“Most of the head injuries were from general life experience, such as contact or extreme sports, and some officers were ex-armed forces,” says Huw Williams, associate professor of clinical neuropsychology at the University of Exeter.
Those with TBI were more likely to have experienced post‐concussion symptoms, which was associated with greater severity of PTSD, depression and drinking to cope.
The research supports findings that head injury can compound PTSD, which almost one in five officers have, and exacerbate drinking as a coping strategy.
The study is the first of its kind, and came about when researchers saw there was no data on the relationship between brain injury in police officers and their mental health.
“We did a brief scoping exercise of the literature, and were fascinated to see there was no research on brain injury in police officers, particularly in connection with brain injury and adverse mental health,” says Nick Smith, graduate research assistant at the University of Exeter.
Williams and Smith were surprised how many officers reported having a brain injury, although they expected there to be a relationship between TBI and adverse mental health.
“We found that, when officers have a mild brain injury, where they were assaulted or in a car accident, they could have PTSD. When they have this with head injury it can be long lasting, and they can exacerbate each other,” says Williams.
“Despite being a relatively small group, the findings were robust enough to say head injury, in the mix with PTSD, depression and drinking to cope, might lead to negative long-term outcomes,” says Williams.
The findings, the researchers argue, highlights a need to tackle TBI and the consequences of post-concussion syndrome, which can cause irritably, poor concentration and memory issues.
The paper states that exploring TBI in the police could, identify a major factor contributing towards ongoing mental health difficulties in a population where, based on previous research, the implications of TBI should not be overlooked.’
“If it’s not properly treated, it could lead to greater absence from work, so it’s reasonable for police forces to pick up on these issues to mitigate risk of long term sickness,” says Williams.
“Otherwise, I can see it snowballing – chronic stresses increase over time and the weight of negative experiences become harder to carry.
“This leads us to think we need a better system in place to identify TBI, an alert system to allow people come back into operations or situations in a way that’s healthy so they’re not exposed to more risk,” Williams says.
In sports, for example, the protocol following a concussion is much clearer, Williams says, and helps to lower a player’s risk of having a second concussion while recovering from the first.
“England Rugby does a great job with concussion management protocols, they identify the problem then do something about it, ensuring people are in the right mindset to be doing a very demanding job,” Williams says.
Increased awareness of TBI in the police would be a natural progression from being aware of prisoners with TBIs, says Williams.
“I’ve worked in prisons looking at how common head injury is in people who end up in prison, and various police forces became interested in working with us in a trauma-informed manner, taking on a more broad view of the vulnerabilities of people they’re working with.
“But working from this perspective involves understanding trauma of people who provide services as well,” he says. “Sixty, 70 percent of the time, police are trying to manage and look after vulnerable people. It’s important to recognise how they can become vulnerable themselves.”
There needs to be a system and trauma-informed principles in place for police officers to manage their own vulnerability, Williams says – and he’s hopeful this will happen in the future.
“Initial conversations with forces indicate a healthy attitude towards trying to improve how can improve psychological wellbeing,” he says.
But this isn’t just up to forces themselves. It’s also important, Smith adds, to lessen divide between police and public.
“Police need help like us – it’s important to understand how trauma might affect them.”
Williams says police are often portrayed negatively in the media, and it’s important that the public is aware of why they make the decisions they make and the laws they have that could lead to them suffering trauma.
PTSD, he says, is more likely to occur when officers don’t feel like society is backing them and the public doesn’t understand why they do what they do.
“It’s important for police to be understood as operating as people for people,” Williams says.
This will also require efforts from across probation, healthcare and education, Williams says, to better understand people from different backgrounds and how to build up empathy across society and reduce violence, as well as educating on the importance of identifying brain injuries when they occur.
Ultimately, Williams is hopeful that police forces want to give officers better protection from the consequences of TBI.
“Police officers need to think about myriad factors at same time, and we want them to be optimum capacity to do that,” Williams says.
