EVIDENCE of brain damage in rugby players has been uncovered in a major new study using advanced imaging and blood biomarkers. Researchers found signs of neurodegeneration and structural brain changes in mid-life former elite athletes, despite no current diagnoses of dementia.
Investigating Brain Damage in Rugby Players
Repetitive head impacts and concussions are known to increase the risk of long-term neurological disease, but the biological underpinnings of brain damage in rugby players remain unclear. Rugby, as one of the most physically intense contact sports, exposes participants to frequent collisions that may have cumulative effects on the brain.
This latest research explored how biomarkers linked to Alzheimer’s and other neurodegenerative diseases could reveal early signs of brain injury in retired players. Using plasma measurements and high-resolution MRI, the study examined subtle indicators of damage long before the onset of clinical dementia.
Methods and Key Findings
In this large prospective study, 200 retired elite rugby players (median age 44 years, 90% male) were compared with 33 unexposed controls. None of the ex-players had dementia, but 12% met diagnostic criteria for traumatic encephalopathy syndrome. Plasma phospho-tau217 concentrations were 17.6% higher in ex-players than controls (95% CI 3.7–33.3, P = 0.047), with 23.1% showing individually elevated levels. Additionally, 9% exhibited raised plasma neurofilament light, a marker of axonal injury.
MRI scans revealed reduced frontal and cingulate cortex volumes, with lower hippocampal volumes linked to longer playing careers. Frontal brain volume correlated negatively with neurofilament light (r = −0.21, P = 0.010), while hippocampal volume correlated negatively with phospho-tau217 (r = −0.19, P = 0.024). These patterns point to measurable structural and biochemical evidence of brain damage in rugby players at mid-life.
Clinical Implications and Future Directions
The study demonstrates that even in the absence of dementia, measurable biomarkers of neurodegeneration can indicate brain damage in rugby players exposed to repeated head impacts. Integrating such screening into player health programmes could improve early intervention and shape safer sporting practices in the future.
Reference
Graham NS et al. Biomarker evidence of neurodegeneration in mid-life former rugby players. Brain. 2025:awaf152.
