FOLLOW-UP STUDY OF NEUROLOGICAL RISKS IN AMATEUR BOXING

长期的脑损伤的可能性 拳击比赛中发生的事情引起了很大的争议 多年，可能与更广泛的头部受伤问题有关。 在很多方面，业余拳击这项运动中发生的伤害 与职业拳击有很大不同，更类似于 那些发生在其他运动和事故中的情况。 因此，一项研究 业余拳击比赛中是否会发生脑损伤 具有具体和广泛的流行病学和医学意义。 我们已经开始并将很快完成第一阶段的研究 500 名业余拳击手旨在回答以下问题： 选定的神经心理学、神经病学或神经生理学 2年间隔后发生的变化与 不同程度的接触，从基本没有到 反复进行亚震荡性打击，有时甚至是震荡性打击。 这个 研究的独特之处在于，拳击手在任何明显的 减值迹象，它是前瞻性的，并且涉及 500 名受试者的代表性样本。 此外，低剂量 使用内部控制。 我们的初步研究表明 拳击手似乎具有其他人无法比拟的独特特征 合理的对照人群可能并不合适。 这个 研究设计是与外部顾问共同制定的 委员会由神经心理学家、流行病学家、 神经科医生、神经外科医生、生物统计学家、拳击教练等 当局。 本提案旨在为后续措施（之后 两年间隔）在这些相同的拳击手上。 在不久的将来 完成神经心理学、电生理学的基线研究， 神经系统测量是在 4 小时的测试过程中进行的。 全部 测试在流动诊所完成。 尿液样本是 收集以测试最近的物质使用情况。 详细的拳击 历史是从拳击手和教练那里获得的。 拟议的 将根据基线研究制定后续措施 协议。 两年后提出后续措施 间隔，作为保持密切关系的愿望之间的折衷 与受试者接触并有足够长的有意义的间隔 观察变化。 与以下机构保持临时联系 受试者以确保高随访率 应采取前瞻性措施。

The possibility of long term cerebral damage from the blows that occur in boxing has been a source of considerable controversy for years and may be relevant to the broader issues of head injuries. In many ways, the injuries that occur in amateur boxing, a sport vastly different from professional boxing, are more analogous to those that occur in other sports and accidents. Therefore, a study of whether cerebral damage occurs in amateur boxing would have both specific and broad epidemiologic and medical implications. We have begun and will shortly complete the first phase of a study of 500 amateur boxers designed to answer the question of whether selected neuropsychologic, neurologic, or neurophysiologic changes which occur after a 2-year interval are associated with varying degrees of exposure ranging from essentially none to repeated subconcussive and in some cases, concussive blows. This study is unique in that boxers are identified before any apparent signs of impairment, it is prospective, and involves a representative sample of 500 subjects. In addition, a low dose internal control is used. Our preliminary studies have shown that boxers appear to have enough unique characteristics that other plausible control populations are probably not appropriate. This study design was developed in concert with an external advisory committee comprised of neuropsychologists, an epidemiologist, neurologist, neurosurgeon, biostatistican, boxing coach, and other authorities. This proposal is to request funds for the follow-up measures (after a two year interval) on these same boxers. In the soon to be completed baseline study neuropsychologic, electrophysiologic, and neurologic measures are made in a 4-hour test session. All tests are completed in a mobile clinic. Urine samples are collected to test for recent substance use. A detailed boxing history is obtained from the boxer and coach. The proposed follow-up measures will be made using the baseline study protocol. Follow-up measures are proposed after a 2-year interval, as a compromise between a desire to maintain close contact with subjects and a meaningful interval long enough to observe changes. Interim contact is being maintained with subjects to assure a high follow-up rate in the event that prospective measures are to be made.