Meta-Analysis

. 2021 Apr;15(2):585-613.

doi: 10.1007/s11682-020-00423-2. Epub 2021 Jan 7.

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

David F Tate^{1

2}, Emily L Dennis^{3

4

5}, John T Adams⁶, Maheen M Adamson^{7

8}, Heather G Belanger^{9

10

11

12}, Erin D Bigler^{3

13

14}, Heather C Bouchard¹⁵, Alexandra L Clark^{16

17}, Lisa M Delano-Wood^{16

17

18}, Seth G Disner^{19

20}, Blessen C Eapen^{21

22}, Carol E Franz^{17

23}, Elbert Geuze^{24

25}, Naomi J Goodrich-Hunsaker^{3

4

13}, Kihwan Han²⁶, Jasmeet P Hayes^{27

28}, Sidney R Hinds 2nd^{29

30}, Cooper B Hodges^{3

4

13}, Elizabeth S Hovenden³, Andrei Irimia^{31

32}, Kimbra Kenney^{30

33}, Inga K Koerte^{34

35}, William S Kremen^{17

18

23}, Harvey S Levin^{36

37}, Hannah M Lindsey^{3

4

13}, Rajendra A Morey^{15

38}, Mary R Newsome^{36

37}, John Ollinger³³, Mary Jo Pugh^{39

40}, Randall S Scheibel^{36

37}, Martha E Shenton^{34

41}, Danielle R Sullivan^{42

43}, Brian A Taylor^{44

45}, Maya Troyanskaya^{36

37}, Carmen Velez^{3

4}, Benjamin Sc Wade^{3

46}, Xin Wang⁴⁷, Ashley L Ware⁴⁸, Ross Zafonte^{49

50}, Paul M Thompson^{5

51

52

53

54

55

56}, Elisabeth A Wilde^{3

4

36}

Affiliations

¹ Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA. david.tate@hsc.utah.edu.
² George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA. david.tate@hsc.utah.edu.
³ Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁴ George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
⁵ Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA.
⁶ Western University of Health Sciences, Pomona, CA, USA.
⁷ Defense and Veterans Brain Injury Center, VA Palo Alto, Palo Alto, CA, USA.
⁸ Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.
⁹ United States Special Operations Command (USSOCOM), Tampa, FL, USA.
¹⁰ Department of Psychology, University of South Florida, Tampa, FL, USA.
¹¹ Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA.
¹² St Michaels Inc, Tampa, FL, USA.
¹³ Department of Psychology, Brigham Young University, Provo, UT, USA.
¹⁴ Neuroscience Center, Brigham Young University, Provo, UT, USA.
¹⁵ Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
¹⁶ VA San Diego Healthcare System, San Diego, CA, USA.
¹⁷ Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
¹⁸ Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.
¹⁹ Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.
²⁰ Minneapolis VA Health Care System, Minneapolis, MN, USA.
²¹ Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA.
²² Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
²³ Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA.
²⁴ University Medical Center Utrecht, Utrecht, Netherlands.
²⁵ Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands.
²⁶ School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA.
²⁷ Psychology Department, The Ohio State University, Columbus, OH, USA.
²⁸ Chronic Brain Injury Program, The Ohio State University, Columbus, OH, USA.
²⁹ Department of Defense/United States Army Medical Research and Materiel Command, Fort Detrick, Frederick, MD, USA.
³⁰ Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
³¹ Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
³² Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
³³ National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.
³⁴ Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA.
³⁵ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.
³⁶ H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
³⁷ Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
³⁸ Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
³⁹ Information Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City, Salt Lake City, UT, USA.
⁴⁰ Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁴¹ Brockton Division, VA Boston Healthcare System, Brockton, MA, USA.
⁴² National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
⁴³ Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
⁴⁴ Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
⁴⁵ C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA.
⁴⁶ Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA.
⁴⁷ Department of Psychiatry, University of Toledo, Toledo, OH, USA.
⁴⁸ Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
⁴⁹ Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital/Brigham & Women's Hospital, Boston, MA, USA.
⁵⁰ Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.
⁵¹ Department of Neurology, USC, Los Angeles, CA, USA.
⁵² Department of Pediatrics, USC, Los Angeles, CA, USA.
⁵³ Department of Psychiatry, USC, Los Angeles, CA, USA.
⁵⁴ Department of Radiology, USC, Los Angeles, CA, USA.
⁵⁵ Department of Engineering, USC, Los Angeles, CA, USA.
⁵⁶ Department of Ophthalmology, USC, Los Angeles, CA, USA.

PMID: 33409819
PMCID: PMC8035292
DOI: 10.1007/s11682-020-00423-2

Meta-Analysis

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

David F Tate et al. Brain Imaging Behav. 2021 Apr.

. 2021 Apr;15(2):585-613.

doi: 10.1007/s11682-020-00423-2. Epub 2021 Jan 7.

