The Mātai Medical Research Institute’s first major mild traumatic brain injury (mTBI/concussion) study started last year 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.
The research involves brain scans at Mātai, using some of the world’s most advanced brain imaging technology in partnership with GE (General Electric) Healthcare; HITIQ high-tech mouthguards to monitor head impacts; eye-movement monitoring; small-RNA analysis by the Institute of Environmental Science and Research Ltd (ESR); and advanced biomechanical modelling by Dr Vickie Shim and the team at the Auckland Bioengineering Institute (ABI); as well as work by Professor Draper at the University of Canterbury; and the Auckland University of Technology (AUT). The research is funded in part by the MBIE Catalyst Strategic Fund, Kānoa Regional Economic Development & Investment Unit, Trust Tairāwhiti, and the JN and HB Williams Foundation.
Thirty-three players across two teams were involved, and data was acquired from 11 games and 30 training sessions.
Dr Patrick McHugh, local medical practitioner says. “Brain injury in sport is a problem that is garnering more attention world-wide and what with a number of prominent ex-Gisborne rugby players having their professional careers cut short by brain injury the involvement of Gisborne Boys High with this research has been deeply appreciated.
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.
Dr Samantha Holdsworth, Mātai Medical Research Institute’s Director of Research, Associate Professor at the University of Auckland, and Principal Investigator at the Centre for Brain Research (CBR), is a leading researcher in brain imaging and emerging MRI (magnetic resonance imaging) technologies. She says the level of collaboration between multi-disciplinary experts makes the project unique. MRI is a promising technology for detecting changes in the brain resulting from impacts to the head. Advances in imaging technology are opening opportunities to see previously invisible damage in the brain caused by mTBI. As our ability to see and understanding of the damage improves, we can help outline pathways from brain injury diagnosis to prevention, education, and treatment.
Combining advanced MRI with other technologies may increase our chances of finding and validating reliable gold-standard tests for concussion, increase our understanding of the injuries, and should help support rehabilitation programmes”.
Mātai Research Fellow Dr Eryn Kwon said, “This is one of the most comprehensive, multi-modal datasets being used in concussion research. A player may feel that they have recovered from a brain injury, and function satisfactorily on standard concussion tests. But in some cases our MRI scans still show signs of damage in the white matter fibres, or functional changes in the brain, which show the person has not quite recovered. This might put the player in increased risk if they suffer another concussion by returning to play. Through our collaborations we aim to further understand these risks and to find a simple test that can objectively tell when a person has recovered completely to return to play safely.”
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.
Rich Easton, CEO of the Neurological Foundation of New Zealand, who are funders of part of the research says, “We are very proud to be supporting research that investigates how we can make a game we all know and love safer for the human brain. Neurological research such as this is so important for future generations.”
Mātai is collaborating with other groups nationwide, including Professor Nick Draper and his team at the University of Canterbury, whose goal is to examine collisions and their effects on neurocognition rugby in junior rugby players and ultimately to contribute to making the game safer for junior players. Their recently commenced study involves assessing the effects of impacts for junior rugby players through a combination of methods including brain imaging. Prof Draper says “we are doing our best to sync brain imaging protocols with the goal of improving the predictive capability of the imaging”.
Mātai is a registered Charitable Trust (CC56831) undertaking not-for-profit medical imaging research in Gisborne-Tairāwhiti, Aotearoa-New Zealand.
06 863 1425
info@matai.org.nz
466 Childers Road
Gisborne, 4010
New Zealand