American Journal of Epidemiology Vol. 139, No. 6: 573-588
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Prospective Study of Central Nervous System Function in Amateur Boxers in the United States
1Department of Epidemiology, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD.
2Department of Neurology and Cognitive Science, Zanvyl-Krieger Mind/Brain Institute, Johns Hopkins Hospital Baltimore, MD.
3Department of Neurology, Johns Hopkins Hospital Baltimore, MD.
4Department of Biostatistics, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD.
5Department of Health Policy and Management, School of Hygiene and Public Health, The Johns Hopkins University Baltimore, MD.
Reprint requests to Dr. Walter Stewart, Department of Epidemiology, School of Hygiene and Public Health, Room 6033, The Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 2120
Active amateur boxers from six US cities were studied in 1986–1990 to determine whether changes in central nervous system function over a 2-year interval (as evaluated by tests of perceptual/motor function, attention/concentration, psychomotor speed, memory, visuoconstructional ability, and mental control, measures of ataxia and brainstem auditory evoked potentials, and electroencephalography) were associated with degree of participation in amateur boxing. A total of 484 participants were examined at baseline; 393 (81.2%) were examined 2 years later. At baseline, 22% of the participants had not yet competed in a bout; 9% had never competed in a bout by the second examination. Exposure was defined by number of bouts, sparring-years, and sparring with a professional boxer. Very few statistically significant odds ratios were found between exposure and change in function. Significant tests of trend were found between the total number of bouts incurred before the baseline examination and changes in memory, visuoconstructional ability, and perceptual/motor ability. The significant trends for change in function in the latter two domains were primarily due to performance on the Block Design test, which was common to both test domains. No statistically significant associations were found between more recent bouts (after the baseline visit) and any functional domains, nor between bouts or sparring and any other outcome measures. The significant trends with past bouts, but not more recent bouts, may reflect the need for a long latency period before effects are manifest. Alternatively, given changes in safety practices, the observed association may be related to more severe exposure from bouts that occurred before 1986, when new safety measures were imposed.
boxing; central nervous system; head injuries; prospective studies
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