The aim of his research is to fill gaps in what we know about how to manage concussion and empower clinicians to make a real difference in outcomes for those struggling with ‘invisible’ but debilitating symptoms.
If we can see the damage inside the brain, we can understand the efficacy of different rehabilitation approaches to inform precision medicine in the future. For example, if we could eventually visualise the damage in much the same way we can see a broken bone on an x-ray, we may be better equipped to predict different recovery outcomes and prescribe early interventions accordingly.
There are many benefits to participating in sport, and some of the narrative about the long-term effects of playing sports like rugby extend beyond the available scientific evidence. This project will provide evidence to address this issue and we hope to identify new ways of understanding how to mitigate the issues mTBI cause in sport.
Mātai Medical Research Institute’s first major mild traumatic brain injury (mTBI/concussion) study started in 2021 with support from the Gisborne Boys High School First XV and Second XV rugby teams, to help us monitor and understand any changes in the brain from injury.
Head impacts are not uncommon in collision sports. Fast and improved head injury detection can better help with appropriate actions, such as removing a player from the game for a certain time period to help reduce the risk of negative long-term outcomes. The data will also aid objective surveillance, assessment and rehabilitation of injuries occurring on the sports field.
Using brain imaging, and by pushing the limits of technology, the team aim to gain new knowledge necessary to implement practical solutions to concussion and help identify interventions and preventative measures.
This study plans to identify individuals who have sustained a TBI acutely, i.e. as soon after the injury as possible and carry out a clinical and MRI assessment at this time. They will then be followed up at 1 month with more detailed assessments and further high-level MRI, and again at 6 months. Normal treatment processes will continue as required.
In taking a more detailed and hopefully accurate history of the consequences of injury – the symptoms and the effects these have had – and linking these to MRI findings we hope to discover a number of things in relation to treatment which may also impact on broader outcomes.
– Earlier recognition and diagnosis of treatable clinical syndromes following TBI.
– Reduced secondary pathology arising from prolonging stressor effects longer than necessary, via lesser epigenetic consequences.
– Reduced consequences for others in the persons environment.
– Reduced secondary health costs due to better defined interventions.
– Reduced costs to other agencies, including social services, police and Corrections Department.
The Doppler ultrasound uses a high-frequency sound, which reflects off the red blood cells to give the measure of the blood flow in real-time. The aim is to measure brain blood flow both pre-season, post-season and immediately following a head injury on the pitch. We will then examine how changes in brain blood flow post injury relate to recovery from injury. If a relationship between blood flow changes at time of injury and recovery periods are found from this study, Doppler measurements would not only help with return to play decisions but could allow for better early treatment options to improve recovery times. The Doppler technology is inexpensive and portable, making it available to be used at a sports ground immediately after an injury, providing faster assessment, and is being trialled as one of the components of the Mātai concussion research with the Gisborne Boy’s High Rugby teams. Jorge is training the Mātai researchers to use the Doppler ultrasound and will work with the team on the analysis of the findings.
Jorge Serrador, Professor of Biomedical Engineering at The MARCS Institute for Brain, Behaviour, and Development, with his team from Western Sydney University, help the Mātai concussion team study the impact on blood flow to the brain using a Doppler ultrasound. He has a PhD in Cardiovascular Physiology specialising in brain blood flow regulation and is an expert in vestibular function and the vestibular and cardiovascular system’s interaction.
As a former rugby player, who has suffered concussions, he is passionate about helping find answers to safer play. Jorge began researching brain blood flow while lecturing at Harvard University, and is currently also working with astronauts at NASA.
This is a branch of the rugby / mild TBI project run by Dr Josh McGeown and Dr Eryn Kwon.
PhD candidate Jess Gu, supervised by Dr Gil Newburn and Prof Justin Fernandez will carry this out.
Attention is a common consequence of TBI. It is unclear if this is the case with sub-concussive injury.
Jess plans to coordinate assessment of attentional function via a standardised computer based testing process at pre-season, mid-season and end of season stages. This data will be compared with high-level MRI imaging data.
This will help to identify potential longer term issues consequent on brain injury to minimise secondary pathology.
This study is made possible thanks to an HRC Explorer Grant, the Hugh Green Foundation, The Fred Lewis Enterprise Foundation, Neurological Foundation of New Zealand, and an anonymous donor.