Mood Changes in Response to Fighting Among Mixed Martial Arts Fighters; A Pre and Post-Fight Analysis

Background: Cryotherapy brings benefits for muscle recovery and reduction of lactate thresholds in fighters; however, the effect of cryotherapy on the autonomous cardiac recovery (ACR) of wrestlers is not yet defined in the scientific literature. Objective: To analyze the effect of cryotherapy on ACR after simulated combat exercise in mixed martial arts (MMA) fighters. Methods: Crossover randomized clinical trial with a sample of 17 MMA fighters (male, age >18 years). There was simulated combat of three rounds of MMA; each round lasted 5-min, there were the 60s between rounds. ACR was assessed by resting heart rate (RHR), which was monitored by a portable Polar-FT1® device. We measured RHR in the interval between the rounds at the 30s and 60s of rest in the conditions: without cryotherapy (Control), application of an ice pack in the thoracic region (TC); Immersion of feet in ice water (FC). Results: At 30-s of RHR, the control condition was better than FC to reduce RHR in rounds 1 and 2 (p<0.05; η2p:0.28). At the 60s of RHR, the control condition was better than FC and TC (p<0.05; η2p:0.32). The control condition had a better RHR recovery rate than the FC condition after rounds one (η2p: 0.23), two (η2p: 0.46), and three (η2p: 0.27) (p<0.05). The TC condition did not show differences concerning the control and FC conditions. Conclusion: Cryotherapy applications in the thoracic region and by complete immersion of the feet did not generate significant effects on the ACR of MMA fighters.

The purpose of this study was to characterize the magnitude of acute weight gain (AWG) and dehydration in mixed martial arts (MMA) fighters before competition. Urinary measures of hydration status and body mass were determined approximately 24 hours before and then again approximately 2 hours before competition in 40 MMA fighters (mean ± SE, age: 25.2 ± 0.65 years, height: 1.77 ± 0.01 m, body mass: 75.8 ± 1.5 kg). The AWG was defined as the amount of body weight the fighters gained in the approximately 22-hour period between the official weigh-in and the actual competition. On average, the MMA fighters gained 3.40 ± 2.2 kg or 4.4% of their body weight in the approximately 22-hour period before competition. Urine specific gravity significantly decreased (p < 0.001) from 1.028 ± 0.001 to 1.020 ± 0.001 during the approximately 22-hour rehydration period. Results demonstrated that 39% of the MMA fighters presented with a Usg of >1.021 immediately before competition indicating significant or serious dehydration. The MMA fighters undergo significant dehydration and fluctuations in body mass (4.4% avg.) in the 24-hour period before competition. Urinary measures of hydration status indicate that a significant proportion of MMA fighters are not successfully rehydrating before competition and subsequently are competing in a dehydrated state. Weight management guidelines to prevent acute dehydration in MMA fighters are warranted to prevent unnecessary adverse health events secondary to dehydration.

Psychological and physical stress can induce dysregulation of gene expression via changes in DNA methylation and microRNA (miRNA) expression. Such epigenetic modifications are yet to be investigated in professional Mixed Martial Arts (MMA) fighters subject to highly stressful training involving repetitive head impacts. This study examined differences in DNA methylation and miRNA expression in elite MMA fighters compared to active controls. Global methylation differences between groups were assessed via a LINE-1 assay. At the same time, PCR arrays were used to estimate differential expression in samples of 21 fighters and 15 controls for 192 different miRNAs associated with inflammatory diseases. An Independent-Samples t-Test found no significant difference in LINE-1 methylation between groups. However, an Independent-Samples Mann-Whitney U Test revealed a significant upregulation in the expression of miR-155 in MMA fighter plasma. Since miR-155 has been recognized as an important regulator of neuroinflammation, this dysregulation suggests a possible epigenetic mechanism responsible for chronic inflammation associated with professional-level MMA training. Consistent with other published works, this study highlights the potential of miR-155 not only as a biomarker for monitoring long-term health risks linked to head trauma but also as a target to remediate the impact of chronic neuroinflammation.

