Alan Pearce

Alan Pearce
La Trobe University · School of Allied Health

PhD

About

243
Publications
155,636
Reads
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4,458
Citations
Citations since 2017
108 Research Items
2962 Citations
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Introduction
Non-award winning, non-grant recipient independent neurophysiologist researching sports-related concussion and repetitive brain trauma using non-invasive brain stimulation (NIBS) techniques including single/paired pulse TMS, rTMS, and tDCS. Adjunct Professor at La Trobe University and Adjunct Research Manager of the Australian Sports Brain Bank (https://www.brainbank.org.au). Twitter and Instagram: @alanpearcephd
Skills and Expertise
Additional affiliations
October 2015 - January 2017
Swinburne University of Technology
Position
  • A/Professor
February 2012 - June 2015
Deakin University
Position
  • Senior Research Fellow
October 2011 - present
University of Melbourne
Position
  • Senior Research Fellow (Adjunct)
Education
July 2013 - December 2013
Deakin University
Field of study
  • Tertiary Education
January 2000 - December 2022
February 1996 - December 1999

Publications

Publications (243)
Article
Full-text available
Background: Concussion is regarded as a common injury in rugby league, however no studies have explored the long-term neurophysiological and cognitive effects of repeated concussion injuries in this sport. Methods: Former professional rugby athletes (n=25) were compared to 25 age-matched participants with no history of a concussion. All participan...
Article
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Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy caused by repetitive head injury. Although it has chiefly been studied in contact sport participants, anyone who experiences repetitive head injury is at risk of CTE. It is associated with a range of neuro-psychological problems, ranging from mood and behavioural symptoms to co...
Article
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Aim: This study investigated the somatosensory and corticomotor physiology of retired contact sport athletes with a history of repeated concussion/subconcussion head trauma. Methods: Retired male athletes with a history of playing contact sports and repeated head trauma (n=122) were divided into two groups: those who expressed concerns regarding th...
Article
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The first case report of chronic traumatic encephalopathy (CTE) in a National Football League player in 2005 opened the floodgates for the identification of CTE in American football. CTE is now reported in ex-players of other contact sports, including ice hockey, soccer, rugby union, and most recently in Australian rugby league. To date, repetitive...
Article
Full-text available
Concussion injury results in a rapid onset of transient neurological impairment that can resolve quickly, or sometimes evolve over time, but usually resolve within seven to ten days. However, a small but noticeable cohort (~10%) of individuals continue to experience persistent lingering effects, particularly fatigue, and recognized as post-concussi...
Article
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Measurement of the adverse outcomes of repeated head trauma in athletes is often achieved using tests where the comparator is ‘accuracy’. While it is expected that ex-athletes would perform worse than controls, previous studies have shown inconsistent results. Here we have attempted to address these inconsistencies from a different perspective by q...
Article
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Managing the health and wellbeing of full-time professional athletes is a multifaceted task. In elite high-performance environments, medical staff and strength training coaches attempt to identify improved methods to monitor player health. Monitoring player health could indicate potential injury risk and assist in adjustments to training and worklo...
Article
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The emphasis of this study was to interview ex-professional male rugby union players (n = 23, mean age 35.5 ± 4.7 years) and discuss concussion management during their careers. In this study, two major themes were identified: (1) the duty of care to professional rugby union players by medical personnel, coaching staff, and owners of professional cl...
Article
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When mild traumatic brain injury (mTBI) occurs following an impact on the head or body, the brain is disrupted leading to a series of metabolic events that may alter the brain’s ability to function and repair itself. These changes may place increased nutritional demands on the body. Little is known on whether nutritional interventions are safe for...
Article
This study aimed to synthesize and quantify the sex-based differences in concussion incidences rate and associated mechanism of injuries in team bat/stick sports. Following a systematic search across five electronic databases, 46 studies were included in the review; 24 were included in the incidence rate (IR) meta-analysis and 13 of the 24 studies...
Article
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Background: Worldwide, 86 million individuals over the age of 20 were diagnosed with knee osteoarthritis (KOA) in 2020. Hallmark features of KOA are the loss in knee extensor strength, increasing knee pain severity, and deficits in functional performance. There is a critical need for the investigation into potential cost-effective therapeutic inter...
