Neurophysiological and cognitive impairment following repeated sports concussion injuries in retired professional rugby league players

Alan J. Pearce*, Billymo Rist, Clare L. Fraser, Adrian Cohen, Jerome J. Maller

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)


Background: Concussion is regarded as a common injury in rugby league, however no studies have explored the long-term neurophysiological and cognitive effects of repeated concussion injuries in this sport. Methods: Former professional rugby athletes (n = 25) were compared to 25 age-matched participants with no history of a concussion. All participants completed standardised motor dexterity, reaction time, and cognitive tasks for working memory, associative learning and rule acquisition and reversal. Single-pulse transcranial magnetic stimulation (TMS) acquired motor evoked potentials and cortical silent period (cSP), as well as paired-pulse TMS for short latency intracortical inhibition and long intracortical inhibition (LICI). Results: Compared to controls, dexterity and visuomotor reaction time was slower in the rugby group compared to controls (p = 0.02, p < 0.01, respectively). The rugby group also demonstrated poorer cognitive performance than controls (p range 0.02 to < 0.01). TMS revealed significantly reduced cSP at suprathreshold stimulation intensities (p range 0.02 to <0.01), and increased LICI (p = 0.03) in the rugby group. Discussion: These findings of motor and cognitive changes, along with neurophysiological alterations, particularly with intracortical inhibition, nearly two decades post-concussion provides evidence for long-term sequelae for athletes with a history of repeated head trauma in contact sports.

Original languageEnglish
Pages (from-to)498-505
Number of pages8
JournalBrain Injury
Issue number4
Publication statusPublished - 21 Mar 2018
Externally publishedYes


  • concussion
  • mild traumatic brain injury
  • motor cortex inhibition
  • motor execution slowness
  • rugby league
  • Sport
  • transcranial magnetic stimulation


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