The Brain Health Research Institute

Permanent link for this collectionhttp://hdl.handle.net/10292/21288

The Brain Health Research Institute (BHRI) (formerly The Traumatic Brain Injury Network) aims to unite people, services and research to discover how to improve brain health across the lifespan.

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Now showing 1 - 6 of 6

Factors Influencing Equestrian Helmet Use, Purchase and Safety Perceptions: A Cross-sectional Study
(Elsevier, 2025-11-27) Gosbee, H; Hume, PA; Theadom, A
Objective Helmets play a critical role in preventing and reducing the severity of head injuries in high-risk sports. Understanding the factors influencing equestrian helmet use and safety perceptions is needed to optimise injury prevention strategies. Methods In this cross-sectional study of 596 equestrian participants aged ≥12 years, we assessed helmet use, factors influencing helmet purchase decisions, and perceptions of helmet safety. Chi square tests and regression models examined differences by age, professional status, jumping versus non-jumping disciplines and concussion history. Results Helmet use whilst riding was high (96 % participants). A high proportion of helmets used for competition (97 %) met at least one safety standard, however this was lower for recreational use (65 %). Younger equestrians (aged 12-44 years) and those who had not experienced a concussion were more likely to rank price as the most important factor for helmet purchase decision making. There were no differences by jumping or non-jumping equestrian disciplines or professional status. Older age and being female were independently linked with higher perceptions of helmet safety in the regression model (p = 0.01). Conclusion Safety messages need to focus on improving understanding of helmet standards and the reasoning behind safety recommendations to help reduce the injury risk in equestrian sports, particularly targeting adolescents/young adults.
The Impact of Balance Exercise on Brain Age and Brain Morphometry: Insights From MRI Analysis
(Springer, 2026-01-22) Narula, Varima; Taylor, Denise; McLaren, Ruth; Taylor, Rachael L; Mahon, Susan; Smith, Paul F; Chaudhary, Shikha; Winton, Roger W; Fernandez, Justin; Shim, Vickie; Wang, Alan
Physical exercise is known to delay the cognitive decline in the elderly. However, the effect of low-impact balance exercises such as yoga or Tai chi has not been explored in detail. This cross-sectional observational study used brain magnetic resonance imaging data to quantify and compare various brain structures between neurologically healthy adults aged between 55 and 65, divided into Control Group and Balance Exercise (BE) Group based on the self-reported balance exercise status. Various brain attributes such as brain age, cortical and subcortical volume, thickness, surface area, and mean curvature were extracted and computed using machine learning algorithm software like brainageR and FreeSurfer. Clinical functional assessments (balance, vestibular and cognitive measures) were also conducted for the participants. Statistical analyses were performed to determine any differences between the groups at a significance level of 5%. The BE group showed statistically significantly higher values for the right caudal anterior cingulate thickness, left and right superior temporal volume, left entorhinal volume and mean curvature, left frontal pole thickness, left superior temporal area and left inferior temporal thickness. A statistically significant cluster after correction for multiple comparisons was found in the left rostral middle frontal gyrus with a higher volume for BE group. Clinical functional assessments (balance, vestibular and cognitive) and brain age differences were nonsignificant. The significant brain regions in the BE group are involved in memory, cognition, focus, planning, language and auditory processing, decision making, emotional regulation and mental health and could be responsible for protecting and delaying the cognitive declines in the elderly.
MRI-T2 Relaxometry is Increased in Mild Traumatic Brain Injury: Indications of Acute Brain Abnormalities After Injury
(Wiley, 2025-04-03) Bedggood, Mayan; Essex, CA; Theadom, A; Murray, H; Hume, P; Holdsworth, SJ; Faull, RLM; Pedersen, M
Mild traumatic brain injury (mTBI) is a common condition, particularly pervasive in contact sports environments. A range of symptoms can accompany this type of injury and negatively impact people's lives. As mTBI diagnosis and recovery largely rely on subjective reports, more objective injury markers are needed. The current study compared structural brain MRI-T2 relaxometry between a group of 40 male athletes with mTBI within 14 days of injury and 40 age-matched male controls. Voxel-averaged T2 relaxometry within the gray matter was increased for the mTBI group compared to controls (p < 0.001), with statistically significant increased T2 relaxometry particularly in superior cortical regions. Our findings indicate subtle brain abnormalities can be identified in acute mTBI using MRI-T2 relaxometry. These brain abnormalities may reflect inflammation present in the brain and could constitute an objective injury marker to supplement current subjective methods that dominate clinical decisions regarding diagnosis and prognosis. Future research should validate this potential marker with other data types, such as blood biomarkers or histological samples.
Concussion-Related Biomarker Variations in Retired Rugby Players and Implications for Neurodegenerative Disease Risk: The UK Rugby Health Study
(MDPI AG, 2024-07-17) Alanazi, N; Fitzgerald, M; Hume, P; Hellewell, S; Horncastle, A; Anyaegbu, C; Papini, MG; Hargreaves, N; Halicki, M; Entwistle, I; Hind, K; Chazot, P