Article
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Traumatic brain injuries (TBIs) are often referred to as the ‘silent epidemic’ because many injuries go unrecognised(Reference Rusnak1). Epidemiological data estimates the incidence of TBI at 27.08 million cases annually, with age-standardised incidence rates at 369 per 100,000 population(Reference James, Theadom and Ellenboge2). Traumatic brain in...
Article
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Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with a history of repetitive head impacts (RHI). CTE was described in boxers as early as the 1920s and by the 1950s it was widely accepted that hits to the head caused some boxers to become “punch drunk.” However, the recent discovery of CTE in American and Australian-...
Article
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Introduction There is limited research on the on-field performance of previously concussed athletes. The aim of this exploratory study was to investigate athlete technical performance pre- and post-concussion in Australian Football. Methods Using publicly available data, male athletes who sustained a concussion during the 2016–19 professional Aust...
Article
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Background: Concussion in sport is an ongoing global concern. The head injury assessment (HIA) by the field of play is acknowledged as the first step in recognising and identifying concussion. While previous systematic literature reviews have evaluated the sensitivity of side-line screening tools and assessment protocols, no systematic review has e...
Article
Full-text available
The purpose of this study was to examine Australian Football athletes' responses to a grade one muscular injury from a psychophysiological perspective to understand the strength of the association between stress, optimism, and cortisol. Forty-five players listed with one professional Australian Football club volunteered for this study. Inclusion cr...
Article
Full-text available
Objective To establish the extent to which Rugby Union was a compulsory physical education activity in state-funded secondary schools in England and to understand the views of Subject Leaders for Physical Education with respect to injury risk.MethodA cross-sectional research study using data obtained under the Freedom of Information Act (2000) from...
Article
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Obstructive sleep apnea (OSA), a frequently under-diagnosed sleep disorder, may lead to future poor health, performance, and wellbeing. Increased OSA prevalence has been reported in individuals who have had a head injury. We systematically searched EMBASE, PSYCINFO, WEB OF SCIENCE, COCHRANE and PUBMED to 18th June 2022. OSA prevalence and demograph...
Article
Full-text available
In this Perspective we explore the evolution of our understanding of chronic traumatic encephalopathy (CTE) and its relationship with repetitive head injury. As with many neurodegenerative conditions, there is an imperfect correspondence between neuropathology and clinical phenotype, but unlike other neurodegenerative diseases, CTE has a discrete a...
Preprint
Full-text available
Objectives: This exploratory study quantified professional Australian rules football players transitioning from the Australian Football League (AFL), comparing responses between retiring and delisted players and if the experience of exiting an AFL club influenced the athlete transition process.Design: Online survey research.Method: Identified male...
Article
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RECENT revelations of plagiarism by Australian sports neurologist Dr Paul McCrory () have sent shockwaves through professional sporting bodies internationally. As a leading member of the international Concussion in Sport Group (CISG) for over 20 years, Dr McCrory’s downfall has cast doubt over international consensus guidelines for the management o...
Article
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The focus of this study was to interview retired professional rugby union players (≤10 years since retirement) to discuss their careers in the game of rugby union. These interviews explored their experiences of being a professional rugby player, with respect to physical injury, concussion incidence and concussion management. In addition, the aims w...
Article
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Objective: This study explored psychophysiological stress in professional Australian Rules football athletes across the course of one competitive season. Methods: A sample of eight players listed with one professional Australian football club participated in this study. Each week during the competitive season (22 weeks), players self-reported their...
Article
Objectives The purpose of this study was to investigate the effectiveness of an isometric neck strengthening program to improve isometric neck strength in elite women's football-code athletes. Design Randomised controlled trial. Method Elite female soccer (n = 10) and Australian football (n = 30) players were randomised into either a control (n =...
Article
Ballistic motor training induces plasticity changes and imparts a cross-transfer effect. However, whether there are age-related differences in these changes remain unclear. Thus, the purpose of this study was to perform a meta-analysis to determine the corticospinal responses and cross-transfer of motor performance following ballistic motor trainin...