BackgroundConstrictive pericarditis (CP) is characterized by scarring and loss of elasticity of the pericardium. This case demonstrates that mixed martial arts (MMA) is a previously unrecognized risk factor for CP, diagnosis of which is supported by cardiac imaging, right and left heart catheterization, and histological findings of dense fibrous tissue without chronic inflammation.Case presentationA 47-year-old Caucasian male former mixed martial arts (MMA) fighter from the Western United States presented to liver clinic for elevated liver injury tests (LIT) and a 35-pound weight loss with associated diarrhea, lower extremity edema, dyspnea on exertion, and worsening fatigue over a period of 6 months. Past medical history includes concussion, right bundle branch block, migraine headache, hypertension, chronic pain related to musculoskeletal injuries and fractures secondary to MMA competition. Involvement in MMA was extensive with an 8-year history of professional MMA competition and 13-year history of MMA fighting with recurrent trauma to the chest wall. The patient also reported a 20-year history of performance enhancing drugs including testosterone. Physical exam was notable for elevated jugular venous pressure, hepatomegaly, and trace peripheral edema. An extensive workup was performed including laboratory studies, abdominal computerized tomography, liver biopsy, echocardiogram, and cardiac magnetic resonance imaging. Finally, right and left heart catheterization—the gold standard—confirmed discordance of the right ventricle-left ventricle, consistent with constrictive physiology. Pericardiectomy was performed with histologic evidence of chronic pericarditis. The patient’s hospital course was uncomplicated and he returned to NYHA functional class I.ConclusionsCP can be a sequela of recurrent pericarditis or hemorrhagic effusions and may have a delayed presentation. In cases of recurrent trauma, CP may be managed with pericardiectomy with apparent good outcome. Further studies are warranted to analyze the occurrence of CP in MMA so as to better define the risk in such adults.

Mixed martial arts (MMA) is a combination of multiple combat sports. Acute injuries in MMA are well known and have been broadly described. However, there is little knowledge about degenerative changes in the musculoskeletal system. The aim of this study was to investigate the impact of techniques used in MMA on the occurrence of degenerative changes in the hand and wrist in comparison to classical boxing. 11 MMA fighters and 10 boxers with chronic wrist pain were clinically examined. Age, weight, years of training, number of fights, level of competition and weekly hours of training were recorded. To determine degenerative changes, an MRI of the symptomatic hand was assessed. Years of training, level of competition and number of fights did not show a significant difference between MMA and boxing fighters (p > 0.05), but MMA fighters showed significantly more hours of training per week (p < 0.001). The MMA fighters had more often and more severe degenerative changes of all examined structures (bone, fibrocartilage, ligaments and tendons), with the category "bone" reaching significance (p = 0.002). MMA athletes show significantly greater incidence and degree of degeneration in hand and wrist joints. The exact reasons are still unknown and further research is needed to determine the influence of MMA techniques on the severity of degenerative changes in the hand and wrist.

Concussion and the damage resulting from this event related to brain function have been widely studied; however, little is known about subconcussive impacts, especially in Mixed Martial Arts (MMA) fighters, which is a combat and full contact sport in which most blows are aimed at the head. This study aims to evaluate the biomarker levels associated with subconcussive hits to the head in MMA fighters. This is an exploratory study in which 30 male subjects (10 MMA fighters, 10 healthy individuals who practice muscle training, and 10 healthy sedentary individuals) aged between 18 and 32 years (25.4±3.8) were evaluated. These individuals underwent blood collection to assess their Ubiquitin C-terminal hydrolase (UCH-L1), Glial Fibrillary Acidic Protein (GFAP) and Brain Derived Neurotrophic Factor (BDNF) levels before, immediately after and 72 hours after the sparring session (for the fighters) and were compared between groups. Significant differences were found at baseline between active and healthy fighters in BDNF levels (p=0.03). A significant reduction of BDNF levels were also observed between the post-immediate and 72h after the sparring session (p=0.03). No differences were observed in the number or severity of symptoms reported by the fighters. Despite the exploratory approach, the findings of this study may help to understand the influence of repeated subconcussive hits to the head in MMA fighters, as well as to propose preventive interventions which can minimize the effects of the impact of hits, preserving fighters' neuronal integrity and function.

