{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:31:17Z","timestamp":1787070677945,"version":"build-2736575974"},"reference-count":53,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract:<\/jats:title>\n                  <jats:p>Mild traumatic brain injury (mTBI) constitutes a pervasive yet often overlooked public health challenge with far-reaching implications for individual well-being and healthcare systems globally. This review synthesizes contemporary evidence on diagnosis, management, and emerging treatment paradigms for mTBI using a structured, comprehensive literature search strategy. Through comprehensive literature analysis spanning multiple databases\u2014PubMed, Cochrane Library, EMBASE, and Web of Science\u2014from January 2018 to January 2025. A total of 183 studies met inclusion criteria, comprising 42 systematic reviews and meta-analyses, 58 randomized controlled trials, and 83 observational studies. We have identified transformative advances in biomarker research, neuroimaging techniques, and targeted interventions while uncovering persistent challenges in standardizing diagnostic and treatment protocols. Recent randomized controlled trials and meta-analyses reveal promising outcomes for early intervention strategies, cognitive rehabilitation approaches, and novel pharmacological treatments. However, methodological limitations\u2014including heterogeneous mTBI definitions, inconsistent outcome measures, and insufficient long-term follow-up\u2014underscore the need for large-scale trials using standardized definitions and common data elements. Future research must prioritize personalized treatment approaches, integration of cutting-edge technology in assessment and monitoring, and addressing the troubling disparities in access to specialized care for mTBI patients\u2014particularly among vulnerable populations.<\/jats:p>","DOI":"10.4103\/bc.bc_52_25","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T08:00:28Z","timestamp":1773129628000},"page":"257-269","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Reframing the \u201cmild\u201d in mild traumatic brain injury: A comprehensive narrative review of diagnosis and treatment paradigms"],"prefix":"10.4103","volume":"12","author":[{"given":"Shibu","family":"Sasidharan","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology, Critical Care Medicine, and Emergency Medicine, Base Hospital, Delhi Cantt, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Mathieu","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Neurosurgery, and Interdepartmental Division of Critical Care, St. Michael\u2019s Hospital, Unity Health Toronto, University of Toronto, Toronto, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nidhi","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Emergency, Lister Hospital, East and North Hertfordshire NHS Trust, Stevenage, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puja","family":"Rani","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, Charing Cross Hospital, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunali","family":"Nanayakkara","sequence":"additional","affiliation":[{"name":"The Neurosciences Critical Care Unit, Addenbrooke\u2019s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean Y. W.","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juranuch","family":"Rojprasitporn","sequence":"additional","affiliation":[{"name":"The Neurosciences Critical Care Unit, Addenbrooke\u2019s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"R1-20260806","article-title":"Surveillance Report of Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths \u2013 United States, 2019","year":"2023","journal-title":"Centers for Disease Control and Prevention, U.S. Department of Health and Human Services"},{"key":"R2-20260806","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1089\/neu.2013.2984","article-title":"Symptomatology and functional outcome in mild traumatic brain injury: Results from the prospective TRACK-TBI study","volume":"31","author":"McMahon","year":"2014","journal-title":"J Neurotrauma"},{"key":"R5-20260806","doi-asserted-by":"crossref","first-page":"e182853","DOI":"10.1001\/jamapediatrics.2018.2853","article-title":"Centers for disease control and prevention guideline on the diagnosis and management of mild traumatic brain injury among children","volume":"172","author":"Lumba-Brown","year":"2018","journal-title":"JAMA Pediatr"},{"key":"R6-20260806","first-page":"31","article-title":"Traumatic brain injuries","volume":"9","author":"Blennow","year":"2023","journal-title":"Nat Rev Dis Primers"},{"key":"R7-20260806","first-page":"134ra60","article-title":"Chronic traumatic encephalopathy in blast-exposed military veterans and a blast neurotrauma