A central challenge in neuroscience is to understand how brain structure relates to cognitive function. Advances in imaging, including magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI), combined with digital cognitive testing (NeuroTrax) are helping to clarify these relationships in clinical contexts like multiple sclerosis (MS) and normal aging.

One study investigated whether MRI-derived brain volumes were associated with cognitive performance in people with MS [1]. Using NeuroTrax’s cognitive testing platform, researchers assessed nine domains, including memory, executive function, and processing speed. Significant correlations were observed between global cognitive scores and whole brain, white matter, gray matter, thalamic, hippocampal, and lesion volumes. Thalamic and lateral ventricular volumes were the strongest predictors of performance across domains, highlighting the thalamus as a key hub for cognitive integrity in MS.

Research in healthy aging populations has provided further insights into how brain microstructure supports cognition [2]. Results showed a domain-specific pattern: executive function was linked to frontal white matter and the superior longitudinal fasciculus (SLF); processing speed correlated with the cingulum, corona radiata, inferior longitudinal fasciculus (ILF), parietal white matter, and thalamus; and memory was associated with temporal and frontal regions, including the cingulate cortex and parahippocampus.

A follow-up study extended these findings with tractography of temporal lobe projections [3]. Executive function performance was tied to DTI parameters in the SLF and uncinate fasciculus (UF), while processing speed was related to integrity in the cingulum, fornix, ILF, and SLF. Memory performance showed strong associations with the fornix, cingulum, ILF, SLF, and UF. Taken together, these results illustrate how distinct white matter pathways underpin different aspects of cognition.

By combining NeuroTrax with MRI and DTI, researchers are able to link specific cognitive domains to measurable brain structures and tracts. This linkage underscores the value of digital cognitive testing for detecting subtle changes, validating neuroimaging findings, and potentially guiding targeted interventions in both clinical and aging populations.

Contact us today to learn how NeuroTrax supports clinical and research applications in brain health.

References:

[1] Golan, D., Doniger, G.M., Srinivasan, J., Sima, D.M., Zarif, M., Bumstead, B., Buhse, M., Van Hecke, W., Wilken, J., and Gudesblatt, M. (2020). The association between MRI brain volumes and computerized cognitive scores of people with multiple sclerosis. Brain and Cognition, 145: 105614. PMID: 32927305

[2] Sasson, E., Doniger, G.M., Pasternak, O., Tarrasch, R., and Assaf, Y. (2012). Structural correlates of cognitive domains in normal aging with diffusion tensor imaging. Brain Structure and Function, 217, 503–515. PMID: 21909706

[3] Sasson, E., Doniger, G.M., Pasternak, O., Tarrasch, R., and Assaf, Y. (2013). White matter correlates of cognitive domains in normal aging with diffusion tensor imaging. Frontiers in Neuroscience, 7:32. PMID: 23493587

Traumatic brain injury (TBI) can cause subtle cognitive deficits that are often challenging to detect with imaging alone. While MRI reveals structural damage, it may not capture a comprehensive view of impairments. Combining advanced neuropsychological testing like NeuroTrax with MRI offers a comprehensive approach to assessment.

NeuroTrax is a clinically focused web-based testing platform for evaluating multiple domains (e.g., memory, attention, executive function, processing speed). Its standardized scores can reveal mild deficits, making it valuable in clinical and legal contexts. For example, a patient with mild TBI may show no obvious abnormalities on structural imaging, however NeuroTrax testing can reveal measurable declines in processing speed or executive function. These insights can validate patient symptoms, guide treatment planning, and provide objective evidence in litigation or compensation cases.

Additionally, embedded in the NeuroTrax platform is an algorithm to assess effort and detect negative response bias (NRB), which can distort testing results. Validated in TBI populations, this algorithm demonstrates high sensitivity (87.5%) and specificity (98%), correctly classifying 94% of cases as genuine effort or malingered effort. This ensures the reliability of cognitive data, particularly in a litigation context.

MRI provides insight into brain structure and activity, but NeuroTrax can provide additional findings of deficits. Combining NeuroTrax’s quantitative assessment with MRI enhances diagnostic accuracy, especially in cases where structural imaging is inconclusive. NeuroTrax includes effort-validation tools that enhance the trustworthiness of cognitive results. This integrated approach guides targeted rehabilitation and provides robust evidence in medical-legal evaluations.

Ultimately, leveraging NeuroTrax's domain-specific tests alongside MRI offers a powerful, comprehensive method for assessing the complex effects of TBI, supporting clinical decision making enabling precise diagnosis and tailored intervention strategies.

Interested in how NeuroTrax can complement MRI to improve post-TBI assessment and rehabilitation? Contact us to learn more about integrating these tools into your practice.

References:

• Bar-Hen, M., Doniger, G.M., Golzad, M., Geva, N., and Schweiger, A. (2015). Journal of Clinical and Experimental Neuropsychology, 37, 1086–1097. PMID: 26327146
• Doniger, G.M., Simon, E.S., and Schweiger, A. (2008). Applied Neuropsychology, 15, 250–263. PMID: 19023742
• Silverberg, N.D., Iverson, G.L., and ACRM Brain Injury Special Interest Group Mild TBI Task Force members. (2023). Archives of Physical Medicine and Rehabilitation, 104, 1343–1355. PMID: 37211140

Fibromyalgia often involves central sensitization, cognitive fog, pain, and limited mobility, particularly challenging when symptoms are rooted in early-life trauma. However, a new case gives reason for optimism: a 62-year-old patient, with fibromyalgia persisting for over ten years and linked to childhood trauma, showed dramatic improvements following hyperbaric oxygen therapy (HBOT).

The HBOT protocol involved 60 sessions over 12 weeks (90 minutes per session at 2 ATA). Post-treatment outcomes were impressive:

• Pain and symptom metrics: FIQR dropped from 60.5 to 44; fibromyalgia criteria score decreased from 16 to 12.
• Medication reduction: Discontinuation of pregabalin and halving of duloxetine dosage.
• Mobility gains: Walking speed increased from 3.2 to 4.5 km/h, with better balance and coordination.
• Neurocognitive improvements: NeuroTrax computerized testing recorded a 10% improvement in global cognitive function and a 26.9% gain in attention, providing objective evidence of cognitive recovery in fibromyalgia.
• Brain imaging: SPECT and diffusion tensor imaging confirmed enhanced brain perfusion and white matter integrity, corroborating the clinical and cognitive outcomes.

This case not only highlights HBOT’s potential to promote neuroplasticity and functional recovery but also demonstrates the unique clinical value of NeuroTrax – its precision facilitated detection and quantification of cognitive changes that traditional assessments might miss. For clinicians managing complex, trauma-associated fibromyalgia, the combination of HBOT and NeuroTrax offers both a promising therapeutic avenue and a rigorous way to track recovery.

Larger studies are needed, but this case, with its rich multi-domain evaluations and NeuroTrax metrics, offers critical, clinician-friendly insights into effective treatment of fibromyalgia.

Contact us to find out more about how NeuroTrax can bring objective cognitive insights to your practice. 

Full text (open access):

https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-025-05453-2

Citation:

Mouzayan, G., Khairy, S., Wang, Z., Qureshi, U., Zaitoun, R., and Efrati, S. (2025). Efficacy of hyperbaric oxygen therapy in treating fibromyalgia linked to childhood trauma after late-onset and over a decade of symptoms: A case report. Journal of Medical Case Reports, 19:386. PMID: 40765001