BOXING AND THE BRAIN
BOXING AND THE BRAIN
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DOI：
10.1136/bmj.298.6666.105
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发表时间：
1989-01-14
影响因子：
--
通讯作者：
CORSELLIS, JAN
中科院分区：
文献类型：
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作者：
CORSELLIS, JAN
1928年，美国病理学家马特兰写了一篇题为《拳击醉酒》的论文，在论文中，他第一次提请人们注意”职业拳击手的一种特殊情况“。他写道：”许多病例症状轻微，但在严重病例中，可能会出现头部异常倾斜，一条腿或两条腿明显拖曳，蹒跚、推进步态，具有帕金森综合征的面部特征，或身体向后摇摆，震颤，眩晕或耳聋。最后，明显的精神恶化可能导致必须接受庇护。“这种变化，即使是温和的，现在也很罕见。对这项运动的控制，虽然各国之间存在很大差异，但已经相当严格，英国当局一直在努力将危险降至最低。尽管如此，击打人的头部总是会对大脑造成一定的危害，而且只要这项运动被某些人当作一种高尚的活动来鼓励，它的存在就必然会受到其他人的质疑。首先，在拳击场上或在比赛后的几天内死亡的风险很小，这通常是由头部内出血引起的灾难。[2]拳击运动中的这种风险似乎并不比其他运动中的风险大，尽管还没有准确的死亡率数据。[3]事实上，McCunney和Russo发现，从大学橄榄球、赛马到滑翔翼和水肺潜水等运动，对生命的威胁要小得多。然而，萨蒙斯在20世纪70年代发现了美国拳击手面临的更大风险。[5]其次，也许更重要的是，那些在拳击生涯中幸存下来的人有患上长期疾病的风险，而这种伤害是最少被讨论的。对头部的反复亚致死打击，无论是否导致击倒，都可能导致潜在的变化，这些变化可能是醉酒状态或米尔斯波拳击员痴呆症的基础。6英国的神经学家已经报道了醉酒状态的许多神经学方面，最近，美国也报道了。3 12病理方面，然而，很少有人研究。也许是偶然的因素进入了前拳击手的大脑供应，因为大多数研究都是基于对单个或几个大脑的显微镜检查。因此，病理学的焦点往往落在这样或那样的变化上，从而损害了可能构成”拳醉“特征的任何更全面的模式。"
The American pathologist Martland wrote a paper entitled" Punch drunk" in 1928, in which he drew attention for the first time to a" peculiar condition among prize fighters."" Many cases remain mild, but in severe cases," he wrote," there may develop a peculiar tilting of the head, a marked dragging of one or both legs, a staggering, propulsive gait with the facial characteristics of the parkinsonian syndrome, or a backward swaying of the body, tremors, vertigo, or deafness. Finally, marked mental deterioration may set in necessitating commitment to an asylum." Such changes, even when mild, are now rarer. Control of the sport, while varying greatly from country to country, has been considerably tightened up, and the authorities in the United Kingdom have worked hard to minimise the dangers. Nevertheless, hitting people on the head must always carry some risk to the brain, andas long as the sport is encouraged as a noble activity by some its existence is bound to be questioned by others.Two forms of damage may occur. Firstly, there is the remote risk ot death in the ring or within a few days after the fight-a catastrophe usually caused by bleed-ing inside the head. 2 This risk in boxing seems to be no greater than that in other sports, although accurate mortality figures do not exist. 3 Indeed, McCunney and Russo found that the threat to life was less than that in sports ranging from college football and horse racing to hang gliding and scuba diving. 4 Sammons, however, uncovered a greater risk to American boxers during the 1970s. 5 Secondly, and perhaps more importantly, there is the risk of unremitting disease in those who survive a career in boxing, and it is this kind of damage that is least discussed. Repeated sublethal blows to the head, whether or not they cause a knockout, may lead to insidious changes that may underlie the punch drunk state'or Millspaugh's dementia pugilistica. 6 The many neurological facets of the punch drunk state have been reported by neurologists in the United Kingdom7-" and, more recently, the United States. 3 12 The pathological aspects, however, have been less often studied. Perhaps an element of serendipity enters into the supply of brains of former boxers, for most studies have been based on the microscopical examination of a single or a few brains. The pathological focus has consequently tended to fallon one or other kind of change to the detriment of any more comprehensive pattern that might underlie the features of" punch drunkenness."