A study of 44 rugby players, almost half of which had sustained a mild head injury while playing, has revealed a significant proportion had signs of white matter abnormalities.
It is the first study to assess long term changes in MRI images of professional rugby players. It also revealed abnormal changes in white matter volume over time.
The researchers say that more work is needed to determine the long term effects of rugby on player’s brain health.
The research is part of the Drake Rugby Biomarker Study. It was led by Imperial College London and published in the journal Brain Communications.
The research
The study took 44 players of which 21 were assessed after sustaining a mild head injury called a mild traumatic brain injury.
These are one of the most commonly reported match injuries accounting for one in five injuries. The rugby players were compared to other athletes in non-collusion sports and people who do not play sport.
Participants in the study underwent two MRI brain scans a year apart during 2017 and 2019.
The study used two advanced types of MRI called susceptibility weighted imaging and diffusion tensor imaging.
This reveals the structure of blood vessels and white matter. The white matter helps the brain cells to communicate with each other.
The players were also asked to complete memory tests to assess brain function.
Scientists analysed the brain scans for changes.
The scans revealed that 23 per cent of all the players showed abnormalities to their cell axons or small blood vessel tears. These tears cause small leaks in the brain called microbleeds.
The changes were seen in the players with and without a head injury.
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Further research needed
Senior author from Imperial’s Department of Brain Science, Professor David Sharp said: “Despite relatively high rates of head injury and an increasing focus on prevention, there has been relatively little research investigating the long-term effects of rugby participation. More objective measures of the effects of sporting head injuries on the brain are needed to assist with the assessment and management of individual players.
“Our research using advanced magnetic resonance imaging suggests that professional rugby participation can be associated with structural changes in the brain that may be missed using conventional brain scans. What is not clear at this stage is the long-term clinical impact of these changes.
“Further research is needed to understand the long-term implications of repeated head injuries experienced during a rugby career and to provide more accurate ways to assess risk for an individual.”
Clinical services
The research was funded by the Drake Foundation. A not-for-profit organisation focused on understanding and improving the health and welfare of people impacted by head injuries.
It was supported by National Institute for Health Imperial Biomedical Research Centre, the UK Dementia Research Institute and the Rugby Football Union (RFU).
Dr Simon Kemp, medical services director at the RFU, added that a specialist clinical service for the assessment and management of retired elite players will be provided. It aims to assess the brain health of players.
“We welcome any research that helps to advance our knowledge which is why we actively collaborated with the academic institutions on the Drake Foundation Rugby Biomarker Study from its inception, particularly to promote the recruitment of players.
“While it is unclear from that research what the individual long-term implications are regarding the brain changes seen in these advanced imaging techniques, it is clearly a priority to investigate this further.”
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