A new article publishing online today in the Quarterly Journal of Medicine has reported the first case showing an association between exposure to head injuries in rugby union players and an increased risk in neurodegenerative disease.
Until now, the association between head injuries and neurodegenerative disease, specifically chronic traumatic encephalopathy (CTE), has predominantly been made with boxers. However Dr Michael Farrell and colleagues have presented the first comprehensive case report of CTE in a former amateur rugby union player, who died six years after displaying the first symptoms of neurological decline at age 57.
The patient in the report played rugby for most of his life, from early teens to age 50 and played just below international standard for much of his career. His family have said that he experienced many head injuries and symptoms of mild concussion throughout this time. The report demonstrates CTE, sometimes known as Punch Drunk Syndrome, arising in an amateur rugby union player who had repeated concussion through participation in the sport. However, the report also illustrates there may still be a way to go. Dr Farrell says "despite increasing recognition of the association between concussion and CTE, confirmed cases remain few."
He went on to say "there remains limited awareness in clinics that the condition occurs in sports outside of boxing...with increased awareness of CTE, we would suggest the diagnosis might be considered in any patient presenting to dementia services with a prior history to exposure of TBI."
In this case report, the patient was not diagnosed with CTE prior to his death, and was only discovered post-mortem. Dr Farrell and colleagues believe that their findings display a need for currently understanding of CTE to be reviewed, especially since concussion levels in rugby union are reported to be among the highest in contact sport.