A survey of all amateur boxing matches in Denmark was made during a 3 year period. Data was gathered on means by which bouts were ended by the referee or attending physician, such as knock outs or blows to the head. A total of 5272 matches were fought: 3240 were senior matches (over age 19) and 2032 were junior matches (ages 17 to 19). Prophylactic intervention--unlimited length of hand bandage, voluntary use of boxing helmets, and heavier gloves for boxers greater than 149 pounds--did not affect the frequency of matches being stopped because of knock outs or blows to the head.
Comment In: Am J Sports Med. 1990 Sep-Oct;18(5):5612252100
Fifty former amateur boxers were examined and compared with two control groups of soccer players and track and field athletes. All subjects were interviewed regarding their sports career, medical history, and social variables. They underwent a physical and a neurologic examination. Personality traits were investigated and related to the platelet monoamine oxidase activity. Cerebral morphologic changes were evaluated using computed tomography and magnetic resonance imaging. Further, clinical neurophysiologic tests were made as well as neuropsychologic tests. No significant differences were found between the groups in any of the physical or neurologic examinations or in platelet monoamine oxidase activity. Socially, the boxers had a lower degree of education and had chosen less intellectual professions, but they were less impulsive and more socialized. The computed tomography images and magnetic resonance imaging studies showed no significant differences between the groups. There was a significantly higher incidence of slight or moderate electroencephalography deviations among the boxers. Neuropsychologically, the boxers had an inferior finger-tapping performance. Thus, no signs of serious chronic brain damage were found among any of the groups studied. However, the electroencephalography and finger-tapping differences between the groups might indicate slight brain dysfunction in some of the amateur boxers.
Comment In: Am J Sports Med. 1993 Sep-Oct;21(5):7648238728
Sweden banned professional boxing in 1969 and has also considered banning amateur boxing. We therefore analysed possible chronic brain damage in 47 former amateur boxers who started their careers after the introduction of stricter Swedish amateur boxing rules. The boxers were compared with three control groups--25 soccer players, 25 track and field athletes and 19 conscripts. All athletes were interviewed about their sports career, medical history and social variables. They then underwent a physical and a neurological examination, including a mini-mental state examination. Personality traits were investigated and related to their platelet MAO activity in the athletes as well as in the conscripts. No significant differences were found between the groups in any of the physical or neurological examinations. All had a normal mini-mental state examination. Thus, results from these test methods did not reveal any signs of chronic brain damage from Swedish amateur boxing. Neither were any significant differences found with regard to platelet MAO activity, while significant differences were found in some of the social and personality traits variables.
It is well known that professional boxers can develop chronic traumatic encephalopathy (dementia pugilistica) due to repeated head trauma. Beside CT findings indicating cerebral atrophy, the presence of a cavum septum pellucidum has been reported to indicate encephalopathy. CT findings in amateur boxers are not as well documented. The aim of this study was to find out if morphological changes could be demonstrated among former amateur boxers using CT and MRI. Two control groups of soccer players and track and field athletes in the same age-range were used for comparison. No significant differences in the width of the ventricular system, anterior horn index, width of cortical sulci, signs of vermian atrophy, or the occurrence of a cavum septum pellucidum were found between boxers and controls. A cavum septum pellucidum was found more often in the controls than in the boxers and is probably not a sign of earlier head trauma. MRI confirm no more findings than CT in this retrospective study.
The aim of the present study was to investigate possible chronic brain damage due to Swedish amateur boxing. Forty seven former amateur boxers, 22 with many (HM = high-matched) and 25 with few matches (LM = low-matched) during their career were examined and compared with two control groups of 25 soccer players and 25 track and field athletes in the same age-range. No severe EEG abnormality was found. There was a somewhat higher incidence of slight or moderate EEG deviations among HM-(32%, 7/22) and LM-(36%, 9/25) boxers than among soccer players (20%, 5/25) and track and field athletes (12%, 3/25). Brain electric activity mapping (BEAM), brainstem auditory evoked potential (BAEP) and auditory evoked P 300 potential (P 300) did not differ significantly between the groups. No neurophysiological variable was correlated to the number of bouts, number of lost fights or length of boxing career. Thus, no signs of serious chronic brain damage was found among the amateur boxers or the soccer players and the track and field athletes. However, it cannot be excluded that the EEG differences between the groups may be a sign of slight brain dysfunction in some of the amateur boxers.
Does Swedish amateur boxing lead to any permanent neuropsychological deficit, caused by chronic brain damage? Fifty Swedish former amateur boxers, 25 soccer players, and 25 track and field athletes were investigated by standardized neuropsychological tests. In only one test did the groups differ significantly. Boxers who had taken part in a large number of bouts had a slightly inferior finger-tapping performance. None of the boxers were considered to have definite signs of intellectual impairment. In conclusion modern Swedish amateur boxing does not seem to lead to significant signs of neuropsychological impairment or "punch drunkenness", nor does it seem to differ in this respect from soccer playing or track and field sports.
The aim of this study was to investigate if olympic (amateur) boxing is associated with elevation of brain injury biomarkers in peripheral blood compared to controls.
Thirty olympic boxers competing in at least 47 bouts were compared to 25 controls. Blood was collected from the controls at one occasion and from the boxers within 1-6 days after a bout and after a rest period of at least 14 days. Tau concentration in plasma was determined using a novel single molecule ELISA assay and S-100B, glial fibrillary acidic protein, brain-derived neurotrophic factor and amyloid ß 1-42 were determined using standard immunoassays.
None of the boxers had been knocked-out during the bout. Plasma-tau was significantly increased in the boxers after a bout compared to controls (mean?±?SD, 2.46?±?5.10 vs. 0.79?±?0.961?ng?L(-1), p?=?0.038). The other brain injury markers did not differ between the groups. Plasma-tau decreased significantly in the boxers after a resting period compared to after a bout (p?=?0.030).
Olympic boxing is associated with elevation of tau in plasma. The repetitive minimal head injury in boxing may lead to axonal injuries that can be diagnosed with a blood test.