mouse model","volume":"4","author":"Goldstein","year":"2012","journal-title":"Sci Transl Med"},{"key":"R8-20260806","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/B978-0-444-52892-6.00004-0","article-title":"The neuropathology of traumatic brain injury","volume":"127","author":"Mckee","year":"2015","journal-title":"Handb Clin Neurol"},{"key":"R9-20260806","doi-asserted-by":"crossref","first-page":"838","DOI":"10.1136\/bjsports-2017-097699","article-title":"Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016","volume":"51","author":"McCrory","year":"2017","journal-title":"Br J Sports Med"},{"key":"R10-20260806","doi-asserted-by":"crossref","first-page":"375","DOI":"10.1097\/00001199-200609000-00001","article-title":"The epidemiology and impact of traumatic brain injury: A brief overview","volume":"21","author":"Langlois","year":"2006","journal-title":"J Head Trauma Rehabil"},{"key":"R11-20260806","first-page":"556","article-title":"Fluid biomarkers for mild traumatic brain injury and related conditions","volume":"17","author":"Zetterberg","year":"2021","journal-title":"Nat Rev Neurol"},{"key":"R12-20260806","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.apmr.2019.10.179","article-title":"Management of concussion and mild traumatic brain injury: A synthesis of practice guidelines","volume":"101","author":"Silverberg","year":"2020","journal-title":"Arch Phys Med Rehabil"},{"key":"R13-20260806","first-page":"169","article-title":"Neuropathology of head injuries","volume":"18","author":"Gennarelli","year":"1998","journal-title":"Semin Neurol"},{"key":"R14-20260806","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1097\/00001199-200307000-00003","article-title":"Diffuse axonal injury in head trauma","volume":"18","author":"Smith","year":"2003","journal-title":"J Head Trauma Rehabil"},{"issue":"Suppl 4","key":"R15-20260806","doi-asserted-by":"crossref","first-page":"S24","DOI":"10.1227\/NEU.0000000000000505","article-title":"The new neurometabolic cascade of concussion","volume":"75","author":"Giza","year":"2014","journal-title":"Neurosurgery"},{"key":"R16-20260806","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1007\/s11682-011-9145-0","article-title":"Neuropathology of mild traumatic brain injury: Relationship to neuroimaging findings","volume":"6","author":"Bigler","year":"2012","journal-title":"Brain Imaging Behav"},{"key":"R17-20260806","doi-asserted-by":"crossref","first-page":"1300","DOI":"10.1212\/WNL.53.6.1300","article-title":"Brain activation during working memory 1 month after mild traumatic brain injury: A functional MRI study","volume":"53","author":"McAllister","year":"1999","journal-title":"Neurology"},{"key":"R18-20260806","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1089\/neu.2007.0241","article-title":"Diffusion tensor imaging detects clinically important axonal damage after mild traumatic brain injury: A pilot study","volume":"24","author":"Bazarian","year":"2007","journal-title":"J Neurotrauma"},{"key":"R19-20260806","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1016\/j.annemergmed.2008.08.021","article-title":"Clinical policy: Neuroimaging and decisionmaking in adult mild traumatic brain injury in the acute setting","volume":"52","author":"Jagoda","year":"2008","journal-title":"Ann Emerg Med"},{"key":"R20-20260806","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1136\/bjsm.2005.018614","article-title":"Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004","volume":"39","author":"McCrory","year":"2005","journal-title":"Br J Sports Med"},{"key":"R21-20260806","doi-asserted-by":"crossref","first-page":"e70312","DOI":"10.1002\/hsr2.70312","article-title":"The Impact of Artificial Intelligence on Healthcare: A Comprehensive Review of Advancements in Diagnostics, Treatment, and Operational Efficiency","volume":"8","author":"Faiyazuddin","year":"2025","journal-title":"Health Sci Rep"},{"key":"R22-20260806","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1212\/WNL.30.7.683","article-title":"Seizures after head trauma: A population study","volume":"30","author":"Annegers","year":"1980","journal-title":"Neurology"},{"key":"R23-20260806","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1227\/00006123-199009000-00014","article-title":"Mild head injury classification","volume":"27","author":"Williams","year":"1990","journal-title":"Neurosurgery"},{"key":"R24-20260806","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0140-6736(00)04561-X","article-title":"The Canadian CT head rule for patients with minor head injury","volume":"357","author":"Stiell","year":"2001","journal-title":"Lancet"},{"key":"R25-20260806","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1056\/NEJM200007133430204","article-title":"Indications