Coordinating Global Multi-Site Studies of Military-Relevant Traumatic Brain Injury: Opportunities, Challenges, and Harmonization Guidelines

David F. Tate, Emily L. Dennis, John T. Adams, Maheen M. Adamson, Heather G. Belanger, Erin D. Bigler, Heather C. Bouchard, Alexandra L. Clark, Lisa M. Delano-Wood, Seth G. Disner, Blessen C. Eapen, Carol E. Franz, Elbert Geuze, Naomi J. Goodrich-Hunsaker, Kihwan Han, Jasmeet P. Hayes, Sidney R. Hinds, Cooper B. Hodges, Elizabeth S. Hovenden, Andrei IrimiaKimbra Kenney, Inga K. Koerte, William S. Kremen, Harvey S. Levin, Hannah M. Lindsey, Rajendra A. Morey, Mary R. Newsome, John Ollinger, Mary Jo Pugh, Randall S. Scheibel, Martha E. Shenton, Danielle R. Sullivan, Brian A. Taylor, Maya Troyanskaya, Carmen Velez, Benjamin Sc Wade, Xin Wang, Ashley L. Ware, Ross Zafonte, Paul M. Thompson, Elisabeth A. Wilde

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Traumatic brain injury (TBI) is common among military personnel and the civilian population and is often followed by a heterogeneous array of clinical, cognitive, behavioral, mood, and neuroimaging changes. Unlike many neurological disorders that have a characteristic abnormal central neurologic area(s) of abnormality pathognomonic to the disorder, a sufficient head impact may cause focal, multifocal, diffuse or combination of injury to the brain. This inconsistent presentation makes it difficult to establish or validate biological and imaging markers that could help improve diagnostic and prognostic accuracy in this patient population. The purpose of this manuscript is to describe both the challenges and opportunities when conducting military-relevant TBI research and introduce the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Military Brain Injury working group. ENIGMA is a worldwide consortium focused on improving replicability and analytical power through data sharing and collaboration. In this paper, we discuss challenges affecting efforts to aggregate data in this patient group. In addition, we highlight how “big data” approaches might be used to understand better the role that each of these variables might play in the imaging and functional phenotypes of TBI in Service member and Veteran populations, and how data may be used to examine important military specific issues such as return to duty, the late effects of combat-related injury, and alteration of the natural aging processes.

Original languageEnglish (US)
Pages (from-to)585-613
Number of pages29
JournalBrain Imaging and Behavior
Issue number2
StatePublished - Apr 2021
Externally publishedYes


  • TBI
  • blast injury
  • military
  • traumatic brain injury
  • veteran

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Neurology
  • Clinical Neurology
  • Cognitive Neuroscience
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health
  • Behavioral Neuroscience


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