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Brain injury

Civilians and military subject of new concussion study

The project will look at ways to accurately predict whether those who have sustained concussion will develop long-term effects

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Identifying new ways to accurately predict whether people – both civilians and military – who have sustained concussion will develop long-term effects is the subject of a pioneering new study. 

The mTBI-Predict project will include a trial involving 400 civilians and 400 military personnel aged over 18 with a new diagnosis of concussion – also known as a mild traumatic brain injury or mTBI – which has resulted in them needing hospital treatment or rehabilitation.

At specific time intervals over two years, the participants will take part in nine different areas of research using a variety of medical techniques and assessments to establish if these can be used routinely by medics as ‘biomarkers’ to indicate prognosis and long term impact of concussion. 

Medical techniques and assessments being trialled include brain imaging and function, analysis of blood and saliva samples, and headache measures, as well as mental health, vision, balance, and cognitive performance.

It also include using the new wearable brain imaging system developed at the University of Nottingham that allows patients to move and perform tasks whilst being scanned.

The study is led by the University of Birmingham and the Defence Medical Rehabilitation Centre, in collaboration with the Defence Medical Services with £2million of funding from the Ministry of Defence. It is set to last for around eight years.

Around 1.4million hospital visits each year are due to head injury in England and Wales – 85 per cent of which are classified as mTBI. It is also estimated that up to 9.5 per cent of UK military personnel with a combat role are diagnosed with mTBI annually. Research has revealed the impact can be long-lasting.

Alex Sinclair, professor of neurology at the University of Birmingham and chief investigator of the project, explained: “Although classified as mild, and many recover, the consequences of concussion can be profound with many patients suffering long-term disability due to persistent headaches, fatigue, imbalance, memory disturbance, and poor mental health including post-traumatic stress disorder, while it can have a significant impact on the economy through loss of working hours and demand on the health system. 

“Identifying those patients most at risk of these disabling consequences is not currently possible. There is therefore a pressing need to develop accurate, reproducible biomarkers of mTBI that are practical for use in a clinical setting and can predict long-term complications. 

“Our programme of research will deliver a step change in the care of patients with mTBI, enabling a personalised medicine approach to target early intervention for those most in need but also identifying those with a good prognosis who can return rapidly to activities of daily living.”

Peter McCabe, chief executive of Headway, said: “We know that even a seemingly minor head injury can have a major impact on a person’s life – and often the lives of those closest to them.

“This is particularly the case if the brain injury goes undiagnosed or its effects are mistaken for other conditions. The frustration of not having an accurate diagnosis or receiving the right support can be compounded by the lack of a clear recovery pathway or timeline. 

“We therefore welcome this study in the hope that it can advance our understanding of concussion and mTBI.”

Minister for Defence People and Veterans, Leo Docherty, said: “This is an exciting and welcome study, showcasing the best research and support that Defence can provide to ultimately improve the quality of care for both civilian patients and our serving personnel.”

The research will involve 20 University of Birmingham experts working across disciplines, including neurology, psychology, sports medicine, mathematics and academics within the University’s Centre for Human Brain Health, and will be coordinated by Birmingham Clinical Trials Unit. It will also be driven by experts at the Defence Medical Rehabilitation Centre Stanford Hall, Aston University, Imperial College London, University of Westminster, University of Nottingham, Royal Centre for Defence Medicine, and University Hospitals Coventry & Warwickshire.

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