Wallaby stars' brains shed light on tackle risks

Australian rugby union greats are putting their brains and hearts under the microscope to reveal just how much damage tackles are doing to the organs of the country’s best sportspeople.

Researchers from the Heart Research Institute and the University of Sydney's Charles Perkins Centre are behind an innovative Australian-first project to better understand the impact of the game on elite players, past and present.

Ex-Wallabies Simon Poidevin, John Eales, Owen Finegan, Topo Rodriguez, Alan Cardy, Warwick Waugh, Mick Martin, David Croft, Tim Kelaher and several current big name professionals are signed up to the project in which cutting-edge imaging technology from GE Healthcare will be used to highlight brain and heart changes in detail never seen before. More Ex-Wallabies are set to take part in the study later this year

“We know that repetitive traumatic injury is taking a serious toll on the neurological and cardiovascular health of our best players but until now we haven’t been able to quantify just how big the risk is,” says lead investigator, Professor Stuart Grieve.

“Using these latest techniques we’ll be able to do just that, and also provide some much-needed hard data to inform recommendations around what constituents safe sporting practice in Australia.”

The first part of the study focuses on the brain, an area of deep concern after data from retired American NFL players showed brain injury sustained during sport can predispose players to Alzheimer’s disease. A team from Sydney Adventist Hospital will use a new technique called multi-band diffusion imaging to visualise changes in the brain circuits.

This produces data that is ten times more detailed than previously available in half the time, Professor Grieve explains. “These new imaging techniques allow us for the first time to see the brain networks that are essential for normal brain functions,” he says. “Understanding the damage to these networks will help us to understand the future risk for cognitive decline or dementia in these players”.

Ultimately the team hopes to provide a scientific evidence base from which to guide sensible changes to law and practices around head injury that will protect players, and allow contact sport to continue to be played safely.

The second part of the study focuses on the changes to the aorta, the body’s main artery, due to accumulated trauma from tackles and other impacts during games and training.

A pioneer study by co-investigator Associate Professor Sharon Kay has shown that professional footballers have markedly enlarged aortas, placing them at greater risk of rupture or dissection.

“The lab at the Heart Research Institute is using a new technique called 4-dimensional flow MRI to precisely map the flow patterns in the heart and chest vessels, and in so doing understand why this enlargement occurs,” Professor Grieve says.

The study involves 30 ex-international rugby union players and 30 ‘control’ athletes involved in non-contact sports without any previous history of concussion or head injury.

The project brings together investigators from Royal North Shore Hospital, Sydney Adventist Hospital and the University of Sydney, and is supported by the Classic Wallabies, GE Healthcare and the Brain Resource Company.

The team hopes to use the data to inform a prospective cross-code study targeting elite juniors who make the transition to professional ranks. “Ultimately it will provide high level evidence to guide the formation of policies that protect player safety,” the researcher says.

Wallabies great Simon Poidevin says the results, to be reported in 2016, are vital for the future of Rugby Union in Australia. “We have a nation that’s passionate about playing rugby so it’s incredibly important that we’re well informed in how best to keep our players safe,” Poidevin says. “By learning the risks and how to avoid them we’ll be making it a better game for everyone to enjoy.”

The company behind the imaging technology, GE Healthcare, has also been trialling it in the US as part of a ground-breaking $60 million research and innovation program with the NFL. The technology will be used for the first time in Australia by Professor Grieve.

ANZ Regional Research Manager Dr Tim O’Meara said, “GE is a leader in developing sophisticated diagnostic imaging technology, but for all the advances in science our knowledge of the brain is far behind that of nearly every other organ in the body. Globally we are working with the NFL to optimise imaging technology and analysis algorithms to better detect subtle changes in the brain after a traumatic event. We’d like to know if concussions are directly related to the later development of neurodegenerative diseases, so early detection of brain changes is critically important.

“The type of research Professor Grieve and his team are conducting here in Australia will further our understanding of sports-related concussions and brain injuries suffered by athletes. Advancing brain science will help communities everywhere and we are incredibly excited to be a part of this pilot study,” said Dr O’Meara. 

About rugby trauma

• A US study has found retired national football league players are 20 times more likely to be diagnosed with Alzheimer’s disease or cognitive impairment.
• A recent study by co-investigator Sharon Kay at North Shore Hospital demonstrated ‘significant’ aorta enlargement in elite footballers but not in non-elite players.
• Despite these concerning findings, there is currently not enough knowledge in this area to make recommendations on what constitutes safe sporting practice.
• The magnitude of the ongoing health risks to former professional sportspeople also needs to be better defined, researchers say
• This HRI-led pilot study uses cutting edge imaging techniques to provide these much-needed insights on the long-term impact of professional rugby on players' hearts and brains.