Study Analyses Brains Of Teenage First XV Over Season, To Better Understand Concussion

Researchers at the Auckland Bioengineering Institute (ABI) are using advanced biomechanical modelling to understand the impact of concussion in a study involving teenage rugby players in the Gisborne area over the course of a season.

The study is being led by Mātai, a Medical Research Institute based in Gisborne-Tairāwhiti, which has a core focus on concussion – commonly described as mild traumatic brain injury (mTBI).
This is Matai’s first mTBI/concussion study and started last year with support from the Gisborne Boys High School First XV Rugby team. Thirty-five players across two teams were involved, and data was acquired from 11 games and 30 training sessions.
With some of the world’s most advanced brain imaging technology, players had their brains scanned at three time points: pre-, mid-, and post-season. Players who experienced head impacts had more MRI scans at different timepoints starting from 24-48 hours after the impact, up to six months post-injury.
The study involves gathering and analysing data from a range of testing modalities, including high-tech mouthguard sensors fitted for each player to monitor head knocks, a portable binocular eye-movement tracker and advanced biomechanical modelling by Dr Vickie Shim and team at the ABI. 
Using NFL data from the USA, Dr Vickie Shim, in collaboration with Mātai and a number of institutions, has developed a simulation model that can process brain injury data in a matter of minutes, rather than hours.
“Previous models required a prohibitively large amount of computational power as well as pre- and post- processing expertise that made them unrealistic for use in clinical settings,” she says. “Our new model, which combines finite element analysis with machine learning, may play an important role in developing a diagnostic tool that can predict the severity of head impacts.”
Finding a way to quantify the impact of a knock to the head (or the transfer of energy on brain tissue) is critical for understanding the mechanisms of mTBI, and to identify appropriate actions in real time, such as removing a player from the game for a certain time period to help prevent long term damage.
“The impact of concussion on the brain generally relies on subjective assessment, of the clinicians assessing them but also the person who has experienced mTBI,” says Dr Shim. “The person who has experienced it can underplay their symptoms, especially rugby players who don’t want to be excluded from the game.” 
The study is being led by 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), and a leading researcher in brain imaging and emerging MRI technologies.
She says the level of collaboration between multi-disciplinary experts makes this project unique. “MRI is a promising technology for detecting changes in the brain resulting from impacts to the head,” she says. “Advances in imaging technology are opening opportunities to see previously invisible damage in the brain caused by mTBI.”
“If we can increase our understanding of mTBI biomarkers (indicators of disorders or injury) by visually seeing the damage via our combination of MRI, saliva tests, eye-tracking, computer simulations, and other methods, it will enable precision medicine and we can better tailor treatment for individuals based on the type and depth of injuries in the brain, better predict the length of time required for recovery, and track recovery over time.”

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