The International Concussion and Head Injury Research Foundation Brain health in Retired athletes Study of Ageing and Impact-Related Neurodegenerative Disease. The ICHIRF-BRAIN Study.

Introduction and aimsTraumatic brain injury (TBI) is a leading cause of death and disability worldwide. Large registry studies have demonstrated a dose-response relationship between TBI and neurodegenerative disease ; however, disentangling the direct effects of TBI from ageing and/or a progressive neurodegenerative process is problematic. This study is a prospective long-term cohort study to examine a population of retired elite athletes at high risk of concussion and mTBI during their sporting careers compared to age- and sex-matched controls with no history of TBI. The aim is to determine the incidence and risk factors for neurodegenerative disease and/or age-related effects on brain health in this population. Methods and analysisA population of retired male and female elite athletes and controls aged 40-85 years, will be assessed at baseline and serial time points over 10 years during life using a multi-dimensional assessment including: Questionnaire; SCAT3/5; Neurological and physical examination; Instrumented balance assessment; Computerised neurocognitive screen; Neuropsychological assessment; Advanced MR brain neuroimaging; Visual saccades; Blood workup; Fluid biomarkers; Gut metabolomics; Salivary MicroRNA analysis; Genetic analysis; and where available Brain banking and neuropathology Ethics and disseminationEthics approval was granted by St Marys University SMEC as well as at the various satellite trial sites. The trial is registered with ISRCTN (BioMed Central) with ID number: 11312093. In addition to the usual dissemination process, this phenotypically well-characterised dataset will reside in a publicly accessible infrastructure of integrated databases, imaging repositories, and biosample repositories and de-identified data will be made available to collaborating researchers.