To explore neurodegenerative risk in mid-life elite retired rugby players exposed to repetitive head impacts using specific biomarkers (plasma neurofilament light, glial fibrillary acid protein, amyloid-β (Aβ)42, Aβ40, and phospho-tau217) and neuroimaging techniques (MRI).
Key Findings:
12% of ex-players met criteria for traumatic encephalopathy syndrome; none had dementia, highlighting the need for ongoing monitoring.
Plasma phospho-tau217 levels were 17.6% higher in ex-players compared to controls, indicating potential early neurodegenerative changes.
23.1% of ex-players had elevated phospho-tau217; 9.0% had raised plasma neurofilament light, suggesting a concerning trend.
Ex-players showed reduced frontal/cingulate cortex volumes and lower hippocampal volume associated with longer career durations, emphasizing the impact of prolonged exposure.
Trauma-associated white matter changes were uncommon (4.6%) in ex-players, suggesting variability in individual responses to head impacts.
Interpretation:
Elevated phospho-tau217 in ex-rugby players may indicate amyloid-dependent tau pathology, suggesting potential neurodegenerative changes linked to sports-related head impacts, warranting further investigation.
Limitations:
Small sample size of controls may limit generalizability, necessitating larger studies to confirm findings.
Cross-sectional design does not establish causality, highlighting the need for longitudinal studies.
Conclusion:
Elite rugby participation is associated with abnormal neurodegeneration biomarkers in mid-life, supporting the need for advanced evaluations of long-term effects from head impacts, particularly in the context of public health and sports safety.
by Neil S N Graham, Karl A Zimmerman, Jessica Hain, Erin Rooney, Ying Lee, Martina Del Giovane, Thomas Parker, Mathew G Wilson, Paresh Malhotra, Michael C B David, Magdalena Kolanko, Maneesh Patel, Elena Veleva, Owen Swann, Amanda Heslegrave, Henrik Zetterberg, Daniel Friedland, Richard Sylvester, David J Sharp
