We can't ignore the impacts of brain injuries
The risks to sports people of brain injury have fortunately received much attention of late.
Prof Willie Stewart and colleagues at the University of Glasgow have demonstrated clear evidence that former professional footballers and international rugby players not only have high prevalence of distinctive degenerative brain pathology known as chronic traumatic encephalopathy (CTE) but also show higher risk of a range of neurodegenerative diseases, including Alzheimer’s disease and motor neuron disease than the general public.
Sports authorities are taking note. In England, the FA introduced new guidance to apply across all levels of the professional and amateur game for heading ahead of the 2021-2022 football season.
This response is commendable but makes it all the more puzzling why so little action has been taken when similar conditions are caused by domestic violence.
Health Minister Lord Markham in response to my question in the House of Lords on 23 October emphasised that victims of domestic violence are 11 times more likely to suffer a consequent traumatic brain injury than from sport.
Global estimates suggesting approximately 30 per cent of women over the age of 15 will have been exposed to physical or sexual Intimate Partner Violence (IPV). Head, neck and facial injuries are reported in up to 90 per cent of women who suffer from IPV.
Indeed, data suggests that in women with a history of IPV, around 70 per cent report sustaining at least one mild traumatic brain injury with 10 per cent reporting at least one moderate/severe injury, and histories of multiple, repetitive Traumatic Brain Injuries (TBIs) are common. Nevertheless, despite the prevalence of IPV in society and, therefore, high exposures to traumatic brain injury, remarkably little attention has been paid to the impact of IPV associated TBI on lifelong health.
Fortunately, the Drake IPV Study is beginning to address the research neglect around IPV related TBI. Commenced in 2021 and led by Professor William Stewart, Professor Craig Ritchie, Dr Graciela Muniz-Terrera as principal investigators at the Universities of Edinburgh and Glasgow, the Study aims to investigate multi modal neuroimaging studies to compare structural and functioning brain imaging in individuals with a history of IPV compared to those with no reported history of IPV. It will also compare cognitive tests for those with and without a history of reported IPV.
Once the test and image results have been gathered there will be checks of whether the individuals experience TBI before the IPV. These investigations will show whether those with a history of IPV have a higher incidence of neuro degenerative disease than the general population.
In addition, the PREVENT dementia team which also includes Prof Craig Ritchie and Dr Graciela Muniz-Terrera of the University of Edinburgh, are carrying out a study of mid-life brain health and has recruited 700 participants aged between 40-59 at baseline, from five sites across the UK and Ireland (Cambridge, Dublin, Edinburgh, London, and Oxford). Among PREVENT Dementia participants, 90 report histories of IPV. Notably, analysis to date on this sub-group demonstrates high risk of mental health disorder, including depression, anxiety, sleep disorder and PTSD symptomatology.
However, further research is important as is Government interest and activity to highlight the problem, so it is reassuring that Lord Markham has shown his commitment to both research and action in this area. In March 2022, the government published the ‘Tackling domestic abuse plan’, in which it promised to pursue perpetrators and prioritise prevention including understanding of what prevention measures work best and which risk factors cause an increased incidence of domestic abuse. Alongside this, the plan seeks to improve the outcomes for victims and survivors.
As Baroness Merron, the shadow health spokesperson in the Lords, highlighted in last week’s oral question, it is vital that there is a reappraisal of IPV and TBI in policing and the criminal justice system to support victims or IPV and enable them to seek the medial support that they need.
Lord Philip Hunt has been a Labour peer since 1997 and is a former deputy leader of the House of Lords.
