Amateur Boxing Linked To Brain

Cell Injury
A study of 14 Swedish amateur boxers suggests that they have higher
levels of certain chemicals in their cerebrospinal fluid in the days
following a bout, indicating injuries to neurons and other cells important
to brain function, according to a report in the September issue of
Archives of Neurology, one of the JAMA/Archives journals.

About 20 percent of professional boxers develop chronic traumatic brain

injury, according to background information in the article. Some studies
have suggested that amateur boxers also damage their nervous systems,
but because their shorter bouts allow fewer blows to the head and
because they must wear safety equipment, the effects tend to be less
severe. These studies have been based on assessment of thinking,
learning, memory and other brain functions long after boxing, rather
than an immediate test performed soon after a fight.

Henrik Zetterberg, M.D., Ph.D., The Sahlgrenska Academy at Göteborg

University, Göteborg, Sweden, and colleagues obtained spinal fluids (via
spinal tap) from 14 amateur boxers (11 men and three women, average
age 22 years) seven to 10 days after a bout and again three months
later, after a rest from boxing. At the first assessment, the boxers
reported how many hits to the head they received during the match and
underwent physical and neurologic examinations; none showed signs of
brain injury. The researchers also tested the cerebrospinal fluids of 10
healthy men who were not boxers as controls. Levels of several
chemicals that indicate damage to brain cells (neurons) and their axons,
the thread-like extensions of the cell that reach toward other brain
cells to transmit electrical impulses, were measured.

Seven to 10 days after a boxing match, the group of boxers had higher
average levels of chemicals known as neurofilament light protein and
total tau than they did three months later. "The cerebrospinal fluid
levels of these proteins increase in disorders with neuronal and axonal
degeneration and damage, and the increase is known to correlate with
the size of the brain lesion," the authors write. "When applied to the
results of this study, the increases in neurofilament protein and total
tau probably reflect damage to neuronal axons from hits to the head
during a bout." They also had elevated levels of glial fibrillary acidic
protein, which indicates damage to the astroglia, specialized cells that
surround neurons to insulate and support them. An increase in this
chemical was also recently found in patients who experienced severe
brain injury, and the levels were linked to the patient's clinical outcome.
Levels of all three chemicals were significantly higher in the seven
boxers who had sustained more than 15 hits to the head or experienced
grogginess during or after a bout, compared with those who had 15 or
fewer hits to the head and no grogginess.

Compared with the non-boxers, immediately after a bout the boxers had
higher levels of neurofilament light protein and glial fibrillary acidic
protein. Three months later, the boxers still had higher levels of
neurofilament light protein than the control subjects.

"Amateur boxing is associated with acute neuronal and astroglial injury,"

the authors conclude. "If verified in longitudinal studies with extensive
follow-up regarding the clinical outcome, analyses of cerebrospinal fluid
may provide a scientific basis for medical counseling of athletes after
boxing or head injury."

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Bellon, Angelo
BSN III-E