Authors

Affiliations

¹ Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA. david.tate@hsc.utah.edu.
² George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA. david.tate@hsc.utah.edu.
³ Department of Neurology, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁴ George E. Wahlen Veterans Affairs Medical Center, Salt Lake City, UT, USA.
⁵ Imaging Genetics Center, Stevens Neuroimaging & Informatics Institute, Keck School of Medicine of USC, Marina del Rey, Los Angeles, CA, USA.
⁶ Western University of Health Sciences, Pomona, CA, USA.
⁷ Defense and Veterans Brain Injury Center, VA Palo Alto, Palo Alto, CA, USA.
⁸ Neurosurgery, Stanford School of Medicine, Stanford, CA, USA.
⁹ United States Special Operations Command (USSOCOM), Tampa, FL, USA.
¹⁰ Department of Psychology, University of South Florida, Tampa, FL, USA.
¹¹ Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa, FL, USA.
¹² St Michaels Inc, Tampa, FL, USA.
¹³ Department of Psychology, Brigham Young University, Provo, UT, USA.
¹⁴ Neuroscience Center, Brigham Young University, Provo, UT, USA.
¹⁵ Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA.
¹⁶ VA San Diego Healthcare System, San Diego, CA, USA.
¹⁷ Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
¹⁸ Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, La Jolla, CA, USA.
¹⁹ Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA.
²⁰ Minneapolis VA Health Care System, Minneapolis, MN, USA.
²¹ Department of Physical Medicine and Rehabilitation, VA Greater Los Angeles Health Care System, Los Angeles, CA, USA.
²² Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
²³ Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA.
²⁴ University Medical Center Utrecht, Utrecht, Netherlands.
²⁵ Brain Research and Innovation Centre, Ministry of Defence, Utrecht, The Netherlands.
²⁶ School of Behavioral and Brain Sciences, University of Texas at Dallas, Dallas, TX, USA.
²⁷ Psychology Department, The Ohio State University, Columbus, OH, USA.
²⁸ Chronic Brain Injury Program, The Ohio State University, Columbus, OH, USA.
²⁹ Department of Defense/United States Army Medical Research and Materiel Command, Fort Detrick, Frederick, MD, USA.
³⁰ Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
³¹ Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
³² Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA.
³³ National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.
³⁴ Psychiatry Neuroimaging Laboratory, Brigham and Women's Hospital, Boston, MA, USA.
³⁵ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Ludwig-Maximilians-Universität, Munich, Germany.
³⁶ H. Ben Taub Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
³⁷ Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.
³⁸ Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
³⁹ Information Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City, Salt Lake City, UT, USA.
⁴⁰ Department of Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
⁴¹ Brockton Division, VA Boston Healthcare System, Brockton, MA, USA.
⁴² National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
⁴³ Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
⁴⁴ Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
⁴⁵ C. Kenneth and Dianne Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA.
⁴⁶ Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA.
⁴⁷ Department of Psychiatry, University of Toledo, Toledo, OH, USA.
⁴⁸ Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
⁴⁹ Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital/Brigham & Women's Hospital, Boston, MA, USA.
⁵⁰ Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.
⁵¹ Department of Neurology, USC, Los Angeles, CA, USA.
⁵² Department of Pediatrics, USC, Los Angeles, CA, USA.
⁵³ Department of Psychiatry, USC, Los Angeles, CA, USA.
⁵⁴ Department of Radiology, USC, Los Angeles, CA, USA.
⁵⁵ Department of Engineering, USC, Los Angeles, CA, USA.
⁵⁶ Department of Ophthalmology, USC, Los Angeles, CA, USA.

PMID: 33409819
PMCID: PMC8035292
DOI: 10.1007/s11682-020-00423-2

Abstract

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.

Keywords: ENIGMA; TBI; blast injury; military; traumatic brain injury; veteran.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest

Dr. Adamson is on the scientific advisory board for TruGenomics, a start-up developing a biomarker for PTSD. Dr. Zafonte received royalties from 1) Oakstone for an educational CD- Physical Medicine and Rehabilitation a Comprehensive Review; 2) Demos publishing for serving as co-editor of the text Brain Injury Medicine. Dr. Zafonte also serves on the Scientific Advisory Board of Myomo, Oxeia Biopharma, Biodirection and ElMINDA. He also evaluates patients in the MGH Brain and Body-TRUST Program which is funded by the NFL Players Association. The views expressed in this article are those of the author(s) and do not reflect the official policy of the Department of Army/Navy/Air Force, Department of Defense, Department of Veterans Affairs, or the U.S. Government.

Figures

**Figure 1.**
Overlap between TBI, PTSD, and Major Depression in symptoms and reported imaging differences. Imaging differences are shown across modalities, including structure, function, and connectivity.

See this image and copyright information in PMC

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

Affiliations

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

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