title: Reduced white matter integrity in amateur boxers.
abstract: BACKGROUND
  Professional boxing can lead to chronic traumatic encephalopathy, a variant of traumatic brain injury (TBI). Its occurrence in amateur boxers is a matter of debate since amateur boxing is considered to be less harmful due to more strict regulations. However, several studies using different methodological approaches have revealed subtle signs of TBI even in amateurs. Diffusion tensor imaging (DTI) is sensitive to microscopic white matter changes and has been proven useful in TBI when routine MR imaging often is unrevealing.
  
  
  METHODS
  DTI, with tract-based spatial statistics (TBSS) together with neuropsychological examination of executive functions and memory, was used to investigate a collective of 31 male amateur boxers and 31 age-matched controls as well as a subgroup of 19 individuals, respectively, who were additionally matched for intellectual performance (IQ).
  
  
  RESULTS
  All participants had normal findings in neurological examination and conventional MR. Amateur boxers did not show deficits in neuropsychological tests when their IQ was taken into account. Fractional anisotropy was significantly reduced, while diffusivity measures were increased along central white matter tracts in the boxers group. These changes were in part associated with the number of fights.
  
  
  CONCLUSIONS
  TBSS revealed widespread white matter disturbance partially related to the individual fighting history in amateur boxers. These findings closely resemble those in patients with accidental TBI and indicate similar histological changes in amateur boxers.
authors.affiliation: Department of Neuroradiology, University of Heidelberg Medical School, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. christian.herweh@med.uni-heidelberg.de.
authors.forename: Christian
authors.initials: C
authors.lastname: Herweh
authors.affiliation: Department of Neurology, University of Heidelberg Medical School, Heidelberg, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Hess
authors.affiliation: Department of Neurology, Krankenhaus Nordwest, Frankfurt, Germany.
authors.forename: Uta
authors.initials: U
authors.lastname: Meyding-Lamadé
authors.affiliation: Department of Neuroradiology, University of Heidelberg Medical School, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
authors.forename: Andreas J
authors.initials: AJ
authors.lastname: Bartsch
authors.affiliation: Department of Neuroradiology, University Hospital Basel, Basel, Switzerland.
authors.forename: Christoph
authors.initials: C
authors.lastname: Stippich
authors.affiliation: National Training Center for Boxing, Heidelberg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Jost
authors.affiliation: Department of Sports Medicine, University of Heidelberg Medical School, Heidelberg, Germany.
authors.forename: Birgit
authors.initials: B
authors.lastname: Friedmann-Bette
authors.affiliation: Department of Neuroradiology, University of Heidelberg Medical School, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Heiland
authors.affiliation: Department of Neuroradiology, University of Heidelberg Medical School, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Bendszus
authors.affiliation: Department of Neuroradiology, University of Heidelberg Medical School, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Hähnel
mesh_terms: D000328:Adult; D001914:Boxing / Q000293:injuries*; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D000070627:Chronic Traumatic Encephalopathy / Q000000981:diagnostic imaging / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D006801:Humans; D056784:Leukoencephalopathies / Q000000981:diagnostic imaging / Q000473:pathology*; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Diffusion tensor imaging; Neuropsychology; Olympic boxing; Traumatic brain injury; White matter disturbance