Like many, we very interested to read the recent findings of a new study by the University of Glasgow’s Professor Willie Stewart, addressing the long-term consequences of participating in contact sports, and the subsequent risks of neurodegenerative diseases.
The paper (available here) specifically focuses on the occurrence of chronic traumatic encephalopathy (CTE), which is associated with a history of traumatic brain injury (TBI) and repetitive head impacts (RHI).
While previous studies have examined this issue in other sports (such as American football) this research aimed to investigate the prevalence of CTE in former rugby players as Professor Stewart’s and his team analysed autopsy data from former players by examining brain samples from three international brain banks.
The results revealed that 68% of the former rugby players had CTE, with the majority having played at the amateur level. The study also found a direct relationship between the length of a rugby playing career and the risk of CTE, indicating that increased exposure to head impacts is a significant factor in CTE development. Additionally, the study suggests that rugby has a notably high risk of concussion compared to other contact sports.
The study isn’t without its critics however.
The relatively small number of brains that were investigated will always leave results open to scrutiny and limit the ability to draw conclusions on a wider scale. There can also be questions raised about the objectivity of the samples provided. Many of those that have allowed their brains to be investigated post mortem, do so because they think they may have been affected by CTE. They can therefore not necessarily be seen as a true reflection of a sporting population.
Here at SSA, we have strong links into concussion research through our work with client Marker Diagnostics (Marker). Marker is the world-leading research and development company behind the CE certified biomarker saliva diagnostic test for concussion, which is currently being trialled across various forms of men’s and women’s rugby, from community to elite level.
The findings of Professor Stewart, while open to criticism, in the main support the importance of biomarker saliva testing for detecting concussion in contact sports like rugby. They suggest a high prevalence of CTE among former rugby players, even among amateurs. This leads to the conclusion that contact sports must work hard to reduce exposure to repetitive head impacts in order to protect the long-term brain health of their athletes.
What is clear is the need for a simple, definitive and objective test that allows players and medical professionals at all levels to determine whether a concussive event has occurred. They can then ensure the correct course of treatment is implemented as soon as possible. Equally important, is the ability of the biomarker test to determine when an individual has fully recovered and is therefore ok to undertake return to play measures.
As Marker Chair, David Cohen, said recently, “Concussion has always been challenging to diagnose, with a heavy reliance on the individual being able to recognise symptoms which may not be obvious. Without an objective diagnostic test, medical professionals are having to make decisions based on a subjective view. That is why biomarker testing is so important, it objectively and accurately supports the diagnosis of concussion, and the ongoing assessment throughout the return to play process.”
That is why collaborations are underway or have recently been completed across competitions such as the Currie Cup in South Africa, the Farah Palmer Cup in New Zealand and as recently announced, is underway with the United Rugby Championship across five competing nations.
SSA continues to support Marker to build new relationships, not only in rugby, but also across sports to raise awareness and understanding of this new technology, which can provide clarity in an area that is by definition, subjective and difficult to define with symptoms differing across individuals.
It is only through objective diagnosis that players can truly be protected while also allowing contact sport to continue and thrive as we all hope it can.
For more information about Marker Diagnostics go to see the website Markerhealth.com or follow them on twitter @Test4Concussion