Research into traumatic brain injuries (TBI) has largely overlooked the unique challenges faced by special operations forces (SOF), according to a recent report by the Rand Corporation. The study highlights a significant lack of focused research on TBI among SOF, despite their increased risk from blast exposure and repetitive neurological stress during both combat and training.
The report, published earlier this month, reviewed TBI studies conducted from 2015 to 2025. It found that out of 480 research papers on TBI, the majority concentrated on Army and Marine Corps personnel, with only seven papers solely addressing SOF and just 14 including SOF in mixed samples. The authors emphasized, “There is limited research focused on TBI among SOF, although this population faces a higher risk.”
The scope of the research neglect extends beyond special operations personnel. The report also pointed out that airmen, sailors, National Guard troops, and reservists have received little attention in TBI research, despite facing significant risks. Since the year 2000, over 500,000 military personnel have been diagnosed with service-related TBI, according to the Department of Defense. The report estimates that more than $2.1 billion in federal and private funds has been allocated to TBI research since 2015.
Though funding has been substantial, the report identifies several critical issues with existing TBI research. Many studies prioritize diagnosing TBI rather than investigating the specific causes of these injuries. For example, the correlation between injury and factors such as blast pressure, soldier positioning, and the source of blasts—whether from breaching or shoulder-mounted artillery—has not been adequately explored.
Further corroborating the report’s findings, a 2024 study from the University of South Florida indicated that repeated exposure to low-level blasts is linked to brain injury in special operations personnel. The Rand report also noted a divide in research focus between short-term and long-term TBI effects. Studies examining the short- to medium-term period following TBI often describe general neurological symptoms like pain and balance issues, rather than specific diagnoses. In contrast, longer-term studies have looked at neurodegenerative conditions, such as Alzheimer’s disease and chronic traumatic encephalopathy (CTE), but have not consistently yielded clear clinical outcomes.
Attention has primarily been directed towards blast-related injuries and mild TBIs, while sub-concussive and penetrating TBIs have received less scrutiny. The report stresses that the connections between injury characteristics and clinical outcomes are not well understood.
An additional area of concern is the comorbidity between TBI and other mental health conditions. While previous research has explored links between TBI and post-traumatic stress disorder, sleep disorders, and other neurological problems, there has been insufficient investigation into TBI’s relationship with substance abuse, as well as auditory and visual impairments.
Moreover, there is a notable gap in research focused on long-term rehabilitation for TBI victims, leaving patients with limited evidence-based recovery options. Despite these shortcomings, the report acknowledges that a decade of research into military TBI has yielded some positive developments. Substantial investments have led to advancements in imaging techniques and biomarker identification, enhancing the understanding of comorbidities such as PTSD and depression.
The report calls for a more comprehensive approach to understanding and treating TBIs. It emphasizes that scientific advancements alone are not sufficient. Progress in this field will enhance prevention measures, sharpen diagnostic processes, improve treatments, and support long-term recovery, ultimately ensuring that service members and veterans receive the care they deserve. As the report concludes, addressing these gaps in understanding is crucial for the health and well-being of those who serve.
