A prestigious neurology clinic has launched an unprecedented brain study of professional fighters with the goal of advancing research to improve various treatments for brain damage.
"We know what permanent brain damage looks like in its final stages, but we know so little about what causes it and what happens during cumulative trauma," said Maureen Peckman of the Cleveland Clinic. Peckman is coordinating the new study between the clinic's Lou Ruvo Center for Brain Health in Las Vegas and officials with the Nevada State Athletic Commission.
The study hopes to get 500 boxers and mixed martial arts fighters to volunteer for the research project. It is being funded by a grant in excess of $400,000 by billionaire Kirk Kerkorian's Lincy Foundation.
Participants will undergo four annual MRI brain scans, along with physical, cognitive and speech tests to monitor how brain activity can be altered by suffering head trauma in the ring.
Boxing promoters Bob Arum and Richard Schaefer and Ultimate Fighting Championship Chairman Lorenzo Fertitta have agreed to encourage their stable of fighters to participate in the study.
"A fighter's health is very important. Who wants to be involved in something that endangers a human life?" said Schaefer, Golden Boy Promotions chief executive. "If they can come up with a way to tell what the implications of boxing are, it's of interest for all of us to know."
Long boxing careers have unquestionably diminished the health of many fighters, including Muhammad Ali, who has Parkinson's disease, and the sport's premier trainer, Freddie Roach.
"The hypothesis is that we will find changes — be it in a brain scan, blood flow, brain fiber sheathing or the size of the brain — that will allow us to establish objective markers for ongoing damage [and] to inform the fighter where he stands," said Dr. Charles Bernick, the neurologist leading the study.
Roach, who had 53 professional fights, is suffering the effects of Parkinson's, including tremors and reduced mobility. He acknowledges he should have quit before his last five bouts.
He shunned the advice to retire from his legendary trainer, Eddie Futch, and fought 47 additional rounds, losing four of his last five fights.
"Something from a high medical authority that can show a boxer's deterioration [and] force guys to retire would be good. That's the only way you're going to get guys to listen," said Roach from his Wild Card Boxing Club in Hollywood. Roach and his staff train amateur boxers, aspiring Olympians, Manny Pacquiao and junior welterweight Amir Khan, who fights Zab Judah on July 23 in a title fight in Las Vegas.
Boxing regulators say they need more objective medical expertise to strengthen restrictions on boxing licenses.
Barring a reported head injury or ailment, boxers need to provide Nevada with only one MRI result over the course of their career to be licensed. The clinic's Peckman called that "archaic."
Assessing how head trauma has affected a fighter is "very subjective," said Keith Kizer, executive officer of the Nevada State Athletic Commission. "A lot of it is guesswork."
"We know there are effects to getting hit in the head.... Can we establish a threshold to determine whether a guy who gets knocked out needs to be off for 30 days, 90 days, or for good?"
Kizer hopes the study will have a "far-reaching impact" as neurologists use the findings to help improve treatments for Alzheimer's, Parkinson's and multiple sclerosis.
Bernick said the study could broaden so that some fighters will take MRIs immediately before and after their bouts.
Earlier this month, the Cleveland Clinic allowed the Los Angeles Times to observe the testing of two of the first participants in the study, former amateur boxer Michael Martinez and veteran pro boxer Laura Serrano.
Martinez, 32, who said he had 150 amateur bouts, was appreciative that he could have an MRI for free rather than paying up to $3,500 out of pocket.
Martinez was slid into a tubelike MRI device. Technicians scanned his brain, producing digital images to determine his brain's blood flow and weight and to check for existing problems. He was also interviewed about his fighting history, given memory and reaction tests, and a neurological exam by Bernick.
Serrano, 43, who has fought 23 times, plans a return to the ring in August after a layoff since 2007. In her 1994 pro debut, Serrano fought legendary boxer Christy Martin to a draw, then took a world lightweight title in her second bout.
Serrano complained about the lack of medical scrutiny in boxing, recalling when one fighter begged off a pre-fight pregnancy test by promising to take it after the bout.
"I remember once in training against a male fighter, he hit me so hard in the temple I felt my body shaking from my head to my toes," Serrano said. "Horrible, horrible feeling. I realized then, 'Whoops, this is dangerous. You can die or get brain damage from this.'"
The researchers will release the overall findings of the study, but the medical results of each participant will remain confidential.
Researchers anticipate their brain study findings will be reviewed by state athletic commissions, and the scientists are hopeful that annual brain scans will become a requirement to get a fight license.
What remains to be seen, of course, is how a sport would cope with a doctor saying a superstar, capable of generating millions of dollars, can no longer fight.
"Right now, it's about, 'Let's get the data; let's see the trends' and empower people to make better informed decisions weighing the highest safety standards," Peckman said.
Veteran Top Rank boxing matchmaker Bruce Trampler has seen thousands of boxing matches and says, with remorse, that he has seen five boxers die in the ring.
Trampler says he has warned some boxing commissions against licensing fighters he doesn't believe should fight any longer. He says he made such an argument in June and was rebuffed the fighter was knocked out in the early rounds.
"I'm glad to see boxing's taking some steps to protect these kids," Trampler said. "Blows to the head seem to affect everyone differently. Jake LaMotta's still walking around at 90, but some other guys half his age are showing visible effects."
Bernick foresees drawing some significant conclusions about cumulative brain trauma after study. Ultimately, he hopes to team up with an ongoing Boston University brain study of retired and dead athletes.
He insisted that their study will not destroy professional fighting. "It may enhance the quality of the sport, keeping in only the fighters of the highest quality," Bernick said.
"We know fighting is not good for your health. We're now just trying to use the technology available to help protect people from a lifetime of dementia, depression or some other chronic residual" effect.