Objective To investigate the correlation between MRI changes of prefrontal cortex microstructure and cognitive function impairment in patients with brain injury.Methods A total of 120 patients with brain injury treated from March 2020 to March 2022 were selected and divided into injury group(n =60)and non-injury group(n =60)according to cognitive function impairment.Another 60 healthy subjects undergoing physical examination were selected as control group.The scores of all dimensions and total scores of the Montreal Cognitive Assessment Scale(MoCA)were compared among the three groups,and the changes of prefrontal cortex microstructure[diffusion anisotropy score(FA),mean diffusion rate(MD),axial diffusion kurtosis(AK),mean diffusion kurtosis(MK),radial diffusion kurtosis(RK)]in patients with or without cognitive function impairment and different injury degrees were compared.The correlation between MRI change of pre-frontal cortex microstructure and the degree of cognitive function impairment was analyzed.Results Visual space and execu-tive function,attention and computing power,language function,abstract ability,delayed memory domain scores and total MoCA scores of the injury group were lower than those of the non-injury group and the control group(P<0.01).The FA,AK and MK on the right side of anterior and paracingulate gyrus in injury group were lower than those in non-injury group(P<0.01).The FA,AK and MK on the right side of anterior and paracingulate gyrus in patients with mild cognitive impairment were higher than those in patients with moderate and severe cognitive impairment(P<0.01).The FA,AK and MK on the right side were negatively correlated with the degree of cognitive function impairment(P<0.01).Conclusion MRI changes of the prefrontal cortex microstructure in patients with brain injury can be used for early assessment of cognitive function im-pairment,providing evidence for clinical assessment of cognitive function impairment in patients with brain injury,which is conductive to carrying out targeted follow-up treatment and improving prognosis.