Uncovering the connection between sport-related head impacts and long-term brain health.
The not-for-profit organisation The Drake Foundation plays a pivotal role in investigating the links between sport-related head impacts and brain health so that everyone can enjoy safe sport practices. To achieve this, the Foundation funds research studies that examine the long-term impact of sports head injuries and has invested over £2.2 million into collaborative research to date. This funding has secured several pioneering research projects, each of which adds to the growing evidence base around the short- and long-term effects of sport-related head impacts on brain health.
Here, we’ll delve into each of these studies and explore their impact on knowledge share in the sports science industry.
Sports Concussion and Head Impacts
As U.S. researchers diagnose more cases of chronic traumatic encephalopathy (CTE) in retired sports players, questions are arising over how to improve the management of sports concussions and head impacts to prevent players from developing neurodegenerative diseases. Meanwhile, The Drake Foundation has spent the past few years funding studies to answer these questions and improve our understanding of head impacts in the UK. The Foundation has funded various studies that examine head injuries like concussion in rugby and concussion in football, revealing increasing evidence that suggests a link between sports-related head impacts and poorer brain health outcomes.
Head Impacts and Concussion in Rugby
In 2016-17, the Professional Rugby Injury Surveillance Project (PRISP) concluded that concussion was the most common match injury in English Premiership Clubs and the England senior team, making up 22% of all match injuries. The Rugby Football Union (RFU) publishes statistics like these and updates its law book in light of new scientific research. The Drake Foundation has funded the following research to develop our understanding of head impacts in rugby.
1. Drake Rugby Biomarker Study
In 2015, The Drake Foundation teamed up with Saracens Rugby Club to work on its first research study, the Drake Rugby Biomarker Study. This study originally examined potential biomarkers of rugby concussions in Saracens rugby players and later expanded to include several Premiership and Championship teams in London. The research involved collecting players’ blood, urine, and saliva samples and applying advanced neuroimaging techniques and cognitive tests to examine changes associated with participation in elite rugby.
In 2021, the results of the advanced neuroimaging wing of this study were published, finding that 23% of the elite rugby players studied had abnormal changes to the white matter (wiring) or blood vessels of their brains and 50% had an unexpected decrease in white matter volume. The RFU and PLR have since announced a new Advanced Brain Health Clinic to support retired rugby players who might be concerned about their brain health.
2. BRAIN Study
In 2016, The Drake Foundation awarded funding to the ongoing BRAIN Study, a cross-sectional examination of the health of 150 former rugby players aged 50+ who played in the amateur era. The research examines the link between head injuries sustained in rugby and subsequent neurodegenerative disease, decline in physical and cognitive capabilities, and quality of life. Participants underwent neurological clinical examinations to identify signs of disease; tests to assess grip strength, memory, and reasoning; face-to-face assessments; and blood and urine samples. The findings should be key to developing an understanding of the long-term effects that rugby head injuries can have on neurological health.
In 2021, the first results from the BRAIN study were published. The researchers found that there was no association between the number of head injuries sustained and later life cognitive function in the ex-players aged 50-75. However, they found that in ex-players aged over 75, there was a link between sustaining a higher number of concussions (3 or more over their career) and poorer cognitive function.
Concussion in Football
Although there aren’t any official statistics on head injury rates in professional English football, several data sets demonstrate that football can cause head injury hospitalisations. In particular, Dr Willie Stewart’s FIELD Study involved the analysis of data from Scottish medical records to determine whether the incidence of degenerative neurocognitive disease is more common in former footballers than in the general population. The study concluded that retired footballers in Scotland are 3.5 times more likely to die from brain disease than men of a similar age and background.The study is now publishing more data on risk versus playing position, disease risk, and mental health outcomes. Meanwhile, the many degenerative brain disease diagnoses of former footballers are indicative of the link between head impacts and concussion in football and brain changes.
The Drake Foundation kickstarted its head injury research with a small project that involved post-mortem examination on the brains of former professional footballers. The Foundation’s portfolio of football studies has since expanded to investigate both the short- and long-term effects of concussions and head impacts in footballers.
