Long-term health outcomes after exposure to repeated concussion in elite level: rugby union players

McMillan, T.M. , McSkimming, P., Wainman-Lefley, J., Maclean, L.M., Hay, J., McConnachie, A. and Stewart, W. (2017) Long-term health outcomes after exposure to repeated concussion in elite level: rugby union players. Journal of Neurology, Neurosurgery and Psychiatry, 88(6), pp. 505-511. (doi: 10.1136/jnnp-2016-314279) (PMID:27951526)

Abstract

Background: There is continuing concern about effects of concussion in athletes, including risk of the neurodegenerative disease chronic traumatic encephalopathy. However, information on long-term health and wellbeing in former athletes is limited. Method: Outcome after exposure to repeated brain injury was investigated in 52 retired male Scottish international rugby players (RIRP) and 29 male controls who were similar in age and social deprivation. Assessment included history of playing rugby and traumatic brain injury, general and mental health, life stress, concussion symptoms, cognitive function, disability and markers of chronic stress (allostatic load). Results: The estimated number of concussions in RIRP averaged 14 (median=7; IQR 5-40). Performance was poorer in RIRP than controls on a test of verbal learning (p=0.022) and of fine co-ordination of the dominant hand (p=0.038) and not significantly different on other cognitive tests (p>0.05). There were no significant associations between number of concussions and performance on cognitive tests. Other than a higher incidence of cardiovascular disease in controls, no group differences were detected in general or mental health or estimates of allostatic load. In RIRP, persisting symptoms attributed to concussion were more common if reporting more than nine concussions (p=0.028), although these symptoms were not perceived to affect social or work functioning. Conclusions: Despite a high number of concussions in RIRP, differences in mental health, social or work functioning were not found late after injury. Subtle group differences were detected on two cognitive tests, the cause of which is uncertain. Prospective group comparison studies on representative cohorts are required.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Stewart, Dr William and Mcskimming, Mrs Paula and McConnachie, Professor Alex and McMillan, Professor Tom and Wainman-Lefley, Ms Jessica and Maclean, Dr Linda
• Authors: McMillan, T.M., McSkimming, P., Wainman-Lefley, J., Maclean, L.M., Hay, J., McConnachie, A., and Stewart, W.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Mental Health and Wellbeing; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Robertson Centre; College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Journal Name: Journal of Neurology, Neurosurgery and Psychiatry
• Publisher: BMJ Publishing Group
• ISSN: 0022-3050
• ISSN (Online): 1468-330X
• Published Online: 07 October 2016
• Copyright Holders: Copyright © 2016 The Authors
• First Published: First published in Journal of Neurology, Neurosurgery and Psychiatry 88(6):505-511
• Publisher Policy: Reproduced in accordance with the publisher copyright policy

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Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
60923	1	The allostatic load model as a predictor of outcome following head injury	Thomas McMillan	Scottish Executive Health Department (SEHHD-CSO)	DTF/12/13	IHW - MENTAL HEALTH & WELLBEING