MRI scans of the brain are revealing subtle but measurable structural and functional changes in survivors of intimate partner violence, according to a new scoping review that maps, for the first time in a comprehensive way, how imaging research has approached this population of patients. The review, published in the open-access journal BMC Medical Imaging, brings together seventeen studies examining magnetic resonance brain imaging findings among survivors of intimate partner violence, a form of abuse that the World Health Organization recognises as a major global public health and human rights concern. The work was led by radiographer Nathaniel Awentiirin Angaag of the Holy Family Catholic Polyclinic in Ghana’s Savannah Region, together with colleagues at institutions in Ghana and Australia, and its conclusions carry significant implications for radiology practice, clinical research and the care of millions of people worldwide who survive abuse at the hands of an intimate partner.
Intimate partner violence, commonly abbreviated IPV, encompasses physical, sexual and psychological abuse directed at a current or former partner. Among its most under-recognised physical consequences are repeated head trauma and strangulation, both of which can cause traumatic brain injury, a condition already associated with long-term neurological and cognitive impairment in athletes, military personnel and accident victims. Yet survivors of IPV have historically been invisible in the brain injury literature, and clinicians have lacked a systematic understanding of what neuroimaging can and cannot detect in this group. Computed tomography is often the first-line investigation in emergency settings, but magnetic resonance imaging is considered the gold standard for detecting subtle brain abnormalities, precisely the kind of diffuse, small-scale damage that repeated low-velocity impacts and mechanical strangulation are expected to produce. The new review set out to map the existing evidence base on MRI findings among IPV survivors and to identify gaps that must be filled before imaging can become a routine part of their clinical care.
To construct this map, the research team conducted a scoping review following the well-established framework of Arksey and O’Malley, a methodology designed to chart the breadth of literature on a topic rather than to pool effect sizes statistically. The authors searched PubMed and Scopus, two of the largest biomedical and multidisciplinary databases, and supplemented these searches with snowballing on Google Scholar, a technique in which the reference lists of retrieved articles are mined for additional relevant studies. A structured data extraction table developed in Microsoft Word was used to record key information systematically from each eligible study. Seventeen studies ultimately met the inclusion criteria. In line with scoping review best practice, the authors reported their process according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, known as PRISMA-ScR, and framed their research question using the Population, Concept and Context framework.
One of the most telling findings of the review concerns the technical composition of the studies themselves. Most of the included research relied on high-resolution T1-weighted magnetic resonance imaging, the workhorse structural sequence that provides excellent contrast between grey matter, white matter and cerebrospinal fluid and allows precise measurement of cortical thickness and regional brain volumes. These structural scans were often complemented by functional magnetic resonance imaging, which tracks changes in blood oxygenation to infer neural activity, and by diffusion tensor imaging, a diffusion-sensitive technique that measures the directional movement of water molecules along white matter fibres and thereby probes the integrity of the brain’s connective wiring. This pattern, the authors note, indicates a predominance of structural and connectivity-focused protocols, with limited use of MRI sequences that are sensitive to vascular and metabolic changes. Techniques such as susceptibility-weighted imaging, which is particularly good at detecting microbleeds from traumatic injury, magnetic resonance angiography, which visualises blood vessels, and proton magnetic resonance spectroscopy, which measures brain metabolites, were rare in the literature, leaving significant blind spots in how IPV-related brain injury has been characterised.
Despite the heterogeneity of the seventeen studies, the review identified four recurring themes: structural brain alterations, functional brain network alterations, neuroimaging correlations with psychological trauma and post-traumatic stress disorder, and cognitive and behavioural correlates of the observed brain changes. Within the first theme, preliminary evidence suggests potential associations between IPV exposure and cortical thinning, a reduction in grey matter volume, and microstructural alterations in white matter. These are not the dramatic haematomas or contusions that a radiologist might see after a single high-impact accident. Instead, they are diffuse, distributed changes that emerge from analyses of large imaging datasets and that mirror patterns reported in other populations exposed to repeated head trauma or chronic stress. Reduced fractional anisotropy on diffusion tensor imaging, a marker of less organised white matter microstructure, and altered mean diffusivity were among the diffusion-based measures linked to abuse exposure in the reviewed literature.
The functional imaging findings are equally striking. Studies using blood-oxygen-level-dependent functional MRI reported limbic hyperactivation, meaning exaggerated activity in the emotional processing circuits of the brain that include the amygdala and related structures. Survivors also showed disrupted salience network connectivity, the network anchored by the anterior insula and anterior cingulate cortex that helps the brain decide which stimuli deserve attention, and dysregulation of the default mode network, the set of regions, including the medial prefrontal cortex and posterior cingulate, that is most active during rest and self-referential thought. Disturbances in these three networks are a recurring signature in trauma-related neuropsychiatric conditions, and their appearance in IPV survivors aligns the neuroimaging literature on abuse with a broader body of work on stress, fear conditioning and post-traumatic stress disorder. Several studies in the review explicitly linked these functional alterations to PTSD symptoms and psychological trauma burden, providing a biological correlate for experiences that survivors have long described.
