Chronic Traumatic Brain Injury Associated with Boxing

Abstract

Chronic traumatic brain injury (CTBI) associated with boxing occurs in approximately 20% of professional boxers. Risk factors associated with CTBI include increased exposure (i.e., duration of career, age of retirement, total number of bouts), poor performance, increased sparring, and apolipoprotein (APOE) genotype. Clinically, boxers exhibiting CTBI will present with varying degrees of motor, cognitive, and/or behavioral impairments. The severe form of CTBI is referred to as dementia pugilistica. The diagnosis of CTBI is dependent upon documenting a progressive neurological condition that is consistent with the clinical symptomatology of CTBI attributable to brain trauma and unexplainable by an alternative pathophysiological process. Pathologically, CTBI shares many characteristics with Alzheimer's disease (i.e., neurofibrillary triangles, diffuse amyloid plaques, acetylcholine deficiency, and/or tau immunoreactivity). The mainstay of treatment of CTBI is prevention, however medications used in the treatment of Alzheimer's disease and/or parkinsonism may be utilized.

Tackling in Youth Football

“…At autopsy, these athletes had pathologic changes to the brain, including ventriculomegaly, cerebral atrophy, b-amyloid deposits, and phosphorylated t deposits, an entity now commonly known as CTE. [35][36][37][38][39][40][41][42][43][44][45][46][47][48][49] These case reports and case series have led to the hypothesis that repetitive blows to the head, whether concussive or subconcussive, result in the pathologic changes noted above and that these pathologic changes are associated with certain neurobehavioral characteristics. Whether the pathologic findings are solely attributable to the blows to the head and whether the pathologic changes are significantly associated with the neurobehavioral correlates is debated because these hypotheses remain to be tested by case-control and cohort studies.…”

Repeated concussion among U.S. military personnel during Operation Iraqi Freedom

“…Although research describing the effects of repeated concussions in military populations is limited, civilian literature points to several detrimental physical, cognitive, and emotional health effects of incurring multiple concussions [9][10][11][12][13]. Evidence exists that some aspects of neurocognitive function do not recover as quickly in those who have experienced multiple concussions, and some studies suggest a permanent reduction in cognitive performance [14][15].…”

Evaluating the Risks and Benefits of Participation in High-School Football

“…Currently, we are unable to predict the probability of long-term problems for a given number of sport-related concussions. Some athletes who have sustained multiple traumatic injuries to the brain over long careers in boxing, American football, and other sports have pathologic changes in the brain such as the deposition of beta-amyloid and phosphorylated tau [15][16][17][18][19][20][21][22][23][24]. This condition has become known as chronic traumatic encephalopathy.…”