biostudies-literatureUnknown17Charney MF<h4>Background</h4>Traumatic Brain Injury (TBI) is a pervasive and important public health concern. TBI can range from mild, resulting in headaches and other neurologic symptoms, to severe resulting in coma and death. Diffusion tensor imaging (DTI) offers the ability to assess tissue microstructure at a level inaccessible to classical neuroimaging methods, such as CT and structural MRI. This systematic review aims to explore studies using DTI in moderate-severe TBI (msTBI) during the 2012-2022 decade, which is the second decade of reported use. The use of DTI in mild TBI during this time period is discussed in our companion systematic review.<h4>Methods</h4>A systematic literature review was conducted by a medical librarian in accordance with the Preferred Reporting Items for Systematic ReFrontiers in neurology1734550https://www.ebi.ac.uk/biostudies/studies/S-EPMC12920199biostudies-literatureThe second decade of DTI in TBI Part 2: a systematic review of moderate and severe TBI.PMC12920199Morris BRashid FDarby TDong YBrain SKentis SOrtega JOkada CAlexander MGlajchen SCharney MFDelbourgo Patton CYao ADZhou CWee JLipton MLHunt EDev AForkan TfalseThe second decade of DTI in TBI Part 2: a systematic review of moderate and severe TBI.<h4>Background</h4>Traumatic Brain Injury (TBI) is a pervasive and important public health concern. TBI can range from mild, resulting in headaches and other neurologic symptoms, to severe resulting in coma and death. Diffusion tensor imaging (DTI) offers the ability to assess tissue microstructure at a level inaccessible to classical neuroimaging methods, such as CT and structural MRI. This systematic review aims to explore studies using DTI in moderate-severe TBI (msTBI) during the 2012-2022 decade, which is the second decade of reported use. The use of DTI in mild TBI during this time period is discussed in our companion systematic review.<h4>Methods</h4>A systematic literature review was conducted by a medical librarian in accordance with the Preferred Reporting Items for Systematic Re2026-01-01T00:00:00Z20262026-07-09T12:14:35.813Z2026-07-09T11:11:16.865ZS-EPMC129201994172573010.3389/fneur.2026.1734550