Abstract
Traumatic brain injury (TBI) is a common source of functional impairment among athletes, military personnel, and the general population. Professional fighters in both boxing and mixed martial arts (MMA) are at particular risk for repetitive TBI and may provide valuable insight into both the pathophysiology of TBI and its consequences. Currently, effects of fighter weight class on brain volumetrics (regional and total) and functional outcomes are unknown. Fifty-three boxers and 103 MMA fighters participating in the Professional Fighters Brain Health Study (PRBHS) underwent volumetric magnetic resonance imaging (MRI) and neuropsychological testing. Fighters were divided into lightweight (≤139.9 lb), middleweight (140.0–178.5 lb), and heavyweight (>178.5 lb). Compared with lightweight fighters, heavyweights displayed greater yearly reductions in regional brain volume (boxers: bilateral thalami; MMA: left thalamus, right putamen) and functional performance (boxers: processing speed, simple and choice reaction; MMA: Trails A and B tests). Lightweights suffered greater reductions in regional brain volume on a per-fight basis (boxers: left thalamus; MMA: right putamen). Heavyweight fighters bore greater yearly burden of regional brain volume and functional decrements, possibly related to differing fight dynamics and force of strikes in this division. Lightweights demonstrated greater volumetric decrements on a per-fight basis. Although more research is needed, greater per-fight decrements in lightweights may be related to practices of weight-cutting, which may increase vulnerability to neurodegeneration post-TBI. Observed decrements associated with weight class may result in progressive impairments in fighter performance, suggesting interventions mitigating the burden of TBI in professional fighters may both improve brain health and increase professional longevity.
Highlights
Traumatic brain injury (TBI) is increasingly recognized as an acute injury event but, in some, as a progressive neurodegenerative process.[1,2,3] As such, it is unsurprising that TBI has been observed to influence neuropsychiatric functioning in the context of neurodegeneration, affecting both symptomatic presentation and clinician evaluation of patients.[4,5] In the context of contact sports, multiple authors have noted neurodegenerative changes due to TBI with accompanying a Michael J.C
The purpose of this study was to investigate the relationship between weight class and longitudinal neuroimaging, cognitive testing, and neuropsychiatric outcomes among boxers and mixed martial arts (MMA) fighters participating in the Professional Fighters Brain Health Study (PFBHS).[13]
Study population Participants were drawn from the PFBHS, a longitudinal prospective cohort study of professionally licensed boxers and MMA fighters followed at the Cleveland Clinic Luo Ruvo Center for Brain Health, Las Vegas, Nevada starting from 2011, as described previously.[13]
Summary
Traumatic brain injury (TBI) is increasingly recognized as an acute injury event but, in some, as a progressive neurodegenerative process.[1,2,3] As such, it is unsurprising that TBI has been observed to influence neuropsychiatric functioning in the context of neurodegeneration, affecting both symptomatic presentation and clinician evaluation of patients.[4,5] In the context of contact sports, multiple authors have noted neurodegenerative changes due to TBI with accompanying a Michael J.C.
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