\u2019s Hospital)","place":["Shaoguan, China"]},{"name":"School of Rehabilitation Medicine, Gannan Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shaoguan University Affiliated Hospital (Shaoguan First People\u2019s Hospital)","place":["Shaoguan, China"]},{"name":"School of Rehabilitation Medicine, Gannan Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longhua","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shaoguan University Affiliated Hospital (Shaoguan First People\u2019s Hospital)","place":["Shaoguan, China"]},{"name":"School of Rehabilitation Medicine, Gannan Medical University","place":["Ganzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shaoguan University Affiliated Hospital (Shaoguan First People\u2019s Hospital)","place":["Shaoguan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zicai","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Shaoguan University Affiliated Hospital (Shaoguan First People\u2019s Hospital)","place":["Shaoguan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"742","DOI":"10.1109\/EMBC.2014.6943697","article-title":"Assessment of white matter microstructure in stroke patients using NODDI","volume":"2014","author":"Adluru","year":"2014","journal-title":"Annu Int Conf IEEE Eng Med Biol Soc"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"823","DOI":"10.3390\/brainsci15080823","article-title":"Combining coronal and axial DWI for accurate diagnosis of brainstem ischemic strokes: volume-based correlation with stroke severity","volume":"15","author":"Alhaj Omar","year":"2025","journal-title":"Brain Sci."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1205426","DOI":"10.3389\/fneur.2023.1205426","article-title":"C-NODDI: a constrained NODDI model for axonal density and orientation determinations in cerebral white matter","volume":"14","author":"Alsameen","year":"2023","journal-title":"Front. 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