Landmark study may help prevent permanent brain injury in fighters

Cleveland ClinicJul 18 2011

The Cleveland Clinic Lou Ruvo Center for Brain Health has launched a landmark study with professional fighters that will help determine whether magnetic resonance imaging (MRI) of the brain, along with other tests, can detect subtle changes in brain health that correlate with impaired thinking and functioning. The Center is working hand-in-hand with the Nevada Athletic Commission, Golden Boy Promotions, Top Rank Boxing and the UFC to spread the word about the importance of this research to the sport.

Researchers hope the information uncovered by this research will eventually result in better ways to prevent permanent brain injury in not only fighters, but also in others who may suffer from brain trauma. This information could also be used in the future to help develop better protective equipment across sports.

"It has been known for decades in the boxing community that recurrent blows to the head can result in permanent brain damage. Many notable fighters have developed striking neurological conditions at relatively young ages," said Charles Bernick, M.D., Associate Medical Director at the Cleveland Clinic Lou Ruvo Center for Brain Health, and principal investigator on the study.  "Our goal is to help the next generation of fighters by improving fighting safety.  New technologies, such as advanced MRI scanning, may offer us the ability to determine who is at greatest risk to develop permanent brain injury and detect it at its earliest stages."

Studies suggest that 20 percent to 50 percent of professional fighters may develop conditions such as Alzheimer's disease, Parkinson's disease, chronic traumatic encephalopathy, depression, and other serious neurological and neuropsychiatric problems, often at a young age. Currently, there is no way to determine if a fighter has sustained, cumulative brain damage.

"We encourage all fighters to participate for their health and for the future of the sport," said Bill D. Brady, Chairman of the Nevada State Athletic Commission. "Together with Cleveland Clinic and Nevada's professional fighters, we can improve brain health awareness within the fighting community."

Researchers have already enrolled about 20 fighters with the ultimate goal of 625 by the study's completion. Involvement in the study is completely voluntary, and fighters who participate in the study will receive free, ongoing assessment of their brain health and brain function, including MRI scans.  Individual tests will be repeated once a year for four years so that any changes to the participants' brains can be noted and monitored.

Researchers will measure changes in brain volume, scarring and blood flow via MRI scans. Any changes seen on the participant's MRI will be correlated with their performance on cognitive assessments and neurologic exams. For fighters who demonstrate a correlation between MRI findings and cognitive decline, researchers hope to determine whether there is any relationship to the number of blows, number of rounds fought, knockouts, dehydration or other factors.

"This study will add key insights into head and neck injuries in professional and amateur athletes that doctors, engineers and others can truly benefit from, building upon Cleveland Clinic's current work in the prevention, diagnosis and treatment of these conditions," said Michael T. Modic, M.D., Chairman of the Neurological Institute at Cleveland Clinic. "It's important to know the true brain health impact that boxing and other combative sports have on fighters.  We hope to find a way to identify fighters with repetitive injuries to be able to knowledgeably tell fighters when to hang up the gloves and help them heal."

Testing results are confidential. No information will be released to any other person or agency without the participant's written permission. Any abnormal findings will be discussed privately with the study participant.

Participants must be 18 or older and licensed (or seeking licensure) in Nevada for professional boxing, mixed martial arts, and/or kickboxing.