Preprint
Full-text available
Measurement of the adverse outcomes of repeated head trauma in contact sport athletes is often achieved using tests where the comparator is the score or the accuracy obtained. While it is expected that ex-athletes would perform worse than controls, previous studies have shown inconsistent results. Here we have attempted to address these inconsisten...
Preprint
Full-text available
Background Concussion in sport is an ongoing global concern. The head injury assessment (HIA) by the field of play is acknowledged as the first step in recognising and identifying concussion. While previous systematic literature reviews have evaluated the sensitivity of sideline screening tools and assessment protocols, no systematic review has eva...
Article
Full-text available
Objective: To document baseline King-Devick (K-D) oculomotor function scores for male and female participants aged between 4 and 20 years old. Methods: Utilising a cross section of schools, rugby clubs and gymnastic clubs, 1936 participants (1300 male, 636 female) completed the spiral-bound K-D test for the identification of disturbed oculomotor...
Article
Full-text available
Background : Management of concussion remains a serious issue for professional sports, particularly with the growing knowledge on the consequences of repetitive concussion. One primary concern is the subjective assessment of recovery that dictates the time until a concussed athlete is returned to competition. In response to this concern, the Austra...
Article
The corticospinal responses to high-intensity and low-intensity strength-training of the upper limb are modulated in an intensity-dependent manner. Whether an intensity-dependent threshold occurs following acute strength training of the knee extensors (KE) remains unclear. We assessed the corticospinal responses following high-intensity (85% of max...
Article
Full-text available
Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents and practitioners keep perspective about these potentially life-altering injuri...
Article
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Purpose of Review Mild traumatic brain injury (mTBI) is a continuing healthcare concern worldwide contributing to significant cognitive and neurological impairment, consequently affecting activities of daily living. While mTBI recovery is becoming well studied, there are no interventions to reduce the known impairments of mTBI. Omega-3 fatty acids...
Article
Full-text available
Five international consensus statements on concussion in sports have been published. This commentary argues that there is a strong need for a new approach to them that foregrounds public health expertise and patient-centered guidance. Doing so will help players, parents, and practitio- ners keep perspective about these potentially life- altering in...
Article
Full-text available
The issue of concussion in sport continues to be discussed widely in the community as current and retired players reveal personal experiences, and concerns, about the long-term sequelae of their concussive injuries. This is the first study to examine evolving attitudes and beliefs towards concussion in sport by comparing data in an Australian exerc...
Article
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BACKGROUND: Previous studies suggest that cross-education of strength may be modulated by increased corticospinal excitability of the ipsilateral primary motor cortex (M1) due to cross-activation. However, no study has examined the influence of bilateral TDCS of both M1 and how it affects corticospinal excitability, cross-activation and cross-educa...
Article
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Sports-related concussion (SRC) is a complex and heterogeneous injury with psychological, cognitive and functional consequences. Advances in diffusion magnetic resonance imaging (dMRI) allow sensitive measurement of white matter pathology post-SRC and may provide insight into injury and recovery. We systematically reviewed and meta-analyzed the lit...
Article
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Emerging research has studied in-game metrics of athletes after returning from concussion injury in an attempt to determine if performance is compromised. The aim of this meta- analysis was to quantify performance metrics in professional athletes prior to and following recovery from concussion. We conducted systematic literature searches in databas...
Preprint
Full-text available
Background Management of concussion remains a serious issue for professional sports, particularly with the growing knowledge on the consequences of repetitive concussion. One primary concern is the subjective assessment of recovery that dictates the time until a concussed athlete is returned to competition. In response to this concern, the Australi...
Article
Full-text available
Emerging evidence of brain injury on risk of neurodegenerative diseases such as Alzheimer’s disease (AD) and chronic traumatic encephalopathy (CTE) have resulted in interest in therapeutic potential of omega-3 fatty acids (n-3FA). We conducted a systematic review of n-3FA therapeutic efficacy for ageing adults at risk of AD/CTE following a history...
Article
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The objective of this systematic literature review was to evaluate the evidence regarding the development of neck strength in reducing concussion and cervical spine injuries in adult amateur and professional sport populations. PubMed, CINAHL, Science Direct, and Web of Science databases were searched systematically. The criteria for inclusion in th...