Background White matter signal abnormalities have been associated with traumatic brain injury (TBI) and repetitive head impacts (RHI) in contact sports (e.g. American football, rugby). However, previous studies of mixed martial arts (MMA) fighters from the Professional Fighters Brain Health Study have not found greater white matter signal abnormalities in fighters versus controls. Objective This study aims to explore the varying white matter effects of football/rugby and MMA by analyzing how football/rugby history in mixed martial arts fighters may relate to white matter signal abnormalities, helping to further our understanding of sport-specific brain health risks. Methods Baseline visits for 90 active, professional, male mixed martial arts fighters and 27 unexposed male controls were cross-sectionally analyzed. Wilcoxon and Kruskal–Wallis tests compared demographics and white matter signal abnormalities, and multivariable regression models examined the associations between football/rugby history and white matter signal abnormality burden in fighters, adjusting for age, education, race, fights, MRI scanner, and supratentorial volume. Results 37/90 fighters had football/rugby history (mean: 4 years; range: 1–12 years). White matter signal abnormalities were significantly greater in fighters with football/rugby history compared to fighters without football/rugby history (Wilcoxon, p = 0.0190). Football/rugby history was significantly associated with white matter signal abnormality burden >75th percentile (OR: 12, CI: 3.3–61, p < 0.001) and >50th percentile (OR: 3.2, CI: 1.2–9.4, p = 0.024) in fighters. Years of football/rugby were also significantly associated with white matter signal abnormalities. Conclusion Our findings expand on previous literature by demonstrating a significant relationship between white matter signal abnormalities (WMSAs) and football/rugby history but not MMA. Furthermore, our study suggests an added risk for WMSAs in MMA fighters with a history of football/rugby. Future research should further evaluate WMSAs in contact sports, helping to inform athletes, regulatory bodies, and healthcare providers of the potential brain health risks of contact sports.

Background: Mixed martial arts (MMA) requires athletes to generate repeated bursts of high-intensity effort with minimal recovery time. Despite the sport’s reliance on anaerobic power, there are minimal data assessing pre-competition physiological capacity in MMA fighters. This study aimed to evaluate anaerobic performance using the Wingate Anaerobic Test (WAnT) and Countermovement Jump (CMJ) in professional MMA athletes, and to examine relationships between performance metrics across weight classes. Methods: Twelve professional male MMA fighters (age 29.00 ± 4.80 years, weight 85.60 ± 13.90 kg) completed both CMJ and WAnT assessments using sensor-integrated devices (Just Jump mat and Wattbike Pro). CMJ height and WAnT variables (peak power, average power, and fatigue index) were measured. Pearson correlations were used to examine the relationships between CMJ and Wingate outputs. Independent t-tests compared performance between lighter (<83.9 kg) and heavier (≥83.9 kg) weight groups. Results: CMJ performance showed significant positive correlations with both average power (r = 0.71, p < 0.001) and peak power (r = 0.61, p = 0.004). Peak power was also positively correlated with fatigue index (r = 0.84, p < 0.001), suggesting greater fatigue in higher power-producing athletes. Finally, the heavier weight group of fighters produced significantly (p = 0.03) more peak power when compared to the lighter weight group. Conclusions: The findings support the use of CMJ and WAnT testing as practical tools for evaluating anaerobic performance in MMA athletes. These assessments can help guide individualized training strategies, particularly when accounting for weight group specific differences in power and fatigue dynamics.

