Boxing―Bad for the Brain

Up to 20% of professional boxers develop neuropsychiatric sequelae. But which acute complications and which late sequelae can boxers expect throughout the course of their career? These are the questions studied by Hans Förstl from the Technical University Munich and his co-authors in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2010; 107[47]: 835-9).

Their evaluation of the biggest studies on the subject of boxers’ health in the past 10 years yielded the following results: The most relevant acute consequence is the knock-out, which conforms to the rules of the sport and which, in neuropsychiatric terms, corresponds to cerebral concussion. In addition, boxers are at substantial risk for acute injuries to the head, heart, and skeleton. Subacute consequences after being knocked out include persistent symptoms such as headaches, impaired hearing, nausea, unstable gait, and forgetfulness. The cognitive deficits after blunt craniocerebral trauma last measurably longer than the symptoms persist in the individual’s subjective perception. Some 10–20% of boxers develop persistent neuropsychiatric impairments. The repeated cerebral trauma in a long career in boxing may result in boxer’s dementia (dementia pugilistica), which is neurobiologically similar to Alzheimer’s disease.

With regard to the health risks, a clear difference exists between professional boxing and amateur boxing. Amateur boxers are examined regularly every year and in advance of boxing matches, whereas professionals subject themselves to their fights without such protective measures. In view of the risk for injuries that may result in impaired cerebral performance in the short or long term, similar measures would be advisable in the professional setting too.

Full bibliographic information

Förstl H, Haass C, Hemmer B, Meyer B, Halle M: Boxing: acute complications and late sequelae, from concussion to dementia. Dtsch Arztebl Int 2010; 107(47): 835–9.
Attached files
  • Credit: JAMES KING-HOLMES / SCIENCE PHOTO LIBRARY Caption: Mouthguard testing. View of a mouthguard being subjected to an impact from a boxing glove. The mouthguard is fitted onto an artificial jaw designed to test the performance of various types of mouthguard. The jaw is the invention of Andrew Greasley of the Open University, England. It is made of a composite material and is fitted with teeth (white) moulded from a ceramic material. The mouthguard being tested is first fitted onto the jaw. Then the jaw is fitted onto a spring loaded support and subjected to an impact similar to that which could occur during sport. The performance of the mouthguard is evaluated by assessing the teeth for damage and dislocation.

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