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Domestic violence an overlooked cause of brain injury While Dr Helen Murray typically uses the brains of rugby players in her research, she is mindful that damage from repeated head knocks affects a broader group, for instance the victims of domestic violence. Despite the focus on athletes, they account for only 20 to 30% of ACC’s traumatic brain injury (TBI) claims each year. Women’s Refuge CEO Dr Ang Jury says the misconception that TBI mainly affects men through sports or serious accidents creates barriers for women who have been beaten by their partners. “People rarely consider the likelihood that women experiencing partner violence will sustain a TBI, even though abusers most often target victims’ heads, faces, necks, and spines – often repetitively,” she says. “There is a high prevalence of TBI in victims of family violence, with just over half of women reporting that they have been punched in the head.” Many domestic violence victims face obstacles to treatment, as abusers will often prevent them seeking medical care, will isolate them from family and friends, and will make it impossible for them to rest and recover. She says education and research to guide specialist agencies and health providers working with victims of domestic abuse is as important as working with sporting bodies. “They can play a key role in supporting victims by proactively asking about head injuries, recognising symptoms, and providing education.” Women’s Refuge and Contact Energy recently released the first comprehensive report on the prevalence of TBI in victims of family violence in Aotearoa. It highlights the experiences and challenges of the unseen victims of TBI – women who have been beaten by their partners. See: womensrefuge.org.nz/safer-how-safer-when/ Dr Helen Murray is a New Zealand representative ice hockey player, and the country’s leading expert on CTE or chronic traumatic encephalopathy – which is caused by repeated head injuries, including concussions and sub-concussive impacts. She is currently supported by a Neurological Foundation Senior Research Fellowship. Her team at the University of Auckland’s Centre for Brain Research (CBR) has made a substantial breakthrough – finding new patterns of inflammation in the brains of rugby players diagnosed with CTE after death. It is an exciting finding as it raises the future possibility of diagnosing CTE in living patients through MRI or blood tests – something currently not possible. “The next step in this research will mark a major shift from studying deceased brains to living brains to progress our understanding of CTE,” Helen says. The brain tissue came from three countries – the Neurological Foundation Human Brain Bank in New Zealand, the Australian Sports Brain Bank, and the UNITE Brain Bank in Boston, USA. The research team found inflammation in the tissue that resembled Alzheimer’s disease, but had unique markers specific to CTE. A vascular inflammation pattern, which Helen describes as “leaky blood vessels”, was observed in CTE cases from all three brain banks, suggesting it is a consistent feature of the disease. “This discovery points to inflammation and vascular health as promising areas for future therapeutic strategies,” Helen says. The next goal is to ensure the translation of these research findings to patients. To achieve this, a specialised CTE Research Clinic is in the early stages of development at the CBR. The purpose of the clinic will be to work directly with people who suspect they have CTE, to gather information and to test new treatments to stop or slow the progression of CTE. Helen actively mentors emerging CTE researchers. Her PhD student Chelsie Osterman was the lead author on the paper – a first for Chelsie. The research was published in the prestigious journal Acta Neuropathologica. “There is a high prevalence of TBI in victims of family violence, with just over half of women reporting that they have been punched in the head.” Dr Ang Jury, Women's Refuge CEO Headlines 11