A landmark University of Alabama at Birmingham study, published in the American Journal of Roentgenology [radiology] in May 2025, and noted by UAB News on September 17, 2025, shows that “White matter hyperintensities [are] no longer a reliable way to diagnose mild traumatic brain injury”. Challenging a diagnostic method used for over three decades, the study found that white matter hyperintensities (WMH)—bright spots visible on brain MRI scans—appear equally in patients with mild traumatic brain injury and healthy individuals, undermining their diagnostic value.

Since the 1990s, WMH have been used to detect subtle brain damage invisible in standard imaging. The 1993 study A semiquantative rating scale for the assessment of signal hyperintensities on magnetic resonance imaging found on the NIH database, established the credibility of WMH by correlating these MRI findings with actual brain tissue damage, including demyelination and axonal degeneration. This finding has been largely accepted in the medical field, as shown by various studies since, many of which reported by the NIH, and made WMH attractive for diagnosing concussions when conventional scans appear normal.

However, medical professionals increasingly questioned the approach. New clinical reports show that WMH lack specificity—appearing not only from trauma, but also from normal aging, silent strokes, multiple sclerosis, and vascular disease. The UAB study confirmed these concerns: 34% of brain injury patients showed WMH compared to 35% of controls, with no correlation between WMH presence and symptom severity or recovery outcomes. Lead researcher Dr. Manoj Tanwar concludes that WMH alone is not enough for a diagnosis and comprehensive clinical assessment remains essential beyond imaging.