Acute Traumatic Brain Injury in Amateur Boxing

ABSTRACT BACKGROUND: Acute traumatic brain injury (ATBI) represents the neurologic consequence of concussive and sub concussive blows to the head. Evidence suggests that ATBI may be associated with boxing and collision sports such as American football and soccer, thus potentially exposing millions of athletes annually. OBJECTIVE: The objectives of this study were to determine whether significant ATBI occurs in boxers who compete and, if present, the nature of the cognitive impairment. A secondary objective was to determine if headgear could reduce the risk for ATBI in amateur boxing. DESIGN: In this inception cohort study, 38 amateur boxers underwent neuropsychological examination before and shortly after a boxing match and were compared with a control group of 28 amateur boxers who were tested before and after a comparable physical test. The main outcome measures were neuropsychological tests (memory, mental and fine-motor speed, planning, and attention) proven to be sensitive to cognitive changes incurred in contact and collision sports. RESULTS: The boxers who competed exhibited an ATBI pattern of impaired performance in planning, attention, and memory capacity when compared with controls. They had significantly different findings in the Categorization Task Test (P = 0.047); Digit Symbol Test (P < 0.02); Logical Memory: Short Term Memory and Long Term Memory subtests (both tests, P< 0.001); and Visual Reproduction: Short Term Memory subtest (P< 0.001) and Long Term Memory subtest (P< 0.03). CONCLUSION: Participation in amateur boxing matches may diminish neurocognitive functioning despite the use of headgear. The neurocognitive impairment resembles cognitive symptoms due to concussions. Guidelines are needed to reduce the risk for repeated ATBI.