Combining powers for future gain

Combat sports rivals unite in pursuit of answers regarding chronic brain damage

Originally Published: February 5, 2014
By Kieran Mulvaney | ESPN.com

Mikey GarciaSaul Loeb/AFP/Getty ImagesMikey Garcia was among those who spoke in support of preventive measures regarding brain health.

WASHINGTON, D.C. -- The conventional wisdom is that nothing can get done in this town, that the nation's capital is beset by gridlock, partisanship and a refusal by each side to talk to the other.

So it's an instructive indication of how polarized the boxing world has become that the more remarkable sight at the U.S. Capitol on Tuesday morning was not former Republican presidential candidate John McCain sharing the floor at a press conference with Senate Majority Leader Harry Reid, but the presence of Top Rank's Todd duBoef and Golden Boy's light-heavyweight titlist Bernard Hopkins sitting behind them.

"It's a rare occasion when Golden Boy Promotions and Top Rank Boxing are in the same room together," chuckled McCain, "so I really congratulate you for that."

Bellator MMA and Glory Kickboxing were in the room, too, as was Lorenzo Fertitta, chairman and CEO of the Ultimate Fighting Championship, flanked by Jon "Bones" Jones and Glover Teixeira, who stood and spoke together even as they prepare to do battle for that organization's light-heavyweight title on April 26. It was, in the words of one participant, a coming together of "fiercely competitive organizations," prompting duBoef to counter that, at least on this occasion, they were instead "fiercely collaborative."

It was an improbable gathering of an unlikely team of rivals, united in pursuit of an answer to a question that has dogged combat sports for decades: Why is it that while some fighters, like the 49-year-old Hopkins, remain eloquent and in command of their faculties into their relative dotage, others struggle from an early age with their movement, memory and cognition? In all too many cases, the latter group becomes ultimately unable to fight or even take care of themselves.

The phenomenon was first clinically identified in 1928 by forensic pathologist Harrison Martland, who dubbed it "punch-drunk syndrome." Today, we know it to be a variant of chronic traumatic encephalopathy (CTE), the same degenerative brain disorder that in recent years has made headlines for its impact on NFL players.

As in the NFL, the disease gains particular attention in boxing when it afflicts the famous. McCain, for example, offered without controversy that "at least part" of Muhammad Ali's present condition "is caused by sustained blows to the head that this great, great, wonderful athlete sustained." Reid, a former pugilist and boxing judge, recalled officiating one of the later fights in the career of Sugar Ray Robinson -- he and his colleagues scored the contest for Robinson's opponent -- and noted, "As we all know, the 150-200 fights he had really took their toll. We all know he ended up really sick."

[+] EnlargeBernard Hopkins and Harry Reid
Saul Loeb/Getty ImagesBernard Hopkins, who is still competing at age 49, believes the real punishment a fighter endures comes before fights in training camp.

But for every Ali and Robinson, there are countless numbers of former pugilists who have fallen out of view and memory, their tremors and slurred speech testament to the cumulative punishment of an unforgiving profession. And while, at its most fundamental level, the cause of their condition is clear -- if you get hit in the head a lot, chances are you'll wind up with brain damage -- the details are more nuanced.

"Most head injuries do not produce brain injuries," explained Jeffrey Cummings, medical director of the Cleveland Clinic Lou Ruvo Center for Brain Health. "But some head injuries do produce a brain injury that starts a process that ends up in something that looks like Alzheimer's disease. We do not understand which head injuries lead to which brain injuries.

"We want to understand two basic things. We want to know, what is the very first change that occurs? Can we detect that in an athlete, so that we can tell that athlete that they're in the beginning of that process? And second, are there predictors? Are there risk factors? Are there vulnerabilities? So that we know which athletes to monitor, and which may be at greatest risk. With these two pieces of information, we can empower our athletes. We can give them that information so they can say, 'Yes, I'm safe,' or 'No, I'm not.'"

To that end, the Lou Ruvo Center is conducting a Professional Fighters Brain Health Study, which encourages pugilists to undergo a series of medical and cognitive tests on an annual basis.

"We're using specialized MRI techniques and common MRI techniques; we're measuring blood genetics; we're looking at speech, at cognition, at behavior," explained the study's principal investigator, Charles Bernick. "So by following these individuals for four, five, six years down the line, we hope to be able to really understand: Can any of these measures tell us if damage is occurring, or predict who's on their way to having problems later on?"

To date, the study has recruited about 400 fighters and aims to reach 650 by its conclusion. The Cleveland Clinic has supported it to the tune of approximately $2 million, and the principal announcement at Tuesday's press conference was that the assembled promotional entities had combined to add another $600,000 to the total.

"We're thrilled that these organizations really stepped up to make sure we finish our business, to sustain our study long enough to be sure we get the answers we need," said Bernick.

Already, some answers are presenting themselves.

"For example, using specialized MRI techniques, we've found that small changes occur in some boxers even within a year's period," Bernick revealed. "So even in that short period, there may be techniques that can tell us if damage is accumulating."

Unsurprisingly, the key variable appears to be the number of fights in a boxer's career. The greater that number, the more likely the tests are to reveal some changes. But not all fights are equal: The boxing style of Hopkins or Floyd Mayweather Jr., for example, results in less punishment than that of, say, Arturo Gatti. Then again, George Foreman was in some hellacious battles, and like Hopkins, Foreman fought well into middle age. Yet he's happily hawking grills and seemingly making the most of life.

One element, as Hopkins pointed out, is that the fights themselves are but the "icing on the cake." The real punishment, he offered, is meted out in "the training, the eight weeks of sparring with two or three guys, the pounding from day in and day out. That's where the damage starts. It's an accumulation in the gym."

Chronic brain damage is, of course, but one aspect of fighter safety and welfare. Much needs to be done -- by some of those in attendance at Tuesday's press conference, among others -- on a raft of issues from PED screening, to rapid medical response at fights, to providing support for boxers in retirement. And there are those who will shrug and suggest that the sight of incapacitated former fighters, while unsavory, is an inevitable consequence of a savage business with willing participants who are fully aware of the potential pitfalls.

But perhaps it need not always be thus, and if it is at all possible to reduce the blight of brain-damaged boxers, then that is a goal that ought to be embraced by all who are involved in, and benefit from, the sport.

"Yes, we chose to sign up for this, but it's also your entertainment," said Hopkins. "We sort of have a deal. I look at this as really being a part of history. I'm very passionate about this. I hope that the boss upstairs will continue to keep my demeanor, my articulate speech, and all the things that are jeopardized because of what I've been doing for so long. We've got two of the biggest promoters in boxing teaming up together, as we are today. We are one on this."

Kieran Mulvaney covers boxing for ESPN.com, HBO.com and Reuters, and also blogs for Discovery Channel News.

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