Two more named in Players' dementia action

The legal action against rugby union’s authorities took a decisive step forward on Thursday when the firm representing nine players diagnosed with long-term brain injuries sent pre-action letters of claim to World Rugby, the Rugby Football Union and the Welsh Rugby Union. Rylands Law also revealed the identities of two more of the nine players involved in the test cases alongside Steve ThompsonAlix Popham and Michael Lipman. They are the former Wales under-20 centre Adam Hughes and the former England under-21 back-row Neil Spence.

The development comes as the former England captain Dylan Hartley spoke out about the lack of teaching in rugby around the risk of dementia. “From when I started until last week, I didn’t know dementia was a potential outcome for any rugby player,” Hartley said on RugbyPass’ Offload podcast. “That wasn’t educated or taught to us.” Hartley admitted he is having his “own problems” with concussion in retirement, but said he does not want to reveal more about them.

Neil Spence during his playing career at Rotherham.
‘A side of me is lost for ever’: two more rugby players on their brain injuries

Hughes, 30, is the youngest player involved in the action so far. He has been diagnosed with “having brain injuries and post-concussion symptoms”, and has been told he is on a “similar medical trajectory” to Popham, Lipman, Thompson and Spence, who have all been diagnosed with early-onset dementia and probable chronic traumatic encephalopathy. Hughes played for the Dragons, Bristol and Exeter between 2010-18, and his experience throws doubt on the argument that the game has become significantly safer in the past decade.

Hughes was forced to retire at the age of 28 after a particularly severe concussion and is now working as a financial adviser. “It was just one head knock too many. I was finding it more and more difficult to recover from each and every bang to the head,” he said. He reports being knocked out eight times in his career. “At first it was the bigger concussions where I was completely knocked out that took me ages to recover from then over the time even the smaller ones started to have an impact. For the sake of my health, I had to bring it to a halt.”

One of Hughes’s former coaches, Rob Baxter at Exeter, said last week the game’s approach to head injuries has improved so much in the years since Thompson, Lipman and Popham retired that “there’s almost very little value in trying to compare the two”. Hughes, who played for the Chiefs in 2014-15, told a different story. “For me, I think the biggest issue around concussions was attitude. It was often treated like a weakness if you don’t dust yourself down and carry on.”

He added that “the game still has a very long way to go in terms of education about concussion”.

Adam Hughes (left), pictured in action for Dragons in 2016, retired age 28 after a severe concussion.
Adam Hughes (left), pictured in action for Dragons in 2016, retired age 28 after a severe concussion. Photograph: Huw Evans/Shutterstock

Four more players involved in the test cases have decided to remain anonymous. Rylands Law is already representing around 100 former rugby players and said 30 more have been in contact since the involvement of Thompson, Popham and Lipman was revealed by the Guardian last week.

In a statement World Rugby, the RFU and the WRU said: “We have been deeply saddened to hear the brave personal accounts from former players. Rugby is a contact sport and while there is an element of risk to playing any sport, rugby takes player welfare extremely seriously and it continues to be our number one priority. As a result of scientific knowledge improving, rugby has developed its approach to concussion surveillance, education, management and prevention across the whole game.

“We have implemented coach, referee and player education and best-practice protocols across the game and rugby’s approach to head injury assessments and concussion protocols has been recognised and led to many other team sports accepting our guidance. We will continue to use medical evidence and research to keep evolving our approach.”

Sir Bill Beaumont, the chairman of World Rugby, added: “As a player who retired on medical advice in the early 1980s, I care deeply about the welfare of all players. As an administrator, I will do all I can to maintain the confidence and wellbeing of those who play the game.”

The pre-action letters of claim set out the broad allegations upon which the cases are based. They state the governing bodies had a duty “to take such steps and to devise and implement such rules and regulations as were required in order to remove, reduce or minimise the risks of permanent brain damage as a consequence of the known and foreseeable risk of concussive and sub-concussive injuries”.

They also allege the risks of concussions and sub-concussive injuries were “known and foreseeable”, listing 24 failures on the part of World Rugby, RFU and WRU. The governing bodies have a maximum of three months from the date of acknowledgment of the letters of claim to provide their initial responses.

We modernise head-injury care with early, objective detection,replacing subjective, paper-based questionnaires and raising the standard of care.

