Traumatic Brain Injury Ages the Brain By Over Four Years

[ErikMagraken]

One of my professional focuses is to stay current on studies addressing safety in combative sports and with traumatic brain injury in general. An importation study was published in the Annals of Neurology last month finding that traumatic brain injury likely causes accelerated atrophy “aging” the brain by an average of over four years.

In the recent stud the researchers were able to accurately predict brain age based on MRI data. The same brain age calculating methods were then applied to MRI’s from patients who suffered traumatic brain injuries. The data set included 99 patients with persistent neurological problems after suffering a traumatic brain injury. The cause of injury included a variety of mechanisms including sports injuries, vehicle collisions, assaults among others.

The study found, regardless of the cause of injury, the patients who suffered a traumatic brain injury had accelerated brain atrophy making their brains appear 4.66 years older than their actual age. The severity of brain injury correlated to the severity of ‘aging’ with more profound brain injuries leading to greater brain atrophy.

The full study is valuable for anyone interested in health and safety issues in combat sports and can be found here – Prediction of Brain Age Suggests Accelerated Atrophy after TBI

Originally published here - Traumatic Brain Injury Ages the Brain By Over Four Years | Combat Sports Law

 

[Splinty]

Erik, thanks for posting this! I've got to run for a little but will be back on shortly to flip through the original study with some opinions on the study strength.

 

[ErikMagraken]

Thanks, I look forward to your feedback.

 

[La Paix]

Awesome post @ErikMagraken thanks for sharing. When I read these kind of things it really makes me question some things as a big mma fan and a father of two. I had my daughter in TKD for about 8 months and have stopped as she wasn't really feeling it but now my younger son (4) is all over fighting. He loves to watch fights and has fun putting in my gloves and duking it out with me which makes me excited to get him signed up for something but those studies definetly make me reconsider. Makes me really want to leave striking alone for a while and get him into BJJ or judo as wrestling is not big around my area and see what path he picks as life unfolds.

 

[Wild]

Some general thoughts:

- Scary stuff that anyone involved in combat sports needs to be aware of.
- Another reason I would personally like to see a Fighters Association formed
- Why I wish these legends that are hanging on (Mirko, Big Nog, Hendo, etc) would hang em up

 

[lookoutawhale]

be interesting to see fighters brains studies to see what the impact is.

 

[ErikMagraken]

be interesting to see fighters brains studies to see what the impact is.

The Cleveland Clinic is working on this as we speak Senators Reid and McCain Join Boxing, MMA Executives to Support Professional Fighters Study at Cleveland Clinic Lou Ruvo Center for Brain Health

 

[lookoutawhale]

The Cleveland Clinic is working on this as we speak Senators Reid and McCain Join Boxing, MMA Executives to Support Professional Fighters Study at Cleveland Clinic Lou Ruvo Center for Brain Health

nice. sounds like a good study that can help fighters in the long term.

 

[Splinty]

Alright, lets look into this thing...

https://canadianmmalawblog.files.wo...ge-suggests-accelerated-atrophy-after-tbi.pdf


So the big things to take are:

- patient age is ~40 years old

- Their main point is to examine a brain, and create an technology to estimate damage for TBIs by imaging (since right now we can't do that).

- They are seeing changes on MRI and then with that they are doing the following. They take an IMAGING CHANGE and estimate a PHYSICAL CHANGE then predict an ageing type decline of FUNCTIONAL CHANGE. They then test their predicted functional score and it is statistically accurate.

-the model estimated brain age to be on average >4 years older than the patient’s chronological age. This discrepancy was only seen in patients with more severe injuries, was independent of the mechanism of injury, and was predictive of cognitive impairment.


They are convincing in their argument for this being a continuing process following injury, not just a single step decline back to the usual curve. However, I would be careful in applying these to all TBIs.
Younger patients were not tested.
Mild TBI didn't show statistical decline.

My opinion?
It's a good thought and should be considered. But I would want to see the study done on a younger age group that are most involved in sport.
I'd like to see more restrictions on return to sport and training and a culture develop that pushes athletes into time off instead of "manning up" and being "tough".

What will be interesting is if we can finally add an imaging modality to determine when a fighter should continue or quit, either short term or longterm.

 

[ErikMagraken]

Alright, lets look into this thing...

https://canadianmmalawblog.files.wo...ge-suggests-accelerated-atrophy-after-tbi.pdf


So the big things to take are:

- patient age is ~40 years old

- Their main point is to examine a brain, and create an technology to estimate damage for TBIs by imaging (since right now we can't do that).

- They are seeing changes on MRI and then with that they are doing the following. They take an IMAGING CHANGE and estimate a PHYSICAL CHANGE then predict an ageing type decline of FUNCTIONAL CHANGE. They then test their predicted functional score and it is statistically accurate.

