Brain health clinic for retired rugby players opens its doors

A specialist clinic for detecting and managing neurological conditions linked to contact injuries in professional sport is now open to patients.

The Advanced BRAIN Health Clinic, based at the Institute of Sport, Exercise and Health (ISEH) in central London, will provide a specialist pathway for retired elite male and female rugby players between the ages of 30-55, who may have concerns over their individual brain health.

The clinic will be operated by experts, including Imperial’s Professor David Sharp and Consultant Neurologist Dr Richard Sylvester, in partnership with the Rugby Football Union (RFU) and Premiership Rugby (PRL).

Through the work of the clinic and managing patients, researchers will be able to investigate the long-term effects of professional rugby on brain health.

The work will build further on Imperial-led research published earlier this year, which found that participation in elite adult rugby may be associated with changes in brain structure.

The study, which included 44 elite rugby players, found signs of abnormalities to the white matter of the brain, and changes in white matter volume over time – with almost half of the players involved having recently sustained a mild head injury while playing.

Brain clinic

All players attending the new clinic will first undergo a comprehensive set of assessments at ISEH including:

• A comprehensive neuropsychological assessment including a range of tests of their cognitive function
• Advanced Magnetic Resonance Imaging (3T MRI) using a range of highly-sensitive scanning techniques able to identify subtle structural and functional changes to the brain
• Blood tests to identify treatable causes of neurological or psychiatric problems
• Ultrasensitive blood biomarker assessment to determine the presence/signs of neurodegeneration or inflammation within the brain.

Once baseline test results are acquired and consolidated, retired players will return to ISEH four to eight weeks later to have a face-to-face neurological consultation from an expert in the assessment and management of post-traumatic and neurodegenerative disorders.

Managing patients

Any treatment needs or brain health actions will be shared with the player and their General Practitioner. This process will be repeated two and four years later to assess any time-related changes in brain health.

The clinic is supported by an integrated research programme to examine the risk, causes, assessment and management of neurological, psychiatric and cognitive symptoms occurring following participation in elite rugby.

Professor David Sharp, from the Department of Brain Sciences at Imperial College London and the UK Dementia Research Institute, said: “Players, coaches, clubs and their support teams may have concerns about the long-term impacts of their sport on the brain, and how these risks can be assessed and mitigated.

"Our new clinic and the aligned research programme will use the latest clinical investigations to identify the cause long-term symptoms retired players may have and will help us to develop new ways to improving the brain health of retired rugby players.”

Dr Richard Sylvester, a Consultant Neurologist from UCL Hospital Trust, said: “The clinic will provide first class medical care to retired rugby players with neurological symptoms and concerns about their brain health.

"The allied research programme provides an incredible opportunity to understand the underlying basis of these issues and will provide important insights into the effects of playing professional rugby on subsequent brain function. We look forward to seeing our first patients.”

Simon Kemp, RFU Medical Services Director, said: “We’re delighted that the doors to this clinic are now open for clients. Since the initial announcement earlier this year we have worked hard with ISEH, PRL and Imperial College London to get things up and running. We hope this clinic will help many recently retired rugby players who might have concerns about their brain health, while allowing us to further develop our understanding in this area.”

Phil Winstanley, the Rugby Director at Premiership Rugby, said: "We continue to invest in world-leading care for our current players but this new clinic is a commitment that we will invest in their health at the end of their career. This clinic will allow players the opportunity to gain access to leading independent experts and reassure themselves about their brain health whilst providing the game with the opportunity to better understand the impact of playing rugby. There has been a significant investment of time and resource to get this operational and this is another example of the collaboration and investment in player welfare by the English game.”

This service for retired elite players complements existing specialist clinics in London based at the ISEH and Birmingham (RECOS) that provide concussion assessments and management plans for players who are currently competing at both elite and recreational levels.

Further information regarding the clinical service is available on the ISEH website. 

This article is based on materials from Rugby Football Union (RFU).