UVA Health: Testing if MRI Can Reveal Undetected Brain Injuries in Soldiers

Hidden injuries have always been one of the most insidious threats in military medicine. From early battlefield concussion to long-term neurological impairment, brain trauma often escapes early detection, particularly in soldiers exposed to repeated low-level blasts. But a new Department of Defense, funded study led by UVA School of Medicine aims to bring these injuries into sharper clinical focus.

The $2.3 million study will investigate whether next-generation MRI technology can detect structural brain changes that standard imaging misses. If successful, the findings could lay the groundwork for a new diagnostic pathway, one that helps distinguish between benign symptoms and progressive damage among service members whose existing scans show “nothing wrong.”

While the study is being led by UVA radiologist James R. Stone, MD, PhD, the implications extend well beyond a single institution. This is a test not just of imaging precision, but of how American medicine recognizes, responds to, and redefines what counts as an “injury.”

A New Tool for an Old Blind Spot

Standard brain imaging often fails to capture the true toll of blast exposure. Soldiers who repeatedly operate near explosives, during training, breaching, or active combat, frequently report cognitive changes, mood disorders, and neurological symptoms that elude clinical explanation. Yet when routine MRIs come back normal, the burden of proof falls back on the patient.

Research teams like Stone’s believe that the problem isn’t imaginary; the tools are just insufficient. The new MRI scanner being tested at UVA’s Fontaine Research Park boasts resolution and analytic capabilities designed to detect astrocytic scarring which can be damage linked to brain injury in prior autopsy studies but undetectable in living patients.

The central hypothesis is that advanced imaging can render visible what has long been considered invisible. If confirmed, this would enable earlier diagnosis, clearer triage decisions, and new opportunities to track recovery or deterioration over time.

Clinical Implications Extend Beyond the Military

The diagnostic breakthrough being pursued here is not relevant to soldiers alone. Repetitive, low-impact brain trauma is also a pressing concern in civilian populations: athletes, domestic abuse survivors, industrial workers, and more. The ability to detect subtle scarring non-invasively could open doors across neurology, psychiatry, and rehabilitation medicine.

A recent study in JAMA Neurology emphasized the clinical ambiguity surrounding mild traumatic brain injury (TBI) diagnosis, with many patients falling into gray zones where symptoms exist but structural proof does not. Technologies capable of bridging this evidence gap would redefine care eligibility, resource allocation, and legal adjudication in both military and civilian contexts.

Moreover, for the Veterans Health Administration, earlier detection could translate into reduced long-term disability costs and improved access to care for service members whose claims were previously denied due to “normal imaging.” That shift alone would represent a systemic correction of clinical blind spots that have persisted for decades.

Research Is Catching Up to What Soldiers Already Know

What makes this study notable is not just its scientific novelty but its alignment with lived experience. Service members have long reported brain fog, irritability, memory lapses, and fatigue after repeated exposure to controlled detonations and heavy artillery. Until now, medicine has lacked the vocabulary, or the tools, to validate those experiences with precision.

Stone’s trial will scan 60 service members across a spectrum of blast exposures and pair the imaging results with neuropsychological testing. The goal is not merely to find injury, but to quantify it in a way that supports targeted interventions.

That pursuit also aligns with larger institutional goals. The study is one of the first marquee initiatives under UVA’s Paul and Diane Manning Institute of Biotechnology, an interdisciplinary hub focused on translational research. The infrastructure investment signals the university’s intent to not just study disease, but actively reshape diagnostics and therapeutics.

Data from the Front Line Can Inform Policy at the Top

One of the most critical outcomes of this work may be its influence on military policy. While blast injuries have been a known risk for years, the threshold for what constitutes “acceptable exposure” remains poorly defined. Without objective biomarkers, setting safety standards has been speculative at best.

Should the MRI trial succeed in linking visible scarring to exposure levels, that data could inform revised training protocols, deployment fitness assessments, and even re-engineer protective gear standards. As the Defense Health Agency continues to modernize its approach to service member wellness, the demand for data-driven thresholds is growing.

The study could also challenge existing return-to-duty evaluations, which often rely on subjective symptom checklists or standard imaging. A new diagnostic paradigm would mean that “invisible” injuries are no longer dismissed, and that care decisions can be grounded in clearer evidence.

A Reminder That Innovation Must Also Be Protective

While the language of innovation often focuses on speed, scale, and performance, this study offers a necessary counterbalance: technology’s role in prevention and protection. Too often, diagnostic innovation arrives after harm has already been done. What makes this initiative different is its attempt to preempt injury, not just confirm it.

There is strategic value in identifying trauma early, particularly in the military. Faster diagnosis can shorten recovery time, reduce misdiagnosis of psychological symptoms, and enhance troop readiness. But more than that, it sends a message: that cognitive health is not a secondary concern but a frontline priority.

Investments like these reflect a growing maturity in military medicine, where operational efficiency and long-term survivability are no longer in tension, but in alignment. Detecting the unseen is about ensuring that those who serve are not left carrying injuries that institutions have refused to name.