-the model estimated brain age to be on average >4 years older than the patient’s chronological age. This discrepancy was only seen in patients with more severe injuries, was independent of the mechanism of injury, and was predictive of cognitive impairment.


They are convincing in their argument for this being a continuing process following injury, not just a single step decline back to the usual curve. However, I would be careful in applying these to all TBIs.
Younger patients were not tested.
Mild TBI didn't show statistical decline.

My opinion?
It's a good thought and should be considered. But I would want to see the study done on a younger age group that are most involved in sport.
I'd like to see more restrictions on return to sport and training and a culture develop that pushes athletes into time off instead of "manning up" and being "tough".

What will be interesting is if we can finally add an imaging modality to determine when a fighter should continue or quit, either short term or longterm.

Great summary and comments!

 

[Wild]

The answer, and intelligent thing to do, for everyone entering the sport or coming into the sport, is to only spar once a week...and only go about 70%. Risking health issues (especially w/ the brain) in their later years, simply is not worth it.

Take @Tim Sylvia for example. It's no secret that those guys at MTF went hard back in the day...and now Tim was refused a license because of the damage an MRI showed. You gotta wonder how many of the guys from the early years are going to have problems over the next 5-15 years.

 

[Zeph]

The answer, and intelligent thing to do, for everyone entering the sport or coming into the sport, is to only spar once a week...and only go about 70%. Risking health issues (especially w/ the brain) in their later years, simply is not worth it.

Take @Tim Sylvia for example. It's not secret that those guys at MTF went hard back in the day...and now Tim was refused a license because of the damage an MRI showed. You gotta wonder how many of the guys from the early years are going to have problems over the next 5-15 years.

There does seem to be a shift in many camps mentalities lately, which is a positive sign.

 

[WoodenPupa]

Can the aging be reversed by getting high? JUST CHECKING.

 

[WoodenPupa]

Seriously though, it seems the more we learn about the brain, the worse fighting for a living looks.

 

[Splinty]

Seriously though, it seems the more we learn about the brain, the worse fighting for a living looks.

EDITORIAL: Why I have chosen to stop watching Mixed Martial Arts, my favorite sport - the mounting evidence of CTE from head trauma

By Ivan Trembow, Guest Writer

A few weeks ago, I made the decision that I am no longer going to be watching MMA (or football, or boxing, or kickboxing).

It was very difficult for me to come to this decision, because MMA has not just been my favorite sport for as long as I can remember; it has also been my biggest interest and passion in life for as long as I can remember. The sport of MMA has been what I often go to bed thinking about, it has been what I've written about for years, it has given me something to look forward to during many tough times, and it has been the sport that I've defended to any of my friends or family who oppose it. I know that no longer watching MMA is going to leave a void in my life, and that no longer watching football, boxing, or kickboxing is going to be easy by comparison.

Very few days have gone by over these many years during which I haven't either read about, or written about, or watched MMA, and for good reason: The technique involved in MMA, the fact that a fighter can employ dozens of different strategies and try to go about winning in so many different ways, the fact that all of those strategies have counter-strategies (and those counters have counters), the fact that there are so many different ways to win... These are the things that have always made me feel that MMA is the most exciting sport in the world to watch.

At the same time, I know that I can't watch it anymore, and I'd like to explain what led to my decision to no longer watch the sport that I've loved so much for so many years.

I recently watched a segment on an episode of the HBO newsmagazine "Real Sports" that I had saved on Tivo. The segment was about a peer-reviewed scientific study that links brain injuries such as concussions to ALS (and to syndromes like ALS), which is probably the single worst way for a human being to (slowly and painfully) die.

Ivan did what he thought was right.
I see it differently. I see ALL sport as risk and reward. Ask fighters, football players,etc. what the greatest moment of their lives was...Any successful professional will answer that following their child's birth, some specific event in their sport career was it. Think about that. All of us that don't do this will think of a vacation or friends party or whatever. But the NFL guys are thinking about that moment the crowd cheered 30 years ago and it still gives them goosebumps. Something so amazing and powerful can't just be dismissed as just a game. Those guys get brain damage? They'll still think, "well damn. but hey I don't regret it. Bad stuff happens. But at least I lived"

But with that reward there are those with less reward and much the same risk. This is really where I get conflicted and think that we need to force people out that don't have a future. Football does that to an extent by the sheer numbers. I'd like to see the UFC and MMA at-large do the same. Once you don't have that future, that reward, we should not continue to encourage the risk just because it sells some tickets to a local audience.

Online fans seem to get this. We talk about our favs retiring and being healthy. But if that person is involved in the right card, they will be a draw so not everyone feels just the same.

