title: Determining brain fitness to fight: Has the time come?
abstract: Professional boxing is associated with a risk of chronic neurological injury, with up to 20-50% of former boxers exhibiting symptoms of chronic brain injury. Chronic traumatic brain injury encompasses a spectrum of disorders that are associated with long-term consequences of brain injury and remains the most difficult safety challenge in modern-day boxing. Despite these concerns, traditional guidelines used for return to sport participation after concussion are inconsistently applied in boxing. Furthermore, few athletic commissions require either formal consultation with a neurological specialist (i.e. neurologist, neurosurgeon, or neuropsychologist) or formal neuropsychological testing prior to return to fight. In order to protect the health of boxers and maintain the long-term viability of a sport associated with exposure to repetitive head trauma, we propose a set of specific requirements for brain safety that all state athletic commissions would implement.
authors: a 1 Department of Neurology, Norton Healthcare , Louisville, KY, USA.|b 2 Department of Neurology, University of Kentucky , KY, USA.|c 3 Kentucky State Boxing Commission , KY, USA.
authors: Tad
authors: T
authors: Seifert
authors: d 4 Lou Ruvo Center for Brain Health, Cleveland Clinic , Las Vegas, NV, USA.
authors: Charles
authors: C
authors: Bernick
authors: e 5 Department of Neurology, Burke Rehabilitation Hospital , White Plains, NY, USA.|f 6 New York State Athletic Commission , NY, USA.
authors: Barry
authors: B
authors: Jordan
authors: g 7 Department of Neurology, Backus Hospital , Norwich, CT, USA.|h 8 Department of Neurology, University of Connecticut , CT, USA.
authors: Anthony
authors: A
authors: Alessi
authors: i 9 Department of Emergency Medicine, Valley Hospital , Las Vegas, NV, USA.|j 10 Ultimate Fighting Championship , Las Vegas, NV, USA.
authors: Jeff
authors: J
authors: Davidson
authors: k 11 Department of Neurosurgery, Emerson Hospital , MA, USA.|l 12 Sports Legacy Institute , Boston, MA, USA.
authors: Robert
authors: R
authors: Cantu
authors: m 13 Department of Pediatric Neurology, University of California at Los Angeles , CA, USA.|n 14 California State Athletic Commission , CA, USA.
authors: Christopher
authors: C
authors: Giza
authors: o 15 Headache Center of Southern Nevada , Las Vegas, NV, USA.|p 16 Voluntary Anti-Doping Association , Las Vegas, NV, USA.
authors: Margaret
authors: M
authors: Goodman
authors: q 17 Department of Orthopedic Surgery, Pro Spine Center , Vero Beach, FL , USA.
authors: Johnny
authors: J
authors: Benjamin
mesh_terms: D001914:Boxing / Q000293:injuries*; D001921:Brain; D001924:Brain Concussion / Q000209:etiology*; D020208:Brain Injury, Chronic / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D009483:Neuropsychological Tests; D012017:Referral and Consultation; D000068958:Return to Sport; D012449:Safety
keywords: Concussion; boxing; dementia; return to play; traumatic brain injury