Olympic boxing may damage the brain

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Olympic boxers can exhibit changes in brain fluids after bouts, which indicates nerve cell damage. This is shown in a study of 30 top-level Swedish boxers that was conducted at the Sahlgrenska Academy in collaboration with the Swedish Boxing Federation, published in PLoS ONE.

It has been debated for quite some time whether Olympic boxing (amateur boxing) is hazardous to the brain. Researchers at the Sahlgrenska Academy, Gothenburg University, joined with colleagues at the Faculty of Health Sciences at Linköping University and the Swedish Boxing Association in conducting a unique study of 30 top-level Swedish boxers and 25 reference persons.

The study shows that repeated blows to the head in the boxing ring can produce a release of brain injury markers to the brain fluid, similar to what is seen with after other types of head trauma, as well as in neurological illnesses such as Alzheimer's.

"Our study shows that after bouts, some of the boxers had elevated concentrations of four different proteins in the brain fluid, which all signal damage to the brain's nerve cells. Moreover, two of the proteins were still elevated after a period of rest" says researcher Sanna Neselius, who has led the study. Sanna Neselius has self been boxing at elite level and was ranked as one of the best female boxers in the world, both as olympic and professional boxer.

As many of 80 percent of the boxers exhibited protein changes that indicate brain damage. The boxers who participated in the study competed on the top-level of Swedish boxing and all had fought at least 47 bouts. None of them had lost on a knock-out, and only one of the boxers mentioned symptoms after a bout (headache).

"The brain injury markers were elevated for 80 percent of the olympic boxers directly after a bout as a result of minor brain damage. That the brain fluid markers were elevated even after weeks of rest for some of the boxers can be interpreted as the damage had yet not healed or that some damage will remain, says Sanna Neselius.

Sanna Neselius has now scheduled a meeting with the Swedish Boxing Federation's board of directors to discuss the results.

"We need to discuss the results and how we can increase the medical safety for boxers, both during training and in competition," says Sanna Neselius. "I further hope that the results will be taken seriously by other martial arts federations, where the safety regulations are not as well defined as in boxing. The results may also be useful when discussing concussion guidelines.

"Preferably, we would like to find a simple blood test that provides the same information as our more advanced brain fluid examinations. The capability does not presently exist, but can perhaps become an option in the future with further and more extensive studies."

Article CSF-Biomarkers in Olympic Boxing: Diagnosis and Effects of Repetitive Head Trauma was published in PLoS ONE, April 4.

Link to article: http://dx.plos.org/10.1371/journal.pone.0033606

Contact:
Sanna Neselius, M.D., Specialist in Orthopaedic Surgery, PhD Student, Sahlgrenska Academy, University of Gothenburg
031-3430870
Cell: +46 706-101014
sanna.neselius@vgregion.se

Press contact
Krister Svahn

Sahlgrenska Academy, University of Gothenburg
46766-18 38 69
4631-786 3869
krister.svahn@sahlgrenska.gu.se


The Sahlgrenska Academy is the faculty of health sciences at the University of Gothenburg. Education and research are conducted within the fields of pharmacy, medicine, odontology and health care sciences. About 4,000 undergraduate students and 1,200 postgraduate students are enrolled at Sahlgrenska Academy. Around 1,400 people work at the Sahlgrenska Academy. 850 of them are researchers and/or teachers. 2009 Sahlgrenska Academy had a turnover of 2,100 million SEK.

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Olympic boxers can exhibit changes in brain fluids after bouts, which indicates nerve cell damage.
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The results may also be useful when discussing concussion guidelines
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80 percent of Swedish elite boxers in new study showed indications of brain damage
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We need to discuss the results and how we can increase the medical safety for boxers, both during training and in competition
Sanna Neselius, researcher at the Sahlgrenska Academy