Whereas the diagnosis of moderate and severe traumatic brain injury (TBI) is readily visible on current medical imaging paradigms (magnetic resonance imaging [MRI] and computed tomography [CT] scanning), a far greater challenge is associated with the diagnosis and subsequent management of mild TBI (mTBI), especially concussion which, by definition, is characterized by a normal CT. To investigate whether the integrity of the blood-brain barrier (BBB) is altered in a high-risk population for concussions, we studied professional mixed martial arts (MMA) fighters and adolescent rugby players. Additionally, we performed the linear regression between the BBB disruption defined by increased gadolinium contrast extravasation on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) on MRI and multiple biomechanical parameters indicating the severity of impacts recorded using instrumented mouthguards in professional MMA fighters. MMA fighters were examined pre-fight for a baseline and again within 120 h post-competitive fight, whereas rugby players were examined pre-season and again post-season or post-match in a subset of cases. DCE-MRI, serological analysis of BBB biomarkers, and an analysis of instrumented mouthguard data, was performed. Here, we provide pilot data that demonstrate disruption of the BBB in both professional MMA fighters and rugby players, dependent on the level of exposure. Our data suggest that biomechanical forces in professional MMA and adolescent rugby can lead to BBB disruption. These changes on imaging may serve as a biomarker of exposure of the brain to repetitive subconcussive forces and mTBI.

This study examines the long-term cognitive consequences of repetitive head impact on executive functions in mixed martial arts (MMA) fighters over two years. Neuropsychological tests assessed executive functions in two groups: competitive (CG; n = 26) and recreational groups (RG; n = 26). A significant interaction between time and group was observed. The CG experienced greater declines in Mental Processing Speed (MPS) after 1 year [4.6 s (3.1; 6.1); p ≤ 0.001] and 2 years [14.6 s (5.1; 24.0); p = 0.003]. Inhibitory control (IC) also declined after 1 year [4.7 a.u. (3.0; 6.2); p ≤ 0.001] and 2 years [10.0 a.u. (11.6; 11.4); p ≤ 0.001]. Cognitive flexibility (CF) showed a pronounced reduction after 1 year [4.8 a.u. (3.0; 6.7); p ≤ 0.001] and 2 years [7.5 a.u. (5.9; 9.1); p ≤ 0.001]. Automatic (AP) and controlled processes (CP), as well as direct (DM) and indirect memory (IM), also showed significant impairments in CG. These findings highlight the detrimental effects of MMA competitions on cognitive function, emphasizing the need for monitoring and interventions to preserve fighters' health and performance.

Objective Mixed Martial Arts (MMA) is a relatively young combat sport. In contrast to classic boxing, MMA combines techniques of grappling and striking. However, characteristic long-term effects of MMA on the wrist are discussed controversially. Aim of this study was to elucidate characteristic degenerative changes of the wrist from MMA fighters in comparison to classic boxers. Methods In this study, eleven professional MMA fighters and ten professional boxers with chronic wrist pain were examined and compared. Age, weight, number of fights and weekly hours of training were recorded. Wrist and hand of each fighter were examined using a 3T-MR scanner. Degenerations of the radial, central and ulnar column were analyzed according to Navarro’s three-column theory and degenerative changes were categorized based on the classification of Fredericson. Results There was no significant difference of age, weight and number of fights between MMA fighters and boxers (p > 0.15). However, MMA fighters practiced significantly more hours per week (19.5 (MMA) vs. 8.5 (boxing) hours/week, p < 0.001). No significant associations were found between different training times per Week in terms of degenerative changes of the wrist in MMA and boxing based on the three column theory. The comparison of degenerative changes in the columns between MMA and boxing showed no significant differences. The MRI showed a significantly higher degeneration in the radial column compared to the central column among MMA fighters for ligaments (p = 0.01) and bones (p = 0.03). Conclusion Due to different fighting techniques, different physical traumas, including falls, pattern of degenerations of the wrist between MMA fighters and boxers are different. MMA fighters suffer of a highly degenerative radial column and boxers suffer of a homogeneous degeneration of all three columns.

