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: 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.