Date Opened: April 2014
Longitudinal observational control study
Single Centre
Current status:
Recruitment to date:
Lead researchers: 
Prof Tony Belli, Dr Michael Grey


The REpetitive COncussion in Sport (RECOS) study is designed to look at the effects of repetitive concussion in athletes. The study is supported by the British Medical Association’s Joan Dawkins Grant.

Sport concussion, defined as a brief period of loss of consciousness, memory loss or feeling dazed or confused following trauma to the head, is a common cause of traumatic brain injury (TBI). This type of mild TBI accounts for 10-25% of all recorded head injuries worldwide. The majority of patients improve rapidly following a single concussion, but repeated concussion prolongs recovery times after each incident. Patients also experience a high incidence of cognitive and behavioural dysfunction, post-traumatic stress disorder and social isolation.

Certain groups of patients, such as athletes and soldiers are at greater risk of repetitive concussion – potentially leading to a catastrophic form of brain injury known as second impact syndrome, thought to be due to the second insult occurring inside a window of metabolic vulnerability in the brain.

Our researchers will look at a group of athletes from sports such as rugby, football, American football, Aussie rules, Gaelic football, cycling, gymnastics, equestrianism, alpine sports, motor racing, martial arts and ice hockey, recruited through University of Birmingham Sport (UBSport). The aim is to study the window of brain vulnerability following single and repetitive concussion, with a view to guiding return-to-play policy.

Who is eligible?

This trial is recruiting male or female athletes participating in sports through contacts in University Sports throughout the West Midlands and adjacent areas.

Individuals must be aged 18-40 years and speak fluent English.

They will have suffered either a single or double concussions.

The study

The athletes will undergo a medical check-up for their injuries, together with a number of assessments within 72 hours of suffering a concussion. The assessments are non-invasive, including an MRI scan and other tests to investigate cognitive impairment, motor cortex plasticity (the extent to which the brain can change physically as a result of experience) and fine motor skill. Some samples of blood and urine will also be collected at the same visit. All the assessments will take place at the Birmingham University Imaging Centre ( and will take approximately 3 hours to complete.

These assessments will be repeated every 15 days until the scan results and self-reported symptoms return to normal (up to 3 or 4 visits at most for each athlete).

All participants will be reimbursed for their travel to attend the study.


For more information or if you are interested in taking part in this study, please contact any of the following researchers:

Lead researchers