None listed
Conditions
Brief summary
Background: With the popularity of sports involving contact or collision worldwide, there is an obligation of health care professionals to focus efforts on the better detection, prevention and treatment of the potentially damaging neurological, social, and psychological effects of sports related concussion. Chronic Traumatic Encephalopathy (CTE) is one potential consequence of a career in collision sports but very little knowledge regarding the the onset and progression of the clinical manifestations of CTE is known. The current study seeks to examine this issue amongst current and former professional football players within the National Rugby League (NRL) in Australia. Methods/Design: This is a cross-sectional, prospective study utilising a sample of current (n=30), short-term retired (<10 years, n=30) and long-term retired (10yrs+, n=30) players who will be recruited through their club, or former club to undertake neurological, psychological and cognitive testing, although with ApoE genotyping, balance testing and olfactory stress testing. Initial baseline assessments will be conducted with a subsequent follow-up/review assessment conduted at 18-24 months post-baseline. The primary outcomes (objective cognitive perfromance, neurological examination, psychological questionnaires and neuroimaging data) will be correlated and compared to each player's exposure to concussive injury. Discussion: This study will provide information about the potential cognitive, neurological and psychological consequences of a career in collision sports and may help to identify potential at-risk characteristics for the development of long-term consequences, such as CTE. This study may have far-reaching application in terms of modifing exposure rates through mandatory rest periods or governing body rule modifications.
Interventions
Recruitment will occur on a rolling basis over a 12-18 month period. The local professional National Rugby League club will be sought to supply current professional players. The club's 'old boys' (alumni) will be sought for retired player recruitment.
Players will be initially contacted via club officials and then contact will be made by the chief investigator to the players to provided study information and obtain consent. Once consent is obtained each participant will be requested to complet
Recruitment will occur on a rolling basis over a 12-18 month period. The local professional National Rugby League club will be sought to supply current professional players. The club's 'old boys' (alumni) will be sought for retired player recruitment. Players will be initially contacted via club officials and then contact will be made by the chief investigator to the players to provided study information and obtain consent. Once consent is obtained each participant will be requested to complete three sessions; (1) neuropsychological assessment, (2) neurological exam, olfactory stress testing and APOE genotyping, and (3) Neuroimaging. The three session will be conducted with each participant once at baseline and then again on one occassion at an eighteen month follow up. Each of the three sessions will be completed within three weeks of one another at each time point. A 2-hour neuropsychological assessment, which involves clinical background including demographic information, educational and learning history, playing history, concussion history, drug use history, family medical history, and general medical history, in addition to the administration of psychological questionnaires and behavioural measures including the depression, anxiety stress scale (DASS), the alcohol use disorders identification test (AUDIT), the Barrett Impulsivity scale, the sports competativeness scale, along with cognitive and balance/postural stability testing will be conducted with each participant. A one hour session including neurological examination, olfactory stress testing (OST) and buccal swab (ApoE genotyping) will also form part of the requirements. For the OST, 20 items of the UPSIT (UPSIT-20) are initially administered to the left nostril (with the right nostril occluded by a wad of cotton wool) after which 1 mg of atropine (0.1ml of 10mg/ml solution) is sprayed high into the left nostril. The patient then adopts a crouching head down position for one minute (the ‘Mecca Position’) to retain the spray. The remaining 20 items of the UPSIT are administered 40–45 min later through the left nostril, again with the right nostril occluded. The change in UPSIT score from baseline to post atropine, or ‘atropine effect’ (AE), represents an objective measure of the impact of atropine on olfactory functioning. The third component, MRI scanning (60-mins) will involve techniques such as the standard structural MRI (three-plane localiser), MP-RAGE (volumetrics), diffusion tensor imaging (DTI), susceptability weighted imaging (SWI), magnetic resonance spectroscopy (MRS) and pulse-wave encephalopathy. Result of each component will be correlated with concussion exposure data.
Sponsors
Brain Foundation
Eligibility
Sex/Gender
Male
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
To be eligible males must be, or have been, a professional rugby league player who plays, or has formerly played, in the National rugby league competition. Control subjects will also be male and aged 18-years or older.
Exclusion criteria
Men need to be clear of any other neurological conditions (aside from the potential effects of concussion), any learning disorder or attention deifict disorder.
Outcome results
None listed