This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attentiondeficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors.

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1,400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of “big data” (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA’s activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive and psychosocial factors.

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Under the influence of genes and a varying environment, human brain structure changes throughout the lifespan. Even in adulthood, when the brain seems relatively stable, individuals differ in the profile and rate of brain changes 1 . Longitudinal studies are crucial to identify genetic and environmental factors that influence the rate of these brain changes throughout development 2 and aging 3 . Inter-individual differences in brain development are associated with general cognitive function 4,5 and risk for psychiatric disorders 6,7 and neurological diseases 8,9 . Genetic factors involved in brain development and aging overlap with those for cognition 10 and risk for neuropsychiatric disorders 11 . A recent cross-sectional study showed brain age to be advanced in several brain disorders. Brain age is an estimate of biological age based on brain structure, which can deviate from chronological age. Several shared loci were found between the genome-wide association study (GWAS) summary statistics for advanced brain age and psychiatric disorders 12 . However, information is still lacking on which genetic variants influence an individual's brain changes throughout life, because this requires longitudinal data. Discovering genetic factors that explain variation between individuals in brain structural changes may reveal key biological pathways that drive normal development and aging and may contribute to identifying disease risk and resilience-a crucial goal given the urgent need for new treatments for aberrant brain development and aging worldwide.As part of the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium 13 , the ENIGMA Plasticity Working Group quantified the overall genetic contribution to longitudinal brain changes by combining evidence from multiple twin cohorts across the world 14 . Most global and subcortical brain measures showed genetic influences on change over time, with a higher genetic contribution in the elderly (heritability, 16-42%). Genetic factors that influence longitudinal changes were partially independent of those that influence baseline volumes of brain structures, suggesting that there might be genetic variants that specifically affect the rate of development or aging. However, the genes involved in these processes are still not known, with only a single, small-scale GWAS performed for longitudinal volume change in gray and white matter of the cerebrum, basal ganglia and cerebellum 15 . In this study, we set out to find genetic variants that may influence rates of brain changes over time, using genome-wide analysis in individuals scanned with magnetic resonance imaging (MRI) on more than one occasion. We also aimed to identify references

Sex is a biological variable that contributes to individual variability in brain structure and behavior. Neuroimaging studies of population-based samples have identified normative differences in brain structure between males and females, many of which are exacerbated in psychiatric and neurological conditions. Still, sex differences in MRI outcomes are understudied, particularly in clinical samples with known sex differences in disease risk, prevalence, and expression of clinical symptoms. Here we review the existing literature on sex differences in adult brain structure in normative samples and in 14 distinct psychiatric and neurological disorders. We discuss commonalities and sources of variance in study designs, analysis procedures, disease subtype effects, and the impact of these factors on MRI interpretation. Lastly, we identify key problems in the neuroimaging literature on sex differences and offer potential recommendations to address current barriers and optimize rigor and reproducibility. In particular, we emphasize the importance of large-scale neuroimaging initiatives such as the Enhancing NeuroImaging Genetics through Meta-Analyses consortium, the UK Biobank, Human Connectome Project, and others to provide unprecedented power to evaluate sex-specific phenotypes in major brain diseases.