Friday 20 September 2019

Study finds repetitive impacts are larger factor in concussive brain injury than single-event head trauma

Trinity College Dublin report hailed as significant advance in understanding of mild head trauma

Former Ireland striker Kevin Doyle (right) retired because of concerns over concussion
Former Ireland striker Kevin Doyle (right) retired because of concerns over concussion
Luke Byrne

Luke Byrne

Repetitive impacts to the head are a larger factor in concussive brain injury than single events, a study by Trinity College Dublin has found.

The finding has been hailed as a significant advance in our understanding of mild head trauma. 

It comes amid an increased focus in recent years on the dangers of concussion in rugby, GAA and combat sports.

However, according to the Trinity researchers, it is also a very common injury in children and young adults.

"(It) represents a significant challenge to physicians due to the lack of any robust biomarkers or objective imaging approaches to manage the injury," the university said.

Dr Matthew Campbell, assistant professor at Trinity, said theirs was a hypothesis-driven project whereby they challenged the hypothesis that repetitive head trauma would induce damage to small blood vessels in the brain that could be shown with MRI-based brain scans.

Rugby players and MMA fighters were among those to take part in the study, which was undertaken by the Trinity-led Concussion Research Interest Group (CRIG).

It used newly developed technologies to confirm the number and severity of head impacts that would lead to the appearance of "leaky" blood vessels within the brain. 

"Our findings, for the first time, suggest that repetitive head trauma can lead to an MRI signal that we can definitively link to the number and severity of impacts to the head," said Dr Colin Doherty, consultant neurologist at St James’s Hospital and clinical lead on the study.

"It appears that the repetitive nature of these impacts as opposed to single events are causing damage to the capillaries of the brain."

While it was clear concussive brain injuries cause clinical symptoms such as dizziness, nausea and confusion, these symptoms occured independent of any adverse findings on CT or MRI scans.

They also occurred without the presence of any clear blood-based biomarkers. 

"Therefore, the clinical management of concussive brain injuries is challenging and needs new technologies to assist in diagnosis and rehabilitation," the study said.

The university said while the study was based on a selected group of MMA fighters and rugby players, the findings could pave the way for more robust and objective return-to-play guidelines and improved player safety in the longer term.

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