Evidence for brain trauma following five two minute rounds in boxing

M. Graham, C. Graham, P. Ryan, P. Evans, D. Renn, B. Davies, N.-E. Thomas, S.-M. Cooper, J. Baker

Research output: Contribution to journalArticlepeer-review



Severe cerebral acute injuries, resulting in morbidity or fatality, are rare in boxing compared with other sports.1 The British Medical Association has campaigned for a complete ban on boxing because of alleged chronic traumatic brain injury.2 A recent epidemiological study has concluded that such evidence is weak.3 The aim of this unique study was to analyse whether punches to the head (PTH), sustained during a boxing event, resulted in cerebral damage as quantified by elevated levels of neurochemical markers of brain tissue damage compared with punches to the body (PTB). Systemic stress was quantified by measuring serum cortisol.


Sixteen amateur boxers were divided into two groups: PTH, (n = 8, mean±s.d., age: 17.6±5.3 years; height: 168.4±13; weight: 65.4±20.3; punches to the head: 35.5±18.4), PTB (n = 8, mean±s.d., age: 19.1±3.2 years; height: 169.6±7.5; weight: 68.5±15). The PTH group received punches to the head and body, while group PTB received only punches to the body. Blood samples were taken pre- and immediately post combat for analysis of S-100B, neurone specific enolase (NSE) and cortisol.


Significant increases (P<0.05) in serum concentrations of S-100B (0.35±0.61 versus 0.54±0.73 μg/L) and NSE (19.7±14 versus 31.1±26.6 ng /mL) and cortisol (372.9±201.5 versus 755.8±93ng /mL) were encountered pre- and immediately post combat in the PTH group but not in the PTB group.


PTH in boxing are sufficient enough to cause biochemically discernible damage of brain tissue. The risk of having an intra-cerebral haemorrhage from a mild brain injury (MBI) is 38%, with 7% requiring neurosurgical intervention.4 The consequences of a MBI may be a transitory post-concussive syndrome.5 Traumatic stress states are a well known pathology and consist of a psychological reaction against the trauma.


The authors have nothing to declare. All research complied with the Declaration of Helsinki. Ethical approval was provided by the University Ethics Committee.

Original languageEnglish
Pages (from-to)S21-S25
Number of pages5
JournalJournal of Cerebral Blood Flow & Metabolism
Issue number1
Publication statusPublished - 1 Oct 2009


Dive into the research topics of 'Evidence for brain trauma following five two minute rounds in boxing'. Together they form a unique fingerprint.

Cite this