When Floyd Mayweather Jr. and Conor McGregor step into the ring Saturday night, there will be much more than pride and money on the line. Brain health is at risk in combat sports, whether it’s Mayweather’s boxing or McGregor’s mixed martial arts.
Although there is not enough evidence to say one sport is definitively more dangerous to the brain, data being collected for the Professional Fighters Brain Health Study (PFBHS) by the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas suggest boxing is worse.
The sport of MMA allows several ways to strike your opponent, including kicking, punching and elbowing. But the volume of punches landed in an average boxing match outnumber those in a MMA bout.
“If you look at it from a very simple standpoint — punch counts — boxers are on the receiving end of a lot more punches,” said Dr. Charles Bernick, associate medical director of the Ruvo Center and the neurologist who guides the PFBHS. “It does seem in many of our analyses boxers do a little worse on various measures of their reaction times and processing speed, on average.”
The study of repetitive head trauma, with more than 750 participants, includes a broad range of annual testing of retired and active fighters. The study, which began in 2011, is planned to continue until 2021. The longer the participants are followed, the more valuable information that will be collected.
Traumatic brain injuries have made headlines over the past few years, as various studies have linked football with chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repeated blows to the head.
A study by Dr. Ann McKee published earlier this year studied the brains of 202 deceased former American football players, with 177 of them showing signs of CTE. The study found that 110 of 111 brains from ex-NFL players had CTE.
Changes in certain areas of the brain can be detected by MRIs as early as within a year in some fighters who are actively competing. Those changes appear to correlate with greater exposure to head trauma and with decline in performance on tests of processing speed.
A Fight Exposure Score, which factors in age, number of professional fights and fights per year, can provide a rough estimate of a fighter’s risk of performing lower on certain cognitive tests.
Welterweight Conor McGregor appears defenseless from another blow by Nate Diaz during their UFC 202 fight night action at the T-Mobile Arena on Saturday, August 20, 2016.
“We’ve looked at markers in the blood that may reflect damage to the brain,” Bernick said. “There may be some blood test that you could do that shows accumulating damage to the brain.”
The goal of the PFBHS is to pinpoint possible issues and identify who might be in line to develop brain issues, such as CTE, in the future.
“Studies like this (blood test) may be able to identify ways to track injury in the brain and predict who’s likely to have long-term neurological consequences,” Bernick said. “Same thing with imaging. We’ve published some work on using an MRI scan, which may help predict who may be sustaining damage to the brain in their sport.”
Andre Berto, right, punches Floyd Mayweather Jr. during their welterweight title fight Saturday. Mayweather, who won the fight, ran his record to 49-0, tying a mark set by the late heavyweight champion Rocky Marciano.
Smaller glove debate
For the Mayweather-McGregor fight, the Nevada Athletic Commission unanimously approved a one-time waiver for 8-ounce gloves instead of 10-ounce gloves that state regulations require in matches above 147 pounds (welterweight).
The approval sparked criticism, citing more risks with smaller gloves on fighters at heavier weights. However, Bernick says the smaller glove size may not affect the amount of damage generated.
“It really has to do with getting the head moving, the rotational movement of the head,” he said. “The brain has the consistency of jello — it’s kind of floating in fluid. If you can quickly rotate the brain, from a punch with a heavier or softer glove or not, you’re going to cause more damage to the brain — more stretching.”
Dr. Timothy J. Trainor, consulting physician for the Nevada Athletic Commission, agreed with Bernick. After looking at the number and type of injuries that occurred using the two sizes of gloves, there was no significant difference in injuries, Trainor says.
“To my knowledge, no good scientific study has proven a health difference between 8- and 10-ounce gloves,” Trainor said. “There have been arguments on both sides to say one glove is less damaging than the other; however, there is no scientific data to prove any of these arguments.”
NAC fighter brain testing
With brain health and athletes, particularly fighters, becoming a hot topic, the Nevada Athletic Commission is looking for ways to improve the health and safety of combat sports athletes. It has also been trying out a brain-testing program that measures a fighter’s motor reflexes and speed of mental processing.
One involves fighters using an iPad to perform C-3 testing neurological function test, which takes 15-20 minutes to complete.
“The C-3 test is already in use in various parts of the United States in such sports as high school football,” Trainor said. “These are all elements of brain function that can possibly be adversely affected in fighters who may be developing brain damage secondary to the nature of combat sports with repetitive blows to the head.”
Despite the promise of such a test, Trainor said they have run into multiple problems with implementing the program, including the lack of accessibility.
“The test is not readily available,” he said. “There are no ‘C-3’ testing centers located throughout the United States. It is easy for any fighter to obtain an MRI or MRA of the brain … but this is not the case for a C-3 test.”
Since February 2016, fighters licensed in Nevada must take a C-3 test annually at the Lou Ruvo Center when they apply or renew. For the C-3 tests to be valuable, participants must take subsequent tests to evaluate changes over time.
“Many combat athletes will come to Nevada for a bout and not return again for many years, if ever at all,” Trainor said. “This fact would not allow us to obtain the necessary serial exams required to make the C-3 test useful.”
Other issues with C-3 testing include legal ramifications that include storage of the information and HIPAA (Health Insurance Portability and Accountability Act of 1996) violations.
“The Nevada Athletic Commission continues to search for tests and exams that will promote the health and safety of our combat athletes,” Trainor said. “However, we do not have ‘a mandatory brain-testing program’ that will be implemented anytime in the immediate future. If we are able to find such a test, we will certainly move forward with it.”
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