FOLLOW-UP STUDY OF NEUROLOGICAL RISKS IN AMATEUR BOXING

长期的脑损伤的可能性， 在拳击比赛中发生的事情一直是一个相当大的争议的来源， 可能与更广泛的头部受伤问题有关。 在许多方面，业余拳击运动中发生的伤害， 与职业拳击有很大的不同， 发生在其他运动和事故中的。 因此，一项研究 业余拳击是否会造成脑损伤 具体和广泛的流行病学和医学影响。 我们已展开第一阶段的研究，并将于短期内完成 500名业余拳击手的设计，以回答这个问题， 选定的神经心理学、神经学或神经生理学 2年后发生的变化与 不同程度的暴露，从基本上没有到 反复的亚震荡性打击有时候是震荡性打击 这 这项研究的独特之处在于，拳击手在任何明显的 这是一种潜在的损害迹象， 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， 拳击手似乎有足够的独特特征， 合理的对照人群可能不合适。 这 研究设计是与外部顾问合作开发的 委员会由神经心理学家，流行病学家， 神经学家，神经外科医生，生物统计学家，拳击教练和其他 当局 这项建议是为后续措施申请资金（在 两年的时间间隔）在这些相同的拳击手。 在不久的将来 完成基线研究神经心理学，电生理学， 在4小时的测试中进行神经学测量。 所有 测试在移动的诊所中完成。 尿样 用来检测最近的药物使用情况 详细的拳击 历史是从拳击手和教练那里获得的。 拟议 将使用基线研究进行后续测量 议定书 2年后提出后续措施 间隔，作为保持密切联系的愿望之间的妥协 与受试者的接触和足够长的有意义的间隔， 观察变化。 目前正与 受试者，以确保在以下情况下的高随访率： 将采取前瞻性措施。

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.