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Arch Clin Neuropsychol. 2014 Feb;29(1):54-9. doi: 10.1093/arclin/act079. Epub 2013 Nov 4.

The protective effect of education on cognition in professional fighters.

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Lou Ruvo Center for Brain Health, Cleveland Clinic, Cleveland, OH, USA.


Education has a protective effect against cognitive deficits following various forms of brain insult. Professional fighting (boxing and mixed martial arts) provides a model for assessing the impact of cumulative brain injuries on cognition and brain health. In the current cross-sectional observational study, we explore whether education would be protective against cognitive loss in fighters. We tested 141 professional fighters using a computerized neurocognitive battery, in addition to structural MRI. We used automated segmentation software to compute the volumes of various brain structures. We found fighters with high school education or less to show more associations between fight exposure and cognitive test scores. The relationship between brain structure volume and exposure did not differ based on education. These results are interpreted as putatively showing a protective effect of education on functional integrity in fighters, although longitudinal data and a larger sample size are required to further understand this relationship.


Boxing; Chronic traumatic encephalopathy; Hippocampus; Mixed martial arts; Thalamus

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