Semin Neurol 2000; 20(2): 179-186
DOI: 10.1055/s-2000-9826
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Chronic Traumatic Brain Injury Associated with Boxing

Barry D. Jordan
  • Brain Injury Program, Burke Rehabilitation Hospital, White Plains, New York and Department of Neurology, Cornell University Medical College, New York, New York
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
31. Dezember 2000 (online)

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.

REFERENCES

  • 1 Martland H AS. Punch drunk.  JAMA . 1928;  91 1103-1107
  • 2 Roberts A H. Brain Damage in Boxers.  London: Pitman Publishing; 1969
  • 3 Critchley M. Medical aspects of boxing, particularly from a neurological standpoint.  Br Med J . 1957;  1 357-362
  • 4 Mendez M F. The neuropsychiatric aspects of boxing.  Int J Psychiatry . 1995;  25 249-262
  • 5 LaCava G. Boxer's encephalopathy.  J Sports Med Phys Fitness . 1963;  3 87-92
  • 6 Jordan B D, Matser E, Zimmerman R D. Sparring and cognitive function in professional boxers.  Physician Sports Med . 1996;  24 87-98
  • 7 Jordan B D, Jahre C, Hauser W A. CT of 338 active professional boxers.  Radiology . 1992;  2 181-185
  • 8 Jordan B D, Relkin N R, Ravdin L D. Apolipoprotein Ee4 associated with chronic traumatic brain injury in boxing.  JAMA . 1997;  278 136-140
  • 9 Jordan B D. Epidemiology of brain injury in boxing. In: Jordan BD, ed. Medical Aspects of Boxing Boca Raton, FL: CRC Press 1993: 147-168
  • 10 Davie C A, Pirtosek Z, Barker G J. Magnetic resonance spectroscopic study of parkinsonism related to boxing.  J Neurol Neurosurg Psychiatry . 1995;  58 688-691
  • 11 Jordan B D. Boxing. In: Jordan BD, Tsairis P, Warren RF, eds. Philadelphia: Lippincott-Williams; 1998: 351-366
  • 12 Jordan B D, Zimmerman R D. Computed tomography, magnetic resonance imaging comparisons in boxers.  JAMA . 1990;  263 1670-1674
  • 13 Casson I R, Siegel O, Sham R. Brain damage in modern boxers.  JAMA . 1984;  251 2663-2667
  • 14 Ross R J, Casson J R, Siegel O. Boxing injuries: neurologic, radiologic and neuropsychologic evaluation.  Clin Sports Med . 1987;  6 41-51
  • 15 Casson I R, Sham R, Campbell E A. Neurological and CT evaluation of knocked-out boxers.  J Neurol Neurosurg Psychiatry . 1982;  45 170-174
  • 16 Sironi V A, Scotti G, Ravagnati L. CT scan and EEG findings in professional pugilists: early detection of cerebral atrophy in young boxers.  J Neurosurg Sci . 1982;  26 165-168
  • 17 Ross R J, Cole M, Thompson J S. Boxers-computed tomography, EEG and neurosurgical evaluation.  JAMA . 1983;  249 211-213
  • 18 Bodensteiner J B, Schaefer G B. Dementia pugilistica and cavum septi pellucidi: born to box.  Sports Med . 1997;  24 361-365
  • 19 Bogdanoff B, Natter H M. Incidence of cavum septum pellucidum in adults: a sign of boxer's encephalopathy.  Neurology . 1989;  39 991-992
  • 20 Jordan B D, Jahre C, Hauser W A. Serial computed tomography in professional boxers.  J Neuroimaging . 1992;  2 181-185
  • 21 Jordan B D, Dane S D, Rowen A J. SPECT scanning in professional boxers.  J Neuroimaging . 1999;  9 59-60
  • 22 Levin H S, Jordan B D. Neuropsychological assessment of brain injury in boxing. In: Jordan BD, ed. Medical Aspects of Boxing Boca Raton, FL: CRC Press 1993: 197-206
  • 23 Thomassen A, Juul-Jensen P, Olivarius B. Neurological electroencephalographic and neuropsychological examination of 53 former amateur boxers.  Acta Neurol Scand . 1979;  60 352-362
  • 24 Matser J T, Kessels A GH, Jordan B D. Chronic traumatic brain injury in professional soccer players.  Neurology . 1998;  51 791-796
  • 25 Matser J T, Kessels A G, Lezak M D. Neuropsychological impairment in amateur soccer players.  JAMA . 1999;  282 971-973
  • 26 Brooks N, Krysshik G, Wilson L. A neuropsychological study of active amateur boxers.  J Neurol Neurosurg Psychiatry . 1987;  50 997-1000
  • 27 Kaste M, Vikki J, Sainio K. Is chronic brain damage in boxing a hazard of the past?.  Lancet . 1982;  2 1186-1188
  • 28 Heilbronner R L, Henry G K, Carson-Brewer M. Neuropsychologic test performance in amateur boxers.  Am J Sports Med . 1991;  19 376-379
  • 29 Levin H S, Lippold S C, Goldman A. Neurobehavioral functioning and magnetic resonance imaging findings in young boxers.  J Neurosur . 1987;  67 657-667
  • 30 Drew R H, Templer D I, Schulyer B A. Neuropsychological deficits in active licensed professional boxers.  J Clin Psychol . 1986;  42 520-525
  • 31 Butler R J, Forsythe W I, Beverly D W. A prospective controlled investigation of the cognitive effects of amateur boxing.  J Neurol Neurosurg Psychiatry . 1993;  56 1055-1061
  • 32 Casson I R, Siegel O, Sham R. Brain damage in modern boxers.  JAMA . 1984;  251 2663-2667