 

[Zeph]

I'm very much a pro-choice advocate and if you want fight in MMA, knowing the risks, then I am fine with it. Just like I believe adults have a right to smoke, drink, do drugs, eat unhealthily, jump out of planes, or anything else which is bad for them or dangerous for their health. It is a personal choice and no one should make it for anyone else.

However, this issue just makes the fighter pay issue more important. If you are going to possibly sacrifice years of your life, or level of comfort in later life, than you should be fairly compensated, and that is in making sure the right % of revenue brought in from their labours finds its way to the fighters.

 

[Splinty]

However, this issue just makes the fighter pay issue more important. If you are going to possibly sacrifice years of your life, or level of comfort in later life, than you should be fairly compensated, and that is in making sure the right % of revenue brought in from their labours finds its way to the fighters.

Absolutely!
They really should have a pooled healthy benefit for the high dollar stuff that results in long term disability. Beyond that, a group health plan should be created that allows people to buy in.
But this all takes massive revenue sharing and only a union could coordinate everyone to distribute the risk appropriately.

 

[WoodenPupa]

We've got a bad tendency as human beings to discount the future. That tendency is at its peak in childhood and (for most people) doesn't really let up until we reach our 30's. The physically optimum fighter is going to be in his 20's, the time when he's least wise in relation to his physical abilities. Trying to make him care for his distant future is very difficult---education in itself isn't a solution (otherwise almost nobody would fight). But it would be nice to have a system in place so that should any fighter fall victim to pugilistic dementia later in life, he's got some help.

 

[ErikMagraken]

Awesome post @ErikMagraken thanks for sharing. When I read these kind of things it really makes me question some things as a big mma fan and a father of two. I had my daughter in TKD for about 8 months and have stopped as she wasn't really feeling it but now my younger son (4) is all over fighting. He loves to watch fights and has fun putting in my gloves and duking it out with me which makes me excited to get him signed up for something but those studies definetly make me reconsider. Makes me really want to leave striking alone for a while and get him into BJJ or judo as wrestling is not big around my area and see what path he picks as life unfolds.

Gymnastics is a brilliant base for almost all sports. If you get your kids into it they will build an incredible foundation for any sports they wish to transition into later in life, be they combative sports or others.

 

[Wild]

Gymnastics is a brilliant base for almost all sports. If you get your kids into it they will build an incredible foundation for any sports they wish to transition into later in life, be they combative sports or others.

My youngest (age 11) started out in gymnastics and then transitioned into all-star cheerleading. It was a great base for that for sure. Starting her in TKD as soon as school lets out.

 

[ErikMagraken]

As exciting as combat sports are the reality is the human body was not designed for a long term career in the sport. There is only so much mileage the body and the brain can take. The toll on the body is generally evident earlier compared to the toll on the brain which can manifest later in life.

Certainly we don't need studies to tell us moderate to severe brain injuries are often accompanied with long term repercussions. The biggest threat is repetitive sub concussive trauma. Those little hits you take over and over again while sparring. I am interested in the data that will be generated by the Cleveland Clinic study. More and more data is coming to light that repetitive concussive and sub concussive hits take their toll on long term brain health.

Everyone who chooses to get involved in combat sports should do so with eyes wide open with a realistic view of the tolls of the sport. With that information at hand choices can be made to train smart, spar safely and ideally get out before your due date expires. Science has no answer on when that due date comes but the more these studies come to light the better educated guess athletes can make. The answer will undoubtedly be 'sooner rather than later'.

 

[Wild]

Agree Erik. I think 99% of athletes know what they're getting into. But I also think they could be smarter about it, and reduce their risks of long term brain issues. Hard sparring 4-5 times a week does far more damage than a 15 minute fight. The good news is, a lot of MMA fighters seem to recognize that now and are cutting back.

The NFL and boxing are completely different stories.

 

[ErikMagraken]

For those interested in combat sports safety studies and safety issues, here are some archived posts

1. Guy Mezger Shares the Legacy of “17 Years of Being Hit in the Head” Guy Mezger Shares the Legacy of “17 Years of Being Hit in the Head” | Combat Sports Law

2. Recent Developments in Combat Sports Brain Injury Studies Recent Developments in Combat Sports Brain Injury Studies | Combat Sports Law

3. Knockouts By Punch Increased Tenfold After Gloves Introduced to MMA Knockouts By Punch Increased Tenfold After Gloves Introduced to MMA | Combat Sports Law

4. More Medical Evidence on the Toll of Sub Concussive Trauma in Combat Sports More Medical Evidence on the Toll of Sub Concussive Trauma in Combat Sports | Combat Sports Law

