Global Disparities in Neuroimaging Research for Mental Health Conditions

Abstract Background Scientific research remains disproportionately grounded in data from high-income countries (HICs), yet efforts to map the distribution of neuroimaging findings by income levels remain limited. Methods Using data from the ENIGMA Consortium, we conducted a systematic quantitative synthesis of 83 publications across nine psychiatric and neurological conditions, analyzing T1-weighted structural MRI data from 16,086 cases in 27 countries. Representation was mapped using World Bank income classifications and World Health Organization (WHO) regions. Results HICs contributed 90.5% of cases; upper-middle-income countries 7.9%; lower-middle-income countries 1.6%; and low-income countries none. Geographically, 85% of cases originated from North America and Europe, while Africa, South-East Asia, and the Eastern Mediterranean were underrepresented. Supplemental analyses of other datasets (Brain Growth Charts; fMRI meta-analysis) revealed similar disparities. Conclusions Equitable neuroimaging science is critical to inform practice and policy decision-making that is context specific. This requires targeted investment in infrastructure, data sharing, and participation from underrepresented regions.