This study was a pilot, and Smith hopes to do a much larger study in other police forces across the UK that controls for PTSD and depression to see if increases in post-concussion syndrome are due to head injury and not any other factors.
The first step, Smith says, is finding out the rate of TBI in the police force, then developing a tool to measure and monitor brain injury over time. The research, he says, will be done to help rehabilitate people with TBI, with the aim to help police understand the people they’re meeting, and vice versa.
Williams argues that this work is very relevant to public protection, and it’s important it continues.
New tech start-up supports those living with dementia
MOJO (Moments of Joy) is a new dementia portal and app connecting everybody involved in the care of a loved one.
The MOJO platform aims to share the load, reduce stress and uncover more crucial opportunities for moments of joy.
MOJO launched the #MomentsOfJoy movement last week, which aims to raise awareness of people affected by dementia, both directly and indirectly.
Dementia is the biggest cause of death in the UK today, with over 850,000 currently diagnosed cases. Unlike many other illnesses however, it is the wider family who often bear the burden of primary care, and there has been very little support available for them during this incredibly challenging journey. MOJO aims to change this with a combination of accessible technical innovation, helpful online resources and real-time support workshops.
Founded by UK-based entrepreneurs John Thornhill and Sasha Cole, MOJO helps families and their loved ones by reducing the stigma around dementia through a holistic support platform and positive philosophy.
The MOJO platform and app provide practical tools to ensure that medical treatment is monitored and reported in a simple way, and imaginative features to create a more comfortable care environment for the whole family.
The suite of tools, includes, ‘MOJO Manager’, which uses imaginative new features to share the practical elements of care amongst the wider family, whilst creating moments of joy during times spent together. MOJO Mentoring, which provides live workshops, advice sessions, and online resources, while MOJO Monitoring is an alert system for situations of disorientation or wandering.
John Thornhill, co-founder of MOJO, realised that technology could revolutionise dementia support. “Most of us have seen the effect of dementia on the patient, but MOJO is for the family. For those whose daily lives are dramatically altered by the practical responsibility and emotional impact of a loved one’s dementia diagnosis.
“Until now there has been little help available for them. We believe our philosophy, ongoing support and technology will make that difficult journey less challenging and more joyful for everybody involved. “
Sasha Cole, co-founder of MOJO adds: “Having worked in dementia-related fields for over ten years, I am acutely aware of the lack of support for patients’ families who are often obliged to provide primary care. The burden of responsibility can be overwhelming. Our aim is to share the load, reduce stress and uncover more crucial opportunities for moments of joy. In this context, what could be more important?
“Philosophically, it’s about going with the flow. It’s easier for us to think like a person who has dementia, than for your loved to think like a person who hasn’t. Although our realities might not always align, the emotional response is what counts. After all, laughter is the best medicine.”
Could female footballers face greater dementia risk?
Female footballers heading the ball could be putting themselves at even greater risk of dementia than male players according to experts at the University of East Anglia.
Dr Michael Grey is running a project to monitor ex-footballers for early signs of dementia.
More than 35 former professional players have now signed up including former Norwich City stars Iwan Roberts and Jeremy Goss, and Crystal Palace hero Mark Bright.
But the research team are urgently looking for amateur and professional female players to take part too.
Research from the University of Glasgow has shown that retired male players are around five times more likely to suffer from Alzheimer’s disease compared with the average person.
But little is known about when players start to show signs of the deteriorating brain health and even less about the effects in women as the majority of research has focussed on men.
Dr Grey, from UEA’s School of Health Sciences, said: “We know that there is greater risk of dementia in former professional footballers, and we think this is related to repetitive heading of the ball.
“We know very little about how this affects female players, but we think female players are at even greater risk of developing sport-related dementia than male players.
“We know there are physical and physiological differences between male and female players and this could be important when it comes to the impact of repeatedly heading the ball.
