Using Dynamic MRI to Advance Traumatic Brain Injury Research

Using dynamic MRI, Dr. Dzung Pham's research at USU's School of Medicine explores how skull acceleration during traumatic brain injuries (TBI) affects brain deformation and injury mechanisms, aiming to improve diagnosis, treatment, and protective gear design for TBI patients.

Researchers are using dynamic MRI to study brain movement during trauma,
advancing our understanding of traumatic brain injuries and improving prevention strategies.
(U.S. Navy photo by Mass Communication Specialist Seaman Luke Cunningham)

February 13, 2025 by Vivian Mason

According to the CDC, approximately 5.3 million people in the United States live with a traumatic brain injury (TBI)-related disability. TBIs often result from a violent jolt or impact to the head, commonly caused by vehicle accidents, falls, sports injuries, and combat trauma. These injuries can lead to long-term complications, neurological damage, or even death.

During a TBI, rapid skull acceleration deforms brain tissue, and the severity depends on factors such as impact force and injury type. Dr. Dzung Pham, professor and vice chair for research in the Department of Radiology and Bioengineering at the Uniformed Services University (USU) School of Medicine, is studying how skull acceleration leads to TBI damage.

“One of the projects that I’ve been involved with for about 12 years,” says Pham, “uses MRI to understand the mechanics of TBI. What I mean by mechanics is how the brain actually moves and deforms when a person gets a bump on the head or has some other type of exposure involving rapid acceleration of the head.”

Pham’s lab has developed specialized MRI-compatible devices that mimic mild head accelerations without causing injury. These tools allow researchers to observe brain movement in real-time using advanced neuroimaging techniques.

Magnetic resonance imaging (MRI scans) play a crucial role in diagnosing brain injuries. While traditional MRIs detect severe brain damage, newer imaging methods can identify subtle injuries, brain function changes, and concussion-related abnormalities. However, many TBI patients experience persistent symptoms even when standard MRIs show no abnormalities.

Because TBI treatment options are limited, researchers aim to uncover the mechanisms behind brain injuries. Key factors such as impact magnitude, frequency, and affected brain regions remain poorly understood. By analyzing brain deformation during acceleration, Pham’s lab identifies areas at higher risk of injury. This data is also used to refine computational models that simulate TBI scenarios, helping predict concussion risks and improve protective gear like helmets.

(a) Device to produce constrained mild rotational head acceleration (neck rotation).
The head is held firmly in a cradle, which rotates when the subject releases a latch
and then comes to a stop. (b) Diagram of head motion during neck rotation.
(c) Device to produce mild frontal-occipital head acceleration (neck extension).
(d) Diagram of head motion during neck extension. (e) Magnetic resonance
elastography uses a vibrating pillow to impart oscillating brain motion,
allowing measurement of stiffness and other properties. (Images courtesy of Dr.
Dzung Pham, USU)

Computer simulations provide critical insights into brain biomechanics. By simulating various skull acceleration patterns, researchers can better understand TBI risks across different impact scenarios.

“The good thing about these simulations,” explains Pham, “is that you can basically try to measure the deformation of the brain under many different kinds of loading conditions, accelerations to the brain, and various types of impacts. You select whatever exposure you want, and your simulation will tell you what will happen to the brain if an individual gets hit in a certain part of the head.” 

Pham stresses that these kinds of models need to be validated or calibrated by using real data to ensure that the simulation is working properly. Results of some of his research have been released publicly to support global TBI research and simulation development.

In addition to dynamic MRI, Pham’s team uses magnetic resonance elastography (MRE)—a noninvasive imaging technique that measures tissue stiffness. This method provides valuable insights into brain elasticity and TBI effects.

During MRE scans, participants rest their head on an air-filled pillow inside an MRI scanner. The device then generates controlled vibrations, sending waves through the brain. By analyzing these waves, researchers determine which brain regions are stiffer, potentially indicating injury or disease.

According to Pham, his lab has been trying to understand not only the motion of the brain, but also how it moves relative to the skull. “What we’ve found in a lot of TBI patients is that they have injury to the meninges,” says Pham. “These meninges form a physical attachment between the brain and the inner table of the skull.”

The Pham lab wants to use elastography to study meningeal injuries to determine if the meninges become stiffer from scarring after injury, which would make the coupling between the skull and brain tighter. This could make the brain more susceptible to injury. 

Interestingly, in second impact syndrome—a condition wherein an individual has had a concussion and is more likely to have a concussion in the future—may be related to injury to attachments between the skull and brain. Therefore, that affects how the brain responds to future accelerations.

Pham’s team is also developing brain phantoms, synthetic models replicating brain tissue, to refine MRI techniques. Their findings could enhance helmet designs, injury prevention strategies, and overall TBI treatment approaches.

“We’re always looking to push the research in ways that will hopefully lead to new insights in TBI,” says Pham.