for computed tomography in patients with minor head injury","volume":"343","author":"Haydel","year":"2000","journal-title":"N Engl J Med"},{"key":"R26-20260806","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/S1474-4422(18)30231-X","article-title":"Serum GFAP and UCH-L1 for prediction of absence of intracranial injuries on head CT (ALERT-TBI): A multicentre observational study","volume":"17","author":"Bazarian","year":"2018","journal-title":"Lancet Neurol"},{"key":"R27-20260806","doi-asserted-by":"crossref","first-page":"1437","DOI":"10.1007\/s40279-017-0707-1","article-title":"A national study on the effects of concussion in collegiate athletes and US military service academy members: The NCAA-DoD Concussion Assessment, Research and Education (CARE) consortium structure and methods","volume":"47","author":"Broglio","year":"2017","journal-title":"Sports Med"},{"key":"R28-20260806","doi-asserted-by":"crossref","first-page":"e1780","DOI":"10.1212\/WNL.0000000000005518","article-title":"Neurofilament light and tau as blood biomarkers for sports-related concussion","volume":"90","author":"Shahim","year":"2018","journal-title":"Neurology"},{"key":"R29-20260806","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1001\/jamaneurol.2014.367","article-title":"Blood biomarkers for brain injury in concussed professional ice hockey players","volume":"71","author":"Shahim","year":"2014","journal-title":"JAMA Neurol"},{"key":"R30-20260806","first-page":"1123","article-title":"Systematic review and meta-analysis of biomarkers for mild traumatic brain injury","volume":"39","author":"Li","year":"2022","journal-title":"J Neurotrauma"},{"key":"R31-20260806","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1586\/erm.10.104","article-title":"Blood-based diagnostics of traumatic brain injuries","volume":"11","author":"Mondello","year":"2011","journal-title":"Expert Rev Mol Diagn"},{"key":"R32-20260806","doi-asserted-by":"crossref","first-page":"2091","DOI":"10.1056\/NEJMoa1008069","article-title":"Detection of blast-related traumatic brain injury in U.S. military personnel","volume":"364","author":"Mac Donald","year":"2011","journal-title":"N Engl J Med"},{"key":"R33-20260806","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1007\/s00234-004-1227-x","article-title":"Abnormalities on magnetic resonance imaging seen acutely following mild traumatic brain injury: correlation with neuropsychological tests and delayed recovery","volume":"46","author":"Hughes","year":"2004","journal-title":"Neuroradiology"},{"key":"R34-20260806","first-page":"2201","article-title":"Diffusion tensor imaging changes following mild, moderate and severe adult traumatic brain injury: A meta-analysis","volume":"15","author":"Wallace","year":"2021","journal-title":"Brain Imaging Behav"},{"key":"R35-20260806","doi-asserted-by":"crossref","first-page":"e1980","DOI":"10.1212\/WNL.0000000000008523","article-title":"Mapping brain recovery after concussion: From acute injury to 1 year after medical clearance","volume":"93","author":"Churchill","year":"2019","journal-title":"Neurology"},{"key":"R36-20260806","doi-asserted-by":"crossref","first-page":"686","DOI":"10.1007\/s13311-021-01027-4","article-title":"The Use, Standardization, and Interpretation of Brain Imaging Data in Clinical Trials of Neurodegenerative Disorders","volume":"18","author":"Schwarz","year":"2021","journal-title":"Neurotherapeutics"},{"key":"R37-20260806","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1089\/neu.2012.2439","article-title":"Biomarkers for the Diagnosis and Prognosis of Mild Traumatic Brain Injury\/Concussion","volume":"30","author":"Jeter","year":"2013","journal-title":"J Neurotrauma"},{"key":"R38-20260806","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1212\/WNL.48.3.586","article-title":"Standardized assessment of concussion in football players","volume":"48","author":"McCrea","year":"1997","journal-title":"Neurology"},{"key":"R39-20260806","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1136\/bjsports-2017-097506","article-title":"The Sport Concussion Assessment Tool 5th edition (SCAT5): Background and rationale","volume":"51","author":"Echemendia","year":"2017","journal-title":"Br J Sports Med"},{"key":"R40-20260806","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.3389\/fneur.2018.01113","article-title":"A multidimensional approach to post-concussion symptoms in mild traumatic brain injury","volume":"9","author":"Polinder","year":"2018","journal-title":"Front Neurol"},{"key":"R41-20260806","doi-asserted-by":"crossref","first-page":"569","DOI":"10.5694\/j.1326-5377.1986.tb112311.x","article-title":"Preliminary validation of a clinical scale for measuring the duration of