“But we don’t fully understand the impact these differences could have, so we are encouraging former amateur and professional female players to come forward to help us with our project.”
The team will use cutting-edge technology to test for early signs of cognitive decline in men and women, that are identifiable long before any memory problems or other noticeable symptoms become apparent.
Dr Grey said: “We have already signed up more than 35 professional male players but we have very few women footballers in the study so far. We are looking for women and men over 40, who live in the UK and do not have a diagnosis of dementia. Testing is conducted on a computer or tablet from the comfort of their own homes and takes around 30 minutes, four times per year.
“We are tracking their brain health over time. And we hope to follow these footballers for many years to come.”
The project is among a number of pieces of work in the Concussion Action Programme, a research group within UEA Health and Social Care Partners.
Want to take part?
The research team are looking for former professional football players, both men and women, who are aged over 40 to take part in the study. Amateur footballers and active non-footballers aged over 40 can also take part.
The research will see a small group of participants coming into the lab, but the majority of the testing will be done online at home.
Magnetic sensor could detect early signs of TBI
Signs of traumatic brain injury, dementia and schizophrenia could be detected at an earlier stage as a result of the development of a new sensor which measures weak magnetic signals in the brain.
Through the development of the new Optically Pumped Magnetometer (OPM) sensor, scientists are hopeful of enabling a greater understanding of connectivity in the brain, which could have significant benefits in the chances of early diagnosis.
The device, developed by teams of scientists at the University of Birmingham, is currently in trail stage and clinicians at the Queen Elizabeth Hospital Birmingham are involved in its use in pinpointing the site of TBIs.
Its potential to increase diagnostics for neurological injury, neurological disorders such as dementia, and psychiatric disorders such as schizophrenia, has been widely recognised, and the team are now seeking commercial and research partnerships to help advance its development further.
The new sensor has enabled advances in detecting brain signals and distinguishing them from background magnetic noise, when compared to commercially available sensors. By using polarised light, the device can detect changes in the orientation of spin atoms when exposed to a magnetic field.
The team was also able to reduce the sensor size by removing the laser from the sensor head, and made further adjustments to decrease the number of electronic components, in a move that will reduce interference between sensors.
Benchmarking tests have taken place at the University’s Centre for Human Brain Health, and has reported “good” performance in environmental conditions where other sensors do not work.
Specifically, the researchers showed that the new sensor is able to detect brain signals against background magnetic noise, raising the possibility of magnetoencephalography (MEG) testing outside a specialised unit or in a hospital ward.
The research – published in the ‘Detection of human auditory evoked brain signals with a resilient non linear optically pumped magnetometer’ report, Kowalczyk et al (2020) – was led by physicist Dr Anna Kowalczyk.
“Existing MEG sensors need to be at a constant, cool temperature and this requires a bulky helium-cooling system, which means they have to be arranged in a rigid helmet that will not fit every head size and shape,” she says.
“They also require a zero-magnetic field environment to pick up the brain signals. The testing demonstrated that our stand-alone sensor does not require these conditions.
“Its performance surpasses existing sensors, and it can discriminate between background magnetic fields and brain activity.”
The researchers expect these more robust sensors will extend the use of MEG for diagnosis and treatment, and they are working with other institutes at the University to determine which therapeutic areas will benefit most from this new approach.
Neuroscientist Professor Ole Jensen, who is co-director of the Centre for Human Brain Health (CHBH), highlighted the potential of the sensor.
“We know that early diagnosis improves outcomes and this technology could provide the sensitivity to detect the earliest changes in brain activity in conditions like schizophrenia, dementia and ADHD,” he says.
“It also has immediate clinical relevance, and we are already working with clinicians at the Queen Elizabeth Hospital to investigate its use in pinpointing the site of traumatic brain injuries.”
The team at the CHBH has also recently been awarded Partnership Resource Funding from the UK Quantum Technology Hub Sensors and Timing to further develop new OPM sensors.
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