Article
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Considerable attention has focused on the risks of contact sports like rugby union, yet the benefits, rewards and opportunities have received less robust analysis. It is for that reason, Griffin et al.'s recent scoping review is a welcome preliminary contribution to our understanding of risk in rugby. There are, however, some concerns that deserve...
Article
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Purpose: Cross-education (CE) increases strength of both the trained and untrained limb, with emerging evidence, suggesting CE could be used to attenuate muscle strength and thickness following periods of limb immobilization. This study examined the available evidence for the clinical efficacy of CE to attenuate muscle strength, thickness and neura...
Article
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Elite competitive sport is linked with a unique collection of stressors distinct from the general population. While there have been advancements in understanding the role that stressors play within the elite sporting environment, uncertainty still exists around a clear process for measuring stressors, and their specific relationship to injury. A nu...
Article
A single bout of aerobic exercise (AE) may induce changes in the excitability of the intracortical circuits of the primary motor cortex (M1). Similar to noninvasive brain stimulation techniques, such as transcranial direct current stimulation, AE could be used as a priming technique to facilitate motor learning. This review examined the effect of A...
Chapter
Introductory chapter to the book explaining the evolving links between neuroscience and exercise science.
Chapter
Understanding motor control is through learning the macro and the micro arrangement of the nervous system. In this chapter, we will focus on the macro: structural, functional and hierarchical organisation of movement. In chapters four and five, we will discuss how motor control occurs through neuromodulation and neuroplastic changes. The study of n...
Chapter
The aim of this chapter is to provide an overview of the non-invasive techniques that are used to assess neurophysiological function in humans during exercise.
Chapter
This chapter will focus on and discuss the neurophysiology and associated motor control outcomes following eccentric exercise resulting in DOMS. This includes strength and power loss and regain, impairment of function and motor skill changes.
Chapter
This chapter will overview the functional injury definition of concussion, then discuss the pathophysiology of concussion leading into the advantages and disadvantages of the electrophysiological methods presented in this chapter, and key variables measured in concussion/mTBI research.
Book
Full-text available
This textbook introduces the key concepts that emphasise human motor control and its application to exercise science and rehabilitation. The topics covered integrate research, theory and the clinical applications of Exercise Neuroscience that will support students, researchers and clinicians to understand how the nervous system responds, or adapts...
Article
Educational interventions aimed at increasing concussion knowledge and attitudes are designed according to different frameworks. The aim of this systematic review of the literature was to determine the effects of educational interventions on concussion knowledge and attitudes, while providing recommendations for future research in the area of concu...
Article
Objective: To investigate the use of the King-Devick (K-D) test for sideline assessment of concussive injuries in a New Zealand amateur women's rugby union team. Design: Prospective cohort observational. Methods: All players were K-D tested during pre-season using a tablet (iPad; Apple Inc., Cupertino, CA). Differences in K-D scores and test-retest...
Article
Full-text available
Reaction time testing is widely used in online computerized concussion assessments, and most concussion studies utilizing the metric have demonstrated varying degrees of difference between concussed and non-concussed individuals. The problem with most of these online concussion assessments is that they predominantly rely on consumer grade technolog...
Article
Concerns about concussion in contact sport have permeated debate within sports medicine. Considerable scientific attention has been focussed on the short-term and long-term outcomes of concussions, as well as the strategies to reduce the risk of traumatic brain injury. The practicalities and impact of altering rules (laws) in sport—including the ev...
Article
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Aim: This systematic review and meta-analysis investigated neurophysiological responses using transcranial magnetic stimulation (TMS) following a concussion or sub-concussion. Methods: A systematic searching of relevant databases for peer-reviewed literature quantifying motor evoked potentials from TMS between 1999 and 2019. A meta-analysis quanti...
Article
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Purpose: To determine whether corticospinal excitability (CSE) and inhibition are differentially modulated following high-volume light-load strength training compared to low-volume heavy-load strength training. We hypothesised high-volume light-load strength training would increase CSE and low-volume heavy-load strength training would reduce intrac...
Article
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Background. Resistance-training causes changes in the central nervous system (CNS); however, the sites of these adaptations remain unclear. Objective To determine sites of neural adaptation to resistance-training by conducting a systematic review and meta-analysis on the cortical and subcortical responses to resistance-training. Methods. Evidence f...