  • 33 McLatchie G, Brooks N, Gailbraith S. Clinical neurological examination, neuropsychology, electroencephalography, and computed tomographic head scanning in active amateur boxers.  J Neurol Neurosurg Psychiatry . 1987;  50 96-99
  • 34 Stewart W F, Gordon B, Selnes O. Prospective study of central nervous system function in amateur boxers in the United States.  Am J Epidemiol . 1994;  139 573-599
  • 35 Johnson J. Organic psychosyndromes due to boxing.  Br J Psychiatry . 1969;  115 45-53
  • 36 Murelius H, Haglund Y. Does Swedish amateur boxing lead to chronic brain damage?.  <~>A retrospective neuropsychological study. Acta Neurol Scand . 1991;  83 9-13
  • 37 Haglund Y, Eriksson E. Does amateur boxing lead to chronic brain damage?.  <~>A review of some recent investigations. Am J Sports Med . 1993;  21 97-109
  • 38 Butler R J. Neuropsychological investigation of amateur boxers.  Br J Sports Med . 1994;  28 187-190
  • 39 Corsellis J AN, Bruton C J, Freeman-Browne C. The aftermath of boxing.  Psychol Med . 1973;  3 270-303
  • 40 Corsellis J AN. Posttraumatic dementia in Alzheimer's disease. In: Jatzman R, Terry RD, Bick K, eds. Senile Dementia and Related Disorders New York: Raven Press 1978: 125-133
  • 41 Roberts G W, Allsop D, Bruton C. The occult aftermath of boxing.  J Neurol Neurosurg Psychiatry . 1990;  53 373-378
  • 42 Tokuda T, Ikeda S, Yanugesa N. Re-examination of ex-boxer's brain using immunohistochemistry with antibodies to amyloid beta protein and tau protein.  Acta Neuropathol . 1991;  82 280-285
  • 43 Dale G E, Leigh P N, Luthert P. Neurofibrillary tangles in dementia pugilistica are ubiquitinated.  J Neurol Neurosurg Psychiatry . 1991;  54 116-118
  • 44 Uhl G R, McKinney M, Hedreen J C. Dementia pugilistica: loss of basal forebrain cholinergic neurons and cortical cholinergic markers.  Ann Neurol . 1982;  12 99
  • 45 Hof P R, Bouras C, Buee L. Differential distribution of neurofibrillary tangles in the cerebral cortex of dementia pugilistica and Alzheimer's disease cases.  Acta Neuropathol . 1992;  85 23-30
  • 46 Geddes J F, Vowles G H, Robinson S FD. Neurofibrillary tangles, but not Alzheimer-type pathology, in a young boxer.  Neuropathology Appl Neurobiol . 1996;  22 12-16
  • 47 Mortimer J A, French L R, Hutton J T. Head injury as a risk factor for Alzheimer's disease.  Neurology . 1985;  35 264-267
  • 48 Merz Brown. Is boxing a risk factor for Alzheimer's?.  JAMA . 1989;  261 2597-2598
  • 49 Saija A, Hayes R L, Lyeth B G. The effects of concussive head injury on central cholinergic neurons.  Brain Res . 1988;  452 303-311
  • 50 Smith C M, Swash M. Possible biochemical basis of memory disorder in Alzheimer's disease.  Neurology . 1978;  3 471-473
  • 51 Nicoll J AR, Roberts G W, Graham D I. Apolipoprotein Ee4 allele is associated with deposition of amyloid beta protein following head injury.  Nat Med . 1995;  1 135-137
  • 52 Mayeaux R, Ottoman R, Maestre G. Synergistic effects of traumatic head injury and apoplipoprotein e4 in patients with Alzheimer's disease.  Neurology . 1995;  45 555-557
  • 53 Katzman R, Galosko D R, Saitoh T. Apolipoprotein e4 and head trauma: synergistic or additive risks?.  Neurology . 1996;  46 889-892
  • 54 Jordan B D, Kanick A B, Horwich M S. Apolipoprotein e4 and fatal cerebral amyloid angiopathy associated with dementia puglistica.  Ann Neurol . 1995;  38 698-699
  • 55 Case records. Massachusetts General Hospital.  N Engl J Med . 1999;  340 1269-1277
  • 56 Teasdale G M, Nicoll J AR, Murray G. Association of apolipoprotein E polymorphism with outcome after head injury.  Lancet . 1997;  350 1069-1071
  • 57 Seliger G, Lichtman S W, Polsky T. The effect of apolipoprotein E on short-term recovery from head injury.  Neurology . 1997;  48 A213
  • 58 Friedman G, Froom P, Sazbon L. Apolipoprotein E e4 genotype predicts a poor outcome in survivors of traumatic brain injury.  Neurology . 1999;  52 244-248
  • 59 Chen Y, Lomnitski L, Michaelson D M. Motor and cognitive deficits in apolipoprotein E deficient mice after closed head injury.  Neuroscience . 1997;  80 1255-1262
  • 60 Colosimo C, Albanese A. Boxer disqualified for taking selegiline.  Lancet . 1995;  346 647
  • 61 Goldberg E, Gerstman L J, Mattis S. Effects of cholinergic treatment on posttraumatic anterograde amnesia.  Arch Neurol . 1982;  39 581
  • 62 Taverni J P, Seliger G, Lichtman S W. Donepezil medicated memory improvement in traumatic brain injury during post acute rehabilitation.  Brain Injury . 1998;  12 77-80
  • 63 Professional Boxing Safety Act of 1996 (HR 4167). Public Law 104-272 104th Congress
  • 64 Jordan B D. Genetic susceptibility to brain injury in sports: a role for genetic testing in athletes.  Physician Sports Med . 1998;  26 25-26
    >