Traumatic brain injury is a major cause of disability and can have major consequences for patients and their loved ones. Patients can suffer a range of physical, cognitive, behavioural and emotional problems.

People who fall and hit their head, or who are in traffic accidents or suffer other head injuries, often undergo an MRI if doctors suspect a brain injury. But it can be difficult to predict from an MRI exactly what kinds of issues, if any, will arise from the trauma.

Now, researchers hope that research on newer and more advanced MRI methods will benefit this patient group even better than today. However, progress to date has been limited by relatively small studies and has lacked standards for sharing and analysing this data across research centres.
"A major challenge in the research is to figure out which injury characteristics and which changes in the brain caused by the injury can predict how patients will recover and what follow-up they need. A big part of the challenge is that individual patients are so different," says Alexander Olsen. He is an associate professor at the Norwegian University of Science and Technology's (NTNU) Department of Psychology and a neuropsychologist at St Olavs Hospital.

The goal of the researchers is to combine and analyse large data sets on brain imaging from around the world to see if they can find connections that aren't discernible in single studies from individual centres.

The main ENIGMA project is based at the University of Southern California, and Olsen is co- leader of a subgroup focused on moderate to severe brain injuries with Frank Hillary from Penn State University.

The brain contains roughly 300 billion brain cells that decode 100 trillion messages to enable us to think and act.

"By pooling our resources, in terms of data, computational power and intellectual expertise, we'll be able to tackle some of the big unanswered questions in our field, such as how sex impacts outcome, whether there are subtypes within the broader patient population, or how to handle lesions in neuroimaging data," said Emily Dennis, who is co-principal investigator for ENIGMA's main group on brain injuries. This main brain injury group is made up of 170 researchers from 13 countries.

"Lots of brilliant scientists around the world have been working on these questions, and made a lot of progress, but this has been limited by the size of our individual samples," she said.

Part of the challenge here is that people's brains are so very different, as different as individual fingerprints, says Erin Bigler, a professor emeritus at Brigham Young University and adjunct professor in neurology and psychiatry at the University of Utah. Bigler has been involved with traumatic brain injury research for 50 years with more than 200 published papers on the subject.

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