The health and well-being of retired rugby union and league players, particularly regarding the long-term effects of concussions, are of major concern. Concussion has been identified as a major risk factor for neurodegenerative diseases, such as Alzheimer’s and Amyotrophic Lateral Sclerosis (ALS), in athletes engaged in contact sports. This study aimed to assess differences in specific biomarkers between UK-based retired rugby players with a history of concussion and a non-contact sports group, focusing on biomarkers associated with Alzheimer’s, ALS, and CTE. We randomly selected a sample of male retired rugby or non-contact sport athletes (n = 56). The mean age was 41.84 ± 6.44, and the mean years since retirement from the sport was 7.76 ± 6.69 for participants with a history of substantial concussions (>5 concussions in their career) (n = 30). The mean age was 45.75 ± 11.52, and the mean years since retirement was 6.75 ± 4.64 for the healthy controls (n = 26). Serum biomarkers (t-tau, RBP-4, SAA, Nf-L, and retinol), plasma cytokines, and biomarkers associated with serum-derived exosomes (Aβ42, p-tau181, p-tau217, and p-tau231) were analyzed using validated commercial ELISA assays. The results of the selected biomarkers were compared between the two groups. Biomarkers including t-tau and p-tau181 were significantly elevated in the history of the substantial concussion group compared to the non-contact sports group (t-tau: p < 0.01; p-tau181: p < 0.05). Although between-group differences in p-tau217, p-tau231, SAA, Nf-L, retinol, and Aβ42 were not significantly different, there was a trend for higher levels of Aβ42, p-tau217, and p-tau231 in the concussed group. Interestingly, the serum-derived exosome sizes were significantly larger (p < 0.01), and serum RBP-4 levels were significantly reduced (p < 0.05) in the highly concussed group. These findings indicate that retired athletes with a history of multiple concussions during their careers have altered serum measurements of exosome size, t-tau, p-tau181, and RBP-4. These biomarkers should be explored further for the prediction of future neurodegenerative outcomes, including ALS, in those with a history of concussion.
A Novel Method to Assist Clinical Management of Mild Traumatic Brain Injury by Classifying Patient Subgroups Using Wearable Sensors and Exertion Testing: A Pilot Study
(MDPI AG, 2023-05-26) McGeown, Joshua P; Pedersen, Mangor; Hume, P; Theadom, Alice; Kara, Stephen; Russell, Brian
Although injury mechanisms of mild traumatic brain injury (mTBI) may be similar across patients, it is becoming increasingly clear that patients cannot be treated as one homogenous group. Several predominant symptom clusters (PSC) have been identified, each requiring specific and individualised treatment plans. However, objective methods to support these clinical decisions are lacking. This pilot study explored whether wearable sensor data collected during the Buffalo Concussion Treadmill Test (BCTT) combined with a deep learning approach could accurately classify mTBI patients with physiological PSC versus vestibulo-ocular PSC. A cross-sectional design evaluated a convolutional neural network model trained with electrocardiography (ECG) and accelerometry data. With a leave-one-out approach, this model classified 11 of 12 (92%) patients with physiological PSC and 3 of 5 (60%) patients with vestibulo-ocular PSC. The same classification accuracy was observed in a model only using accelerometry data. Our pilot results suggest that adding wearable sensors during clinical tests like the BCTT, combined with deep learning models, may have the utility to assist management decisions for mTBI patients in the future. We reiterate that more validation is needed to replicate the current results.
Brain Injury Screening Tool (BIST): Test-retest Reliability in a Community Adult Sample
(BMJ Journals, 2022) Shaikh, N; Tokhi, Y; Hardaker, N; Henshall, K; Forch, K; Fernando, K; King, D; Fulcher, M; Jewell, S; Bastos-Gottgtroy, R; Hume, P; Theadom, A
OBJECTIVE: To determine the test-retest reliability of the Brain Injury Screening Tool (BIST), which was designed to support the initial assessment of mild traumatic brain injury (mTBI) across a variety of contexts, including primary and secondary care. DESIGN: Test-retest design over a 2-week period. SETTING: Community based. PARTICIPANTS: Sixty-eight adults (aged 18-58 years) who had not experienced an mTBI within the last 5 years and completed the BIST on two different occasions. MEASURES: Participants were invited to complete the 15-item BIST symptom scale and the Depression, Anxiety and Stress Scale (DASS-21) online at two time-points (baseline and 2 weeks later). To account for large variations in mood affecting symptom reporting, change scores on the subscales of the DASS-21 were calculated, and outliers were removed from the analysis. RESULTS: The BIST total symptom score and subscale scores (physical-emotional, cognitive and vestibular) demonstrated moderate to good test-retest reliability with intraclass correlation coefficients ranging between 0.51 and 0.83. There were no meaningful differences between symptom reporting on the total scale or subscales of the BIST between time1 and time2 at the p<0.05 level when calculated using related samples Wilcoxon signed-rank tests. CONCLUSION: The BIST showed evidence of good stability of symptom reporting within a non-injured, community adult sample. This increases confidence that changes observed in symptom reporting in an injured sample are related to actual symptom change rather than measurement error and supports the use of the symptom scale to monitor recovery over time. Further research is needed to explore reliability of the BIST within those aged <16 years.

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