A University of Arkansas for Medical Sciences professor is the lead author of a new study of cognitively impaired professional boxers and mixed martial arts fighters.
The brain’s waste-clearing system significantly declines in function with repeated head impacts, according to the study, the findings for which were recently presented at the Radiological Society of North America annual meeting.
Sports-related traumatic brain injuries account for up to 30 percent of all brain injury cases, and boxing and mixed martial arts are major contributors. Repeated head impacts are risk factors for neurodegenerative and neuropsychiatric disorders.
The glymphatic system is a network of fluid-filled channels that plays a crucial role in clearing waste products from the brain. It is comparable to the lymphatic system in other parts of the body, according to an RSNA press release.
“The recently discovered glymphatic system is like the brain’s plumbing and garbage disposal system,” said Dhanush Amin, M.D., lead author of the study. “It’s vital for helping the brain flush out metabolites and toxins.”
Amin authored the study while he was at the University of Alabama at Birmingham, working with researchers from UAB and Cleveland Clinic Nevada.
“When this system doesn’t work properly, damaging proteins can accumulate, which have been linked to Alzheimer’s and other forms of dementia,” said Amin, now an assistant professor of neuroradiology at UAMS. “Studying this system gives us a new window into understanding and possibly slowing memory loss.”
The researchers analyzed baseline data from Cleveland Clinic’s Professional Athletes Brain Health Study, a longitudinal study of approximately 900 active fighters, of which roughly 300 professional fighters have been followed for at least three years. The study included data from 280 fighters, 95 of whom were cognitively impaired at baseline, and 20 demographically matched healthy controls.
Contrary to their hypothesis, the researchers observed a significantly higher glymphatic index among impaired fighters that deteriorated over time with the total number of knockouts. In athletes with continued trauma, glymphatic function significantly declined.
“We believe that the glymphatic index was initially high in the impaired athlete group because the brain initially responds to repeated head injuries by ramping up its cleaning mechanism, but eventually, it becomes overwhelmed,” Amin said. “After a certain point, the brain just gives up.”
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