Article
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Objective: The King-Devick (K-D) test is a rapid visual screening tool that can assess underlying brain trauma such as concussion via impairments in saccadic rhythm. A new tablet version of the K-D test using randomised numbers is now available, but reliability for this new version, as well as comparison to the traditional K-D test has not yet been...
Article
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Background: Transcranial direct current stimulation (tDCS) is a non-invasive brain stimulation technique that utilizes weak direct currents to induce polarity-dependent modulation of corticospinal excitability. Although tDCS exerts a modulatory effect over the stimulation region, several studies have also demonstrated that distal areas of the brain...
Article
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Background: The effect of warming-up prior to exercise on increased neuromuscular transmission speed remains largely untested. Objective: This study used transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS) to quantify neuromuscular transmission along the corticospinal tract (CST) before and after a warm-up protocol of the...
Article
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Purpose: The motor cortex (M1) appears to be a primary site of adaptation following both a single session, and repeated strength-training sessions across multiple weeks. Given that a single session of strength-training is sufficient to induce modification at the level of the M1 and corticospinal tract, this study sought to determine how these acute...
Article
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This study determined whether there are task-dependent differences in cortical excitability following different types of strength training. Transcranial magnetic stimulation (TMS) measured corticospinal excitability (CSE) and intracortical inhibition (ICI) of the biceps brachii muscle in 42 healthy subjects that were randomised to either paced-stre...
Conference Paper
Full-text available
The Australian Sports Brain Bank was established in March 2108 with the aim of characterising the spectrum of neurodegenerative disease among ex-players of Australian contact sports. To date, the ASBB has received over 250 pledges and ten post-mortem brain donations. We will present the clinical and pathological findings of our completed brain exam...
Article
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Persistent post concussion symptoms (PPCS) describe the condition when an individual experiences chronic symptoms, particularly fatigue, beyond the expected time of recovery. The aim of this study was to quantify the effect of fatigue and related ongoing symptoms on somatosensory and corticomotor pathways using reaction time (RT) testing, and singl...
Article
Full-text available
Objectives: The recognition and management of concussion has become a major health concern across all sports. Despite recent attention, concussion assessment and return-to-play protocols appear to be highly variable between leading professional sporting bodies across Australia. Without readily available guidelines, players at all levels may be at r...
Conference Paper
Full-text available
Background and Aims: The Australian Sports Brain Bank launched in March 2018, as a collaboration between the Neuropathology Department of RPA Hospital and the Brain & Mind Centre, University of Sydney. The aim of the ASBB is to describe the spectrum of neurodegenerative disease that may be associated with sporting and non-sporting concussion in Aus...
Article
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Background There is a paucity of studies reporting on women’s injuries in rugby union. Objective The aim of this systematic review was to describe the injury epidemiology for women’s rugby-15s and rugby-7s match and training environments. Methods Systematic searches of PubMed, SPORTDiscus, Web of Science Core Collection, Scopus, CINAHL(EBSCO) and...
Article
Full-text available
Purpose Transcranial magnetic stimulation (TMS) usually investigates the corticospinal responses of the agonist muscle to strength training, despite the role of the antagonist muscle in strength development. We examined the intracortical responses from an agonist and antagonist muscle following a single session of heavy-loaded strength training (do...
Article
Full-text available
Background: Sport-related concussion is a growing public health concern. Defined as a injury that disturbs neurological functions, concussion is characterised by a constellation of signs and symptoms. However, clinical imaging methods do not reveal any structural damage. Recently, neurophysiological techniques such as single and paired-pulse transc...
Article
Full-text available
This article updates coaches and tennis sports scientists on recent changes to the consensus statement for sports-related concussion. Specifically, the article provides new information that can be applied to tennis. While concussion in tennis is rare, head injuries in tennis do occur. It is important that in-lieu of medical staff available at train...
Article
Aim: To provide epidemiological data and related costs to the national health insurance scheme for traumatic brain injury (TBI) in New Zealand. Method: A retrospective analytical review utilising detailed descriptive minor and moderate-to-severe epidemiological TBI data obtained from the Accident Compensation Corporation (ACC) for 2012-2016. Inj...