Thu. Nov 26th, 2020

Rugby players may undergo brain changes even without a concussion

6 min read

Rugby players who experience repeated small blows to the head during a season may undergo subtle brain changes even if they haven’t suffered a concussion

  • Researchers followed 101 female college athletes over the course of a season
  • MRI scans were taken of 70 female rugby players and 31 rowers and swimmers 
  • The rugby players experienced changes in their brain not seen in other athletes 

Young rugby players who suffer repeated small blows to the head can develop subtle brain damage – even without a recent concussion, a new study claims.  

Western University researchers compared MRI scans of female college athletes competing in rugby, swimming and rowing over the course of a season. 

Changes were found in the rugby player brains – to areas that regulate fear, anger and pleasure – but no changes were found in the brains of the swimmers or rowers. 

Researchers say their findings add to existing evidence that even if a knock to the head doesn’t lead to concussion, it can cause long-term brain damage.   

Western University researchers compared MRI scans of female college athletes competing in rugby, swimming and rowing over the course of a season. Stock image

‘There’s no longer a debate that when an athlete is diagnosed with a concussion caused by a sharp blow or a fall, there is a chance it may contribute to brain changes that could either be temporary or permanent,’ said study author Ravi S. Menon. 

‘But what are the effects of the smaller jolts and impacts that come with playing a contact sport,’ Menon asked.

‘Our study found they may lead to subtle changes in the brains of otherwise healthy, symptom-free athletes.’    

For the study 101 female college athletes – including 70 rugby players and 31 swimmers and rowers – had MRI scans and wore impact detection headbands.  

For the study 101 female college athletes – including 70 rugby players and 31 swimmers and rowers – had MRI scans and wore impact detection headbands. Stock image

Some of the rugby players were followed and monitored by the team for two years, with the swimmers and rowers followed for a year. 

All athletes were concussion-free six months prior to the start of the study and during the study as well, however some rugby players had a concussion history before the six-month period while non-contact athletes had experienced none.

Measurements from the impact headbands found that while rowers did not experience any impacts, 70 per cent of the rugby players did.

In fact those rugby players being hit experienced an average of three impacts during two practices and one pre-season game. 

‘While we only looked at these impacts during a few events during the season, previous research has shown these kinds of subclinical impacts may accumulate over years of participation in contact sports,’ said Menon. 

Researchers used MRI machines to scan the brains of all the athletes during the season, as well as before and after the season.

With the brain scans, researchers examined how water molecules moved throughout the white matter to determine if there were small changes. 

They also investigated how different areas of the brain communicated with each other and whether there were any changes in how those areas worked together.

Researchers used MRI machines to scan the brains of all the athletes during the season, as well as before and after the season. Stock image

In rugby players, researchers found changes in the microstructure of the white matter, including in nerve fibres that connect areas of the brain that control basic emotions like fear, pleasure and anger. 

In some of the rugby players, the changes progressed over time. Researchers did not find changes in the brains of swimmers or rowers. 

The Canadian team also found that for rugby players only, the microstructure of the brain changed between in and off-seasons.

Specifically changes were found in the brain stem, which controls the flow of messages between the brain and body. 

Researchers also found differences in the functional organisation of the brain. 

When compared to swimmers and rowers, rugby players had changes in connectivity in their brain. 

In some of the rugby players, the changes progressed over time. Researchers did not find changes in the brains of swimmers or rowers. Stock image

That is how the brain communicates between the areas of the brain that control memory retrieval and visual processing. 

‘Even with no concussions, the repetitive impacts experienced by the rugby players clearly had effects on the brain,’ said Menon. 

‘More research is needed to understand what these changes may mean and to what extent they reflect how the brain compensates for the injuries, repairs itself or degenerates so we can better understand the long-term health effects of playing a contact sport.’ 

A limitation of the study was that while the rugby athletes did not experience a diagnosed concussion, there may have been undiagnosed concussions that went unnoticed by the coaching staff.

The findings have been published int he journal Neurology. 

BRAIN INJURIES IN SPORTS: FAST FACTS ABOUT CTE RISKS, TESTS, SYMPTOMS AND RESEARCH

by Mia de Graaf, US Health Editor

As athletes of all sports speak out about their brain injury fears, we run through the need-to-know facts about risks, symptoms, tests and research.

1. Concussion is a red herring: Big hits are not the problem, ALL head hits cause damage

All sports insist they are doing more to prevent concussions in athletes to protect their brain health.  

However, Boston University (the leading center on this topic) published a groundbreaking study in January to demolish the obsession with concussions.

Concussions, they found, are the red herring: it is not a ‘big hit’ that triggers the beginning of a neurodegenerative brain disease. Nor does a ‘big hit’ makes it more likely. 

In fact, it is the experience of repeated subconcussive hits over time that increases the likelihood of brain disease. 

In a nutshell: any tackle or header in a game – or even in practice – increases the risk of a player developing a brain disease.  

2. What is the feared disease CTE?

Head hits can cause various brain injuries, including ALS (the disease Stephen Hawking had), Parkinson’s, and dementia. 

But CTE is one that seems to be particularly associated with blows to the head (while the others occur commonly in non-athletes). 

CTE (chronic traumatic encephalopathy) is a degenerative brain disease that is caused by repeated hits to the head.

It is very similar to Alzheimer’s in the way that it starts with inflammation and a build-up of tau proteins in the brain. 

These clumps of tau protein built up in the frontal lobe, which controls emotional expression and judgment (similar to dementia).

This interrupts normal functioning and blood flow in the brain, disrupting and killing nerve cells.

Gradually, these proteins multiply and spread, slowly killing other cells in the brain. Over time, this process starts to trigger symptoms in the sufferer, including confusion, depression and dementia.

By the later stages (there are four stages of pathology), the tau deposits expand from the frontal lobe (at the top) to the temporal lobe (on the sides). This affects the amygdala and the hippocampus, which controls emotion and memory.  

3. What are the symptoms?

Sufferers and their families have described them turning into ‘ghosts’. 

CTE affects emotion, memory, spatial awareness, and anger control. 

Symptoms include:

  • Suicidal thoughts
  • Uncontrollable rage
  • Irritability
  • Forgetting names, people, things (like dementia)
  • Refusal to eat or talk 

4. Can sufferers be diagnosed during life?

No. While a person may suffer from clear CTE symptoms, the only way to diagnose their CTE is in a post-mortem examination.

More than 3,000 former athletes and military veterans have pledged to donate their brains to the Concussion Legacy Foundation for CTE research. 

Meanwhile, there are various studies on current and former players to identify biomarkers that could detect CTE.  

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