The review also documented cognitive and behavioural consequences tied to the imaging findings. Structural and functional alterations, particularly cortical thinning and white matter changes, were associated with deficits in cognition among survivors, touching domains such as memory, attention and executive function that are essential to daily life, employment and parenting. The authors emphasise that these associations remain preliminary; the evidence base is small, cross-sectional and dominated by studies conducted in high-income settings. Crucially, none of the included work came from low- and middle-income countries, despite the fact that the burden of intimate partner violence is disproportionately high in such settings. The review’s authorship, drawn largely from Ghanaian institutions and including radiographers, radiologists and public health researchers, highlights this inequity directly, arguing that multisite and longitudinal studies across diverse populations are needed to strengthen understanding and ensure that findings generalise beyond Western, well-resourced cohorts.
The methodological limitations the authors catalogue are themselves a form of news for the field. Because the seventeen studies used different MRI protocols, field strengths, sequence parameters and analysis pipelines, their findings cannot be easily compared or synthesised quantitatively. The absence of standardised, multimodal imaging protocols means that subtle abnormalities detectable with one combination of sequences might be missed entirely with another. The authors call for research that combines structural T1-weighted imaging with T2-weighted fluid-attenuated inversion recovery, susceptibility-weighted imaging, diffusion imaging, functional MRI and spectroscopy in a single protocol, and for longitudinal designs that image survivors over time to distinguish pre-existing differences, acute injury effects and chronic maladaptive changes. Such studies would also help determine whether imaging findings predict clinical outcomes, guide rehabilitation, or resolve after safety and recovery, questions that current evidence cannot answer.
For radiologists and radiographers, the practical message is that intimate partner violence should be treated as a recognized mechanism of traumatic brain injury, worthy of informed imaging interpretation. Patients may present with nonspecific symptoms such as headache, dizziness, memory complaints or mood changes, and the medical history may not immediately disclose abuse. The review argues for IPV-informed imaging practices, in which clinicians are aware of the mechanisms of injury in abusive relationships, including strangulation, and understand which sequences are most likely to reveal relevant pathology. Radiology departments, as sites where survivors may first interact with the health system in an investigative context, are also well positioned to support screening, documentation and referral, and the authors suggest that imaging practice and research should be designed with the safety, privacy and trauma history of survivors in mind.
The broader significance of the review lies in its reframing of intimate partner violence as not only a social and legal crisis but also a neurological one. By consolidating the existing MRI evidence, the authors give clinicians and researchers a starting map of what is known, what is suspected and what remains unknown about the brains of survivors. Their conclusion is measured but clear: survivors of IPV show structural and functional brain alterations, including cortical thinning, white matter changes and disrupted network connectivity, which are associated with cognitive deficits. Closing the gaps they identify, through standardised protocols, longitudinal and multisite studies and inclusion of populations in low- and middle-income countries, could ultimately transform MRI from a research tool into a clinical instrument that validates survivors’ experiences, informs their treatment and shapes rehabilitation after abuse. The study, which received no specific funding and was published open access under a Creative Commons licence, is citable now with a permanent DOI, with the final version of record to follow.
Subject of Research: Magnetic resonance brain imaging findings in survivors of intimate partner violence
Subject of Research: Medicine
Article Title: Magnetic resonance brain imaging in survivors of intimate partner violence: a scoping review and implications for radiology practice and research
Article References: Angaag, N. A., Ago, J. L., Acquah, G., Tigbee, I., Korsah, S., Takyi, A. O., & Amesawu, E. (2026). Magnetic resonance brain imaging in survivors of intimate partner violence: a scoping review and implications for radiology practice and research. BMC Medical Imaging. https://doi.org/10.1186/s12880-026-02744-y
Image Credits: AI Generated
DOI: 10.1186/s12880-026-02744-y
Keywords: Intimate partner violence, Brain imaging, Magnetic resonance imaging, Traumatic brain injury, Diffusion tensor imaging, Functional MRI, Cortical thinning, White matter alterations, Post-traumatic stress disorder, Radiology practice, Scoping review, Default mode network
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Cassandra Pierce. (September 9, 2026). Brain MRI findings in intimate partner violence survivors: a scoping review. Scienmag. https://scienmag.com/brain-mri-findings-in-intimate-partner-violence-survivors-a-scoping-review/
Cassandra Pierce. “Brain MRI findings in intimate partner violence survivors: a scoping review.” Scienmag, 9 September 2026, https://scienmag.com/brain-mri-findings-in-intimate-partner-violence-survivors-a-scoping-review/. Accessed 9 September 2026.
Cassandra Pierce. “Brain MRI findings in intimate partner violence survivors: a scoping review.” Scienmag. September 9, 2026. https://scienmag.com/brain-mri-findings-in-intimate-partner-violence-survivors-a-scoping-review/
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