Research Working Group on Brain Injury – RWGBI

Background

Research on the impact of concussive /sub-concussive blows on brain structure and function is pressing, given the ubiquity of collision sports at all levels (amateur to professional) and recent high-profile cases. Most players recover from concussion in days, but some develop long-lasting symptoms with emerging evidence of long-term changes in brain structure. However, despite much focus on this topic, there have yet been no prospective studies published.

Athletes, parents, schools, coaches, and sporting governing bodies of all contact sports worldwide are concerned that repeated exposure to sports-related concussion (SRC) may reduce quality of health/life in current and retired athletes. Given the popularity of collisions sports worldwide, this is a substantial community facing issues requiring considerable attention. Concern regarding SRC has been expressed through media and government bodies, e.g. poor management of SRC in the world’s biggest sport – football – has led The Telegraph (31/05/16) to ask football authorities to commission independent research on, ‘Does playing football increase your risk of dementia and other degenerative brain diseases?’ Discussing American Football, President Barrack Obama, at a Summit on concussion, said he was unsure if he would allow his children to play given the risks. In rugby, the case of Ben Robinson, a schoolboy who died after suffering repeated SRC, led to guidelines being adopted across the regions and nations of UK & NI for improving detection and management of SRC.

Meanwhile the UK government has asked schools to “team up” with sports clubs to improve fitness of pupils – which has met a backlash from public health physicians warning of the dangers of rugby. At the professional level, regulators are responding to concerns by making changes to rules to mitigate such risk. However, there are numerous unanswered questions that require quality empirical research. The funding support through the GW4 will enable pilot data to be collected to examine our initial research question: does a single season of exposure to rugby training and match play result in any detectable MRI or cognitive change? If this is the case then multiple-seasons of exposure could lead to greater neurohealth burden and possibly poorer outcome in some individuals, but this is yet to be determined.

Project summary

The community intended to complete detailed neuroimaging and cognitive testing of professional rugby players, and non-contact sports professionals, at two time points; pre- and post-season. Exposure data (medically-diagnosed concussions, tackles/collisions involved in) would then be correlated with pre- and post-season MRI/cognitive data, to identify whether training and match play have any neurological or cognitive impact, and if so whether these point to risk-mitigation recommendations.

The community was able to run a pilot project, scanning a small number of rugby players and refining methods. However, recruitment struggled because of the time commitment required from the athletes, and ultimately the decision was made to stop the project early.