The King–Devick test and sports-related concussion: Study of a rapid visual screening tool in a collegiate cohort

Immersive virtual reality (VR) is increasingly applied in various areas of life. The potential of this technology has also been noticed in recreational physical activity and sports. It appears that a virtual environment can also be used in diagnosing certain psychomotor abilities. The main aim of this study consisted of assessing the relevance and reliability of VR-implemented tests of simple and complex reaction time (RT) performed by mixed martial arts (MMA) fighters. Thirty-two professional MMA fighters were tested. The original test developed in the virtual environment was applied for RT assessment. The fighters’ task consisted of reacting to the lighting up of a virtual disc situated in front of them by pushing a controller button. The relevance of the test task was estimated by juxtaposing the obtained results with the classic computer test used for measuring simple and complex reactions, while its reliability was assessed with the intraclass correlation procedure. Significant relationships found between the results of VR-implemented tests and computer-based tests confirmed the relevance of the new tool for the assessment of simple and complex RT. In the context of their reliability, RT tests in VR do not differ from tests conducted with the use of standard computer-based tools. VR technology enables the creation of tools that are useful in diagnosing psychomotor abilities. Reaction time tests performed by MMA fighters with the use of VR can be considered relevant, and their reliability is similar to the reliability obtained in computer-based tests.

Aim:The purpose of this study was to determine the amount of visual acuity loss with head movement in actively training mixed martial arts (MMA) fighters.Methods:Vestibulo-ocular reflex function of 22 asymptomatic, male MMA fighters (age = 29.2 ± 5.1) was assessed by taking the difference between static visual acuity and the dynamic visual acuity test, in both yaw and pitch planes.Results:The mean static visual acuity testing logMAR was -0.173 (standard deviation [SD] = 0.114). Mean dynamic visual acuity test values decreased with head movement to 0.196 logMAR (SD = 0.103) in yaw; p < 0.001, and to 0.283 logMAR (SD = 0.133) in pitch; p < 0.001.Conclusion:MMA fighters had a decay, beyond normal ranges, in visual acuity during head movement. These decreases may suggest vestibulo-ocular reflex impairment and were unrelated to self-reported concussion history. These results should be cautiously interpreted since there was not a control group.

Head strikes are legal and commonly used in mixed martial arts (MMA) competitions, putting MMA fighters at substantial risk for brain injury. Following a knockout (KO) or technical KO (TKO), fighters typically receive time-based medical suspensions that do not include objective determinations for safe return-to-play. Fighters who do not suffer a KO or TKO may not receive any medical suspensions, even though they may have incurred an undiagnosed concussion or subconcussive brain injury. PURPOSE: To determine if participating in a single MMA competition is associated with impaired neurologic function of MMA fighters. METHODS: Neurologic function of ten amateur and professional MMA fighters (9 men, 1 women; 26.1 ± 2.6 yr) was assessed before (61 ± 91.8 days; T1) and after (3.8 ± 1.3 days; T2) competition. Control participants (9 men, 1 women; 27.1 ± 2.7 yr) were assessed on two separate occasions, 38 ± 15.2 days apart (T1, T2). All participants were evaluated for static balance (Wii Balance Board; SB), dynamic balance (Y Balance Test; DB), eye movement speed and accuracy (King-Devick test; KD), near point of convergence (Vestibular / Ocular-Motor Screening; NC), hand-eye reaction time (FITLIGHT Trainer; RT), visuomotor ability (FITLIGHT Trainer, VM), and multiple object tracking speed (NeuroTracker, MOT). RESULTS: Two MMA participants lost their competition by KO/TKO (one due to strikes). DB, KD and NC improved significantly in control subjects relative to MMA fighters (β = -0.019, P = 0.005; β = 2.874, P = 0.039; and β = 5.662, P = 0.002, respectively). However, SB, RT and VM improved significantly in MMA fighters relative to control subjects (β = -1.042, P < 0.001; β = -0.017, P = 0.037; β = -0.062, P = 0.015, respectively). Changes in MOT between T1 and T2 were not significantly different between groups (β = 0.257, P = 0.285). CONCLUSION: MMA fighters had deficits in some assessments of neurologic function a few days after competition, yet they seemed to improve in other aspects. Measures of dynamic balance and eye function were impaired relative to control subjects, whereas static balance and reactive movement skills were improved in MMA fighters. Overall, it appears that some aspects of neurologic function may be more susceptible to impairment following MMA competition, though general abnormalities were not present.