1. Mixed Pathologies Study
In 2017, The Drake Foundation completed its first study: Mixed Pathologies Including Chronic Traumatic Encephalopathy Account for Dementia in Retired Association Football (Soccer) Players. This study tested 14 retired footballers for signs of CTE and included a post-mortem brain examination of six of these players. The study found that:
- Former footballers who developed dementia did so at an average age of 63.6 years. From this point, the players’ average lifespan was 10 years.
- 12 out of 14 players displayed behavioural changes.
- 12 out of 14 displayed signs of apathy.
- 10 out of 14 showed more signs of aggression.
- 7 out of 14 experienced motor impairment issues.
Furthermore, during the post-mortem stage of the study, researchers found that all six former footballers displayed signs of Alzheimer’s, and four out of six displayed signs of CTE.
2. HEADING Study
In 2018, The Drake Foundation expanded on its BRAIN Study by funding the HEADING Study. This ongoing research examines approximately 300 retired professional footballers to identify links between repeatedly heading the ball and the risk of developing neurodegenerative diseases later in life. Retired footballers aged 50+ are undergoing neurological clinical examinations, extensive tests to capture their physical and cognitive capabilities, face-to-face assessments, and blood samples to gain essential data. The current England men’s team manager Gareth Southgate and former Arsenal and England footballer Tony Adams have been advocating for the study and encouraging retired footballers to participate in the research.
3. Drake Football Study
In 2019, The Drake Foundation launched the Drake Football Study, the most comprehensive study in professional footballer physical and mental health to date. The longitudinal study involves the gathering of epidemiological data on neurocognitive, musculoskeletal, cardiovascular, and mental health trends in professional footballers over their pre- and post-retirement years. Researchers will collect data for at least 10 years to generate new insights into over 200 players’ health. The study is set to inform future preventative and curative measures for players.
4. Drake Football Concussion Study
The Drake Foundation’s latest football head injury study involves a partnership with the University of Birmingham. The partnership has enabled The Drake Football Concussion Study, which involves testing Premier League footballers’ saliva and urine samples to identify potential markers for head injuries using the revolutionary ‘Birmingham Concussion Test’. This test is based on a decade of research led by neurosurgeon Professor Tony Belli.
Aside from the University of Birmingham, The Drake Foundation collaborates with several stakeholders in the UK football arena, including through the Drake Sports Head Impact Research Symposium. The Foundation hosts this annual scientfic conference in partnership with the Football Association, Rugby Football Union, England and Wales Cricket Board, and British Horseracing Authority.
The Drake Foundation’s Latest Work: The Drake IPV Study
In 2021, The Drake Foundation expanded its scope to examine brain health outcomes in people who have been exposed to intimate partner violence (IPV). Much like the organisation’s contributions to the sports arena, the Drake IPV Study is set to develop our scientific understanding of the link between head impacts and long-term brain health.
Although approximately 30% of women aged 15+ experience physical or sexual IPV around the world, few studies examine the lifelong consequences of this abuse. The Drake IPV Study will investigate changes in neuroimaging, cognitive test data, and changes that correlate with TBI exposure in domestic abuse victims to gain a better understanding of IPV-related head injuries and any links to dementia risks.
Read more about The Drake Foundation’s projects.
About James Drake, Chairman of The Drake Foundation
Philanthropist James Drake founded The Drake Foundation in 2014 to improve knowledge share about the long-term health implications of a career in football or rugby. Drake is also the founder of the progressive scientific and medical publisher Future Science Group and the not-for-profit organisation The Drake Calleja Trust. While Future Science Group is home to 34 peer-reviewed journals that publish the latest in scientific, medical, and biotechnological research, The Drake Calleja Trust offers scholarships for exceptional musicians, songwriters, and producers from underprivileged backgrounds. Drake is also the founder of several art and literature projects, including the Troubetzkoy Archive Project.
