Functional magnetic resonance imaging technology and traumatic brain injury rehabilitation: Guidelines for methodological and conceptual pitfalls

Objectives: To illuminate the current methodological and conceptual pitfalls inherent in conducting functional magnetic resonance imaging (fMRI) research with individuals who have sustained traumatic brain injury (TBI) and to discuss appropriate remedies. The aim is describe fMRI research, its limitations, and how to best use this technology to examine TBI. Discussion: The topics discussed in this article include issues regarding signal detection, brain activation measurement, head movement, and sources of signal artifact. Issues surrounding data interpretation and the importance of analyzing the brain as a connected neural network is also discussed. Finally, problems with spatial normalization when examining individuals with TBI are reviewed. Conclusions: To date, there is a scarcity of research applying fMRI technology to the study of TBI. However, because it is a noninvasive procedure with high availability in hospital settings across the country, the next decade of TBI research will likely include a proliferation of this form of investigation. At this time, much work is needed to better understand how to optimally use this technology to examine the effects of TBI on behavior. For fMRI to enhance TBI research it will be imperative to establish valid research protocols and reliable methods of data interpretation.