6.“Rates of KOs and TKOs in MMA are higher than previously reported “ “Rates of KOs and TKOs in MMA are higher than previously reported “ | Combat Sports Law

7. ARP Calls For Weight Cut Reform in Combat Sports ARP Calls For Weight Cut Reform in Combat Sports | Combat Sports Law

8. Two Sober Reminders of the Reality of Head Trauma in Combat Sports Two Sober Reminders of the Reality of Head Trauma in Combat Sports | Combat Sports Law

9. Concussions Accompanied With Visible Alterations in the Brain Concussions Accompanied With Visible Alterations in the Brain | Combat Sports Law

10. Association of Ringside Physicians Says “Eliminate” TRT TUE’s in Combat Sports Association of Ringside Physicians Says “Eliminate” TRT TUE’s in Combat Sports | Combat Sports Law

11. Illegal PED’s And Science Based Suspensions In MMA Illegal PED’s And Science Based Suspensions In MMA | Combat Sports Law

12. There is Nothing Mild (Nor Unusual) About TJ Grant’s Mild Traumatic Brain Injury There is Nothing Mild (Nor Unusual) About TJ Grant’s Mild Traumatic Brain Injury | Combat Sports Law

13. How Much Head Trauma is Too Much in a Combat Sports Career? How Much Head Trauma is Too Much in a Combat Sports Career? | Combat Sports Law

14. Study Shows Multiple Subconcussive Hits Take Their Toll on Brain Function Study Shows Multiple Subconcussive Hits Take Their Toll on Brain Function | Combat Sports Law

15. Combat Sports Safety Literature Update Combat Sports Safety Literature Update | Combat Sports Law

16. With Tragedy At Hand, Weight Cut Reform Takes the Spotlight in MMA With Tragedy At Hand, Weight Cut Reform Takes the Spotlight in MMA | Combat Sports Law

17. What Are the Risks of Chronic Brain Damage For Retired Athletes? What Are the Risks of Chronic Brain Damage For Retired Athletes? | Combat Sports Law

18. The Canadian Medical Association Takes a Swipe at Bill S-209 The Canadian Medical Association Takes a Swipe at Bill S-209 | Combat Sports Law

19. Spar Smart! – Study Shows Long Term Brain Dysfunction More Related to Intensity of Sparring Than Frequency of Knockouts Spar Smart! – Study Shows Long Term Brain Dysfunction More Related to Intensity of Sparring Than Frequency of Knockouts | Combat Sports Law

20. Overall Risk of Injury in Amateur Boxing “Lower Than Football, Hockey, Wrestling and Soccer” Overall Risk of Injury in Amateur Boxing “Lower Than Football, Hockey, Wrestling and Soccer” | Combat Sports Law

21. Boxing Glove Coupled With Headgear Found Best Combination to Reduce Concussive Impacts For Striking Sports Boxing Glove Coupled With Headgear Found Best Combination to Reduce Concussive Impacts For Striking Sports | Combat Sports Law

22. Documenting The Tolls of Rapid Extreme Weight Cuts in MMA Documenting The Tolls of Rapid Extreme Weight Cuts in MMA | Combat Sports Law

23. Here is a recent study looking at the impact differences between MMA and boxing gloves. It concludes

"MMA gloves produced 4?5 times greater peak force and 5 times faster load rate compared to the boxing glove."

Striking dynamics and kinetic properties of boxing and MMA gloves | Lee | Revista de Artes Marciales Asiáticas

24. brain volume objectively decreases based on the number of bouts and years in the fight game with boxers fairing worse than MMA fighers

https://canadianmmalawblog.files.wo...rts-med-2015-bernick-bjsports-2014-093877.pdf

Also these - (sorry no links)

1) Determining the prevalence and assessing the severity of injuries in MMA athletes. Rainey, Lt. Charles; N Am J Sports Phys Ther. Nov 2009; 4(4): 190-199
WWW.ncbi.nlm.nih.gov/pmc/articles/PMC29

2) NHB sport fighting: a 10 year review of MMA competition
Buse GJ; Br J Sports Med. 2006 Feb; 40(2):160-72
No holds barred sport fighting: a 10 year review of mixed martial arts competition. - PubMed - NCBI

3) MMA: injury patterns and issues for the ringside MD
Seidenberg PH; Curr Sports Med Rep. 2011 May-June; 10(3):147-50
Mixed martial arts: injury patterns and issues for the ringside physician. - PubMed - NCBI

4) Incidence of injury among male BJJ fighters at the world Jiu-jitsu No-Gi championships
Kreiswirth EM. Journal of athletic training. 2014; 49(1)89-94
WWW.ncbi.nlm.nih.gov/pmc/articles/PMC39