New study tries to answer old boxing question

The question has puzzled doctors since the days Joe Louis ruled

the heavyweight division.

Why do some fighters suffer brain damage from punches absorbed

in the ring while others get hit in the head for years and show few

effects?

A study that has applications outside of boxing could provide at

least a partial answer, and researchers say their intent isn’t to

end contact sports, but to find ways to make them safer.

”You can’t stop these sports, and the last thing we want to do

is stop these sports,” said Dr. Charles Bernick, the chief

investigator for the project. ”But we want to be able to protect

athletes from long-term brain issues.”

Almost 150 current boxers and mixed martial arts fighters have

already taken their first set of tests for the study, funded mostly

by Las Vegas hotel magnate Kirk Kerkorian and conducted at the

Cleveland Clinic’s new Lou Ruvo Center for Brain Health in downtown

Las Vegas. Researchers hope to eventually enroll more than 600

fighters in what is hoped to be at least a four-year study of their

brains.

The motive for most of the fighters is simple – they save $800

to $1,000 for a baseline MRI they would need anyway to get a Nevada

state license to box or participate in professional MMA. For some,

though, it is more about peace of mind than it is about the

money.

”It’s my profession and I want to pursue a long, healthy

life,” said Diego Magdaleno, an undefeated super featherweight

ranked No. 2 by the World Boxing Association. ”If there is

anything that will help me keep from going into the deep end with

any kind of severe injury I’m all for it.”

That the study – the first big project for the new center – is

based in Las Vegas is fitting because the city is recognized as the

boxing capital of the world and is also the headquarters of the

Ultimate Fighting Championship. A gala celebrating Muhammad Ali’s

70th birthday on Saturday at the MGM Grand – site of most of

boxing’s major fights in the past two decades – is a fundraiser for

the center.

Ali suffers from Parkinson’s disease, a degenerative brain

condition that some doctors say can be brought on by punches to the

head. Ali’s own neurologist told The Associated Press last month,

however, that he didn’t believe the heavyweight great’s condition

was caused by head blows.

Bernick said much still wasn’t known about why some fighters

develop Alzheimer’s or dementia pugilistica – also known as punch

drunk syndrome – while others seem to suffer little from repeated

hits to the head. The study, he said, could lead to better ways to

predict which fighters are more at risk for brain damage later in

their lives.

”Our study is not to prove that getting hit in the head will

lead to brain damage. We know that already in some sense,” he

said. ”We know being exposed to repetitive blows to the head is a

risk factor to developing these conditions, but you can’t prove it

in any one person unless you have an autopsy.”

The list of boxers who suffered from brain damage is a long one,

and goes back a long way. Louis had dementia symptoms late in life,

while Sugar Ray Robinson – who sometimes boxed every other week and

fought an astonishing 1,403 rounds in his career – developed

Alzheimer’s disease in his later years. Jerry Quarry, a heavyweight

contender who fought Ali twice, died at the age of 53 from dementia

pugilistica, while his brother, Mike, a light heavyweight, died

from the same thing at 55.

As far back as 1928, doctors were studying the causes of brain

damage in boxing. That year, Dr. Harrison S. Martland told the New

York Pathological Society about his observations of fighters:

”Fighters in whom the early symptoms are well recognized are

said by the fans to be `cuckoo,’ `goofy,’ `cutting paper dolls,’ or

`slug nutty,”’ Martland said. ”Punch drunk most often affects

fighters of the slugging type, who are usually poor boxers and who

take considerable head punishment, seeking only to land a knockout

blow. It is also common in second rate fighters used for training

purposes, who may be knocked down several times a day.”

Still, there are large numbers of fighters who have never

suffered any noticeable brain damage, and doctors have yet to

pinpoint why these athletes don’t seem to be affected by repeated

blows to the head.

”We don’t know why two individuals both exposed to the same

number of blows and years of fighting, why one person develops

chronic brain disorders and one doesn’t,” Bernick said. ”When it

comes to cumulative head trauma there are many, many things we just

don’t know.”

During their first visit to the clinic, fighters are given an

MRI and a series of cognitive and memory tests. They are tested for

judgment and reasoning, and doctors look for signs of impulsiveness

and depression. The tests will be used as a baseline for annual

checks, and researchers will study all the data to see if there are

common links.

”We would hope it would go on forever, but we need at least

four years,” Bernick said. ”We hope to learn enough by then to

give us some insight into what happens in real time to individuals

involved in activities where they are exposed to head trauma.”

Bernick said the study may provide valuable information that can

be used in other sports, like American football, where concussions

are an ongoing issue. The Cleveland Clinic is also involved in

concussion studies, including one which looks into the

effectiveness of a blood test in identifying concussions in college

football players.

Boxing promoter Bob Arum said he welcomes the study, which, he

said, could be particularly useful when a boxer is deciding how

long he will fight.

”A lot of questions people have about when is enough enough

will be able to be somewhat solved by what’s being done there,”

Arum said. ”We’ll have a body of facts and evidence that we never

had before.”

Magdaleno, who has been fighting since the age of 8 and has had

132 amateur and 21 professional fights, went with his brother,

Jesse, also a professional fighter, for his first test at the

clinic. He plans to take the battery of tests after his March 23

fight against Miguel Beltran Jr. in Tucson, Arizona.

”When I first heard about it I wasn’t too interested because I

didn’t understand it all,” he said. ”But after it was explained

to me, I’m all for it. I want to be an inspiration to others and

make them come in and do their tests, too.”