Prospective cohort study of long-term neurological outcomes in retired elite athletes: the Advanced BiomaRker, Advanced Imaging and Neurocognitive (BRAIN) Health Study protocol

• Published in: BMJ open Vol. 14; no. 4; p. e082902
• Main Authors: Zimmerman, Karl A, Hain, Jessica A, Graham, Neil S N, Rooney, Erin Jane, Lee, Ying, Del-Giovane, Martina, Parker, Thomas D, Friedland, Daniel, Cross, Matthew J, Kemp, Simon, Wilson, Mathew G, Sylvester, Richard J, Sharp, David J
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 24.04.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Series: Protocol
• Subjects: Anxiety; Athletes - psychology; Athletic recruitment; Biomarkers; Biomarkers - blood; Brain - diagnostic imaging; Brain research; Chronic pain; Chronic traumatic encephalopathy; Clinical outcomes; Cognition; Cohort analysis; Concussion; Dementia; Disease; Exercise; Female; Football; Football - injuries; head & neck imaging; Humans; Male; Medical imaging; Mental depression; Metabolism; Neurodegeneration; Neuroimaging; Neuroimaging - methods; neurological injury; Neurology; Neuropsychological Tests; Prospective Studies; Research Design; Retirement; Rugby; Sleep; Soccer - injuries; sports medicine; Traumatic brain injury; head & neck imaging; sports medicine; neurological injury
• ISSN: 2044-6055; 2044-6055
• DOI: 10.1136/bmjopen-2023-082902

IntroductionAlthough limited, recent research suggests that contact sport participation might have an adverse long-term effect on brain health. Further work is required to determine whether this includes an increased risk of neurodegenerative disease and/or subsequent changes in cognition and behaviour. The Advanced BiomaRker, Advanced Imaging and Neurocognitive Health Study will prospectively examine the neurological, psychiatric, psychological and general health of retired elite-level rugby union and association football/soccer players.Methods and analysis400 retired athletes will be recruited (200 rugby union and 200 association football players, male and female). Athletes will undergo a detailed clinical assessment, advanced neuroimaging, blood testing for a range of brain health outcomes and neuropsychological assessment longitudinally. Follow-up assessments will be completed at 2 and 4 years after baseline visit. 60 healthy volunteers will be recruited and undergo an aligned assessment protocol including advanced neuroimaging, blood testing and neuropsychological assessment. We will describe the previous exposure to head injuries across the cohort and investigate relationships between biomarkers of brain injury and clinical outcomes including cognitive performance, clinical diagnoses and psychiatric symptom burden.Ethics and disseminationRelevant ethical approvals have been granted by the Camberwell St Giles Research Ethics Committee (Ref: 17/LO/2066). The study findings will be disseminated through manuscripts in clinical/academic journals, presentations at professional conferences and through participant and stakeholder communications.