Study of Concussion in Rugby Union through MicroRNAs (SCRUM): a study protocol of a prospective, observational cohort study

Research output: Contribution to journalArticlepeer-review


  • Kamal M Yakoub
  • Conor Bentley
  • Callum N Watson
  • Mario Forcione
  • Ugo Scarpa
  • Jonathan R B Bishop
  • Emma Toman
  • Douglas Hammond
  • Matthew J Cross
  • Keith A Stokes
  • Simon P T Kemp
  • David K Menon

External organisations

  • University Hospitals Birmingham NHS Foundation Trust
  • Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Aging, University of Birmingham , Birmingham, United Kingdom.
  • Neurotrauma and Ophthalmology Research Group, Institute of Inflammation and Aging, University of Birmingham, Birmingham, UK.
  • Head Injury Management Research Group, Faculty of Clinical and Biomedical Science, School of Dentistry, University of Central Lancashire, Preston, UK.
  • Premiership Rugby, Twickenham, London, UK.
  • Rugby Football Union, Twickenham, London, UK.
  • The Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana Champaign, Illinois, USA.
  • Addenbrooke's Hospital


INTRODUCTION: The diagnosis of mild traumatic brain injury or sports-related concussion is a challenge for all clinicians, players, coaches and parents involved in contact sports. Currently, there is no validated objective biomarker available to assess the presence or severity of concussion in sport, and so it is necessary to rely on subjective measures like self-reporting of symptoms which depend on the cooperation of the athlete. There is a significant health risk associated with repetitive injury if the diagnosis is missed, and so there is great value in an objective biomarker to assist diagnostic and prognostic decisions.

OBJECTIVE: To establish a panel of non-invasive MicroRNA biomarkers in urine and saliva for the rapid diagnosis of sports-related concussion and investigate the kinetics and clinical utility of these biomarkers in assisting diagnostic, prognostic and return-to-play decisions.

METHODS AND ANALYSIS: Observational, prospective, multicentre cohort study recruiting between the 2017-2018 and 2018-2019 Rugby Union seasons. Professional rugby players in the two highest tiers of senior professional domestic rugby competition in England will be recruited prospectively to the study. During the season, three groups will be identified: athletes entering the World Rugby Head Injury Assessment (HIA) protocol, uninjured control athletes and control athletes with musculoskeletal injuries. Saliva and urine will be collected from these athletes at multiple timepoints, coinciding with key times in the HIA protocol and return-to-play process.

ETHICS AND DISSEMINATION: Ethics approval has been obtained. The compiled and analysed results will be presented at national and international conferences concerning the care of patients with traumatic brain injury. Results will also be submitted for peer review and publication in the subject journals/literature.


Original languageEnglish
Article numbere024245
JournalBMJ open
Issue number11
Publication statusPublished - 25 Nov 2018


  • biomarkers, chronic traumatic encephalopathy, concussion, miRNA, sport concussion, traumatic brain injury