post-traumatic amnesia","volume":"144","author":"Shores","year":"1986","journal-title":"Med J Aust"},{"key":"R42-20260806","first-page":"943","article-title":"The association between sport-related concussion and subsequent lower extremity musculoskeletal injuries in collegiate athletes","volume":"48","author":"Gardner","year":"2018","journal-title":"Sports Med"},{"key":"R43-20260806","first-page":"262","article-title":"Cognitive rehabilitation for military service members with mild traumatic brain injury: A randomized clinical trial","volume":"36","author":"Cooper","year":"2021","journal-title":"J Head Trauma Rehabil"},{"key":"R44-20260806","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/s00134-015-4124-3","article-title":"The reliability of the Glasgow Coma Scale: A systematic review","volume":"42","author":"Reith","year":"2016","journal-title":"Intensive Care Med"},{"key":"R45-20260806","first-page":"1730","article-title":"Executive and social cognition performance in chronic traumatic brain injury: Association with neuroimaging parameters","volume":"12","author":"Mart\u00ednez-Pern\u00eda","year":"2018","journal-title":"Brain Imaging Behav"},{"key":"R46-20260806","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1001\/jamapediatrics.2018.4397","article-title":"Early subthreshold aerobic exercise for sport-related concussion: A randomized clinical trial","volume":"173","author":"Leddy","year":"2019","journal-title":"JAMA Pediatr"},{"key":"R47-20260806","first-page":"747","article-title":"The effect of physical exercise after a concussion: A systematic review and meta-analysis","volume":"48","author":"Lal","year":"2020","journal-title":"Am J Sports Med"},{"key":"R48-20260806","first-page":"442","article-title":"Can vestibular rehabilitation exercises help patients with concussion? A systematic review of efficacy, prescription and progression patterns","volume":"53","author":"Murray","year":"2019","journal-title":"Br J Sports Med"},{"key":"R49-20260806","first-page":"129","article-title":"Transcranial direct current stimulation in traumatic brain injury: A systematic review of current knowledge and future prospects","volume":"33","author":"Davidson","year":"2019","journal-title":"Brain Inj"},{"key":"R50-20260806","first-page":"255","article-title":"Amantadine for treatment of cognitive dysfunction in moderate to severe traumatic brain injury: A multicenter, placebo-controlled, randomized trial","volume":"37","author":"Richardson","year":"2022","journal-title":"J Head Trauma Rehabil"},{"key":"R51-20260806","doi-asserted-by":"crossref","first-page":"e1919771","DOI":"10.1001\/jamanetworkopen.2019.19771","article-title":"Association of blood biomarkers with acute sport-related concussion in collegiate athletes: Findings from the NCAA and department of defense CARE consortium","volume":"3","author":"McCrea","year":"2020","journal-title":"JAMA Netw Open"},{"key":"R52-20260806","first-page":"53","article-title":"Derivation and validation of a clinical risk score for persistent post-concussion symptoms among children with acute concussion in the ED","volume":"327","author":"Yeates","year":"2022","journal-title":"JAMA"},{"key":"R53-20260806","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1097\/HTR.0b013e3181e50ef1","article-title":"Prevalence, assessment, and treatment of mild traumatic brain injury and posttraumatic stress disorder: A systematic review of the evidence","volume":"26","author":"Carlson","year":"2011","journal-title":"J Head Trauma Rehabil"},{"key":"R54-20260806","doi-asserted-by":"crossref","first-page":"e2313568121","DOI":"10.1073\/pnas.2313568121","article-title":"Impact of repeated blast exposure on active-duty United States Special Operations Forces","volume":"121","author":"Gilmore","year":"2024","journal-title":"Proc Natl Acad Sci U S A"},{"key":"R55-20260806","first-page":"692","article-title":"A randomized controlled trial of an integrated treatment for military trauma","volume":"6","author":"Winter","year":"2018","journal-title":"Clin Psychol Sci"}],"container-title":["Brain Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_52_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:34:44Z","timestamp":1787067284000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/bc.bc_52_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,9]]},"references-count":53,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/bc.bc_52_25","relation":{},"ISSN":["2394-8108","2455-4626"],"issn-type":[{"value":"2394-8108","type":"print"},{"value":"2455-4626","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,9]]},"assertion":[{"value":"2025-03-25","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-18","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}