Head Injuries in Sport

Modernising head-injury care with early, objective detection—replacing subjective paper tools. Physical activity benefits individuals and communities—enhancing health, cohesion, skills, confidence, and economic value. Evidence indicates population-wide physical activity lowers dementia risk and the incidence of stroke, heart disease, obesity-related conditions, some cancers, and depression.

Stronger, faster athletes—enabled by advances in coaching, conditioning, equipment, and facilities—heighten the need to prioritise acquired brain injury and concussion, reinforcing the duty-of-care agenda highlighted by Baroness Grey-Thompson (2017).

The DCMS Select Committee’s inquiry into concussion in sport (July 2021) provides a valuable call to action aligned with the Government’s approach.

We aim  for all ages and abilities to be active, whilst  addressing head injuries requires coordinated action across sport, health, education, academia, and technology. Minimise avoidable risk and ensure clear, consistent head-injury guidance; risk can’t be eliminated, and sweeping rule changes aren’t always required, but practical measures should be implemented.

We work with partners to implement and refine measures as research, technology, and data evolve—maintaining a continuous programme, reviewed and updated as evidence warrants.

We work with partners to implement and refine measures as research, technology, and data evolve—maintaining a continuous programme, reviewed and updated as evidence warrants.

How BHN Works

Clinical need
Current head injury diagnosis relies on recognising a potentially injurious event followed by self- or third-party reporting. Evidence shows that individuals may exhibit subtle, measurable brain changes with minimal or no symptoms. There is a clear need for sensitive, objective tools that reduce reliance on self-reporting and enable timely treatment and recovery.

BHN solution
The BHN Portable Real-Time EEG device offers rapid, objective assessment using a small array of dry electrodes and does not require pre-injury baseline recordings.

Technology
The BHN system comprises five flexible, conductive-polymer EEG electrodes with leads connected to a microcontroller housed in a module approximately the size of a USB thumb drive. It integrates with a range of headgear to provide portable, unobtrusive EEG monitoring and is designed for use in high-risk civilian, military, and sports settings. The device is engineered to support real-time detection of mTBI as events occur

 

 

BHN Research Approach

TaCKLE (Tackle and Contact Kinematics, Load and Exposure) is a joint initiative between the Betfred Super League, the Rugby Football League (RFL) and BHN to strengthen concussion management and wider player welfare. “That’s our evidence-based approach to make sure we have the information” says Professor Ben Jones..

The project uses BHN’s miniaturised EEG technology to assess player exposure and neurophysiological responses. Brainwave data are collected at rest, post-match (controls), and following head injuries to evaluate the system’s reliability, validity and practical utility. Findings will inform the application of BHN’s technology in rugby league and support ongoing player-welfare initiatives.

BHN Portable Wearable Sensor

BHN Overview
BHN offers a first-of-its-kind wearable decision-support platform that combines high-fidelity EEG monitoring with artificial intelligence to automate key elements of triage and management for suspected head injuries.

Role in mTBI Care
BHN introduces a new position in the mTBI pathway by detecting an objective physiological signal of brain injury, independent of the precipitating force, and generating alerts so assessment, care, and documentation can begin immediately.

Differentiation and Impact
Unlike prior approaches that infer injury from environmental or biomechanical surrogates (e.g., impact counts or accelerations), BHN measures the brain’s electrical activity directly. In sport, mTBI is estimated to be missed in up to 50% of cases; BHN aims to reduce undetected injuries and support safer, evidence-based return-to-play decisions.

 

Electronic Brain Record

Data Integration and Access

Securely unify longitudinal EEG data and integrate with EHRs via HL7, giving field-side and clinic teams timely access to vitals and neurophysiological metrics for immediate care and recovery planning.

 

Addressing a Critical Unmet Need

Purpose
A portable, non-invasive, real-time monitoring device designed to support the recognition of mild TBI.

Clinical Value & Deployment
BHN delivers more precise injury characterisation and a comprehensive view of brain status. We are advancing sports deployment through a phased, safety- and feasibility-led programme, backed by decades of clinical and device experience and a clear path to market—positioned to markedly improve early recognition, treatment, and recovery given the high incidence of match-play head injuries.

Key Attributes

  • Baseline-free, direct measurement of neurophysiological injury

  • On-device processing with longitudinal tracking via a secure, hosted cloud

  • Minimal training required