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January 21, 2018

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Fighters embrace Ruvo Center project that tackles head trauma

Researchers studying brain scans to better understand cognitive diseases


Steve Marcus

Trish Lake, an MRI technician, operates an MRI machine from a control room as an MMA fighter gets a brain scan at the Cleveland Clinic Lou Ruvo Center for Brain Health Tuesday, February 7, 2012. The fighter was getting a scan as part of the Professional Fighters Clinical Research Study. (Photo has been digitally altered to remove personal patient information)

Cleveland Clinic Lou Ruvo Center for Brain Health

A view looking upward at the events center at the Cleveland Clinic Lou Ruvo Center for Brain Health Monday, February 6, 2012. Launch slideshow »

In the same city where some of the most significant bouts of the past 50 years have taken place, a new fight is beginning that could change the future of contact sports.

The Cleveland Clinic Lou Ruvo Center for Brain Health has launched a study aimed at reducing traumatic head injuries and brain diseases sometimes suffered by fighters. The research centers on detecting changes in fighters’ brains over a four-year span through top-of-the-line MRI technology and cognitive testing.

The hope is that the results could enable doctors to identify and treat combatants at a heightened risk for such diseases as pugilistic dementia, Alzheimer’s disease and Parkinson’s disease.

“For fighters, there’s a definite and immediate benefit,” said Keith Kizer, executive director of the Nevada State Athletic Commission. “But this is something that goes beyond the sport of boxing and beyond sports as a whole. It’s a major coup for our community.”

Researchers are 10 months into the study, which gives boxers and mixed martial artists free access to tests they need to receive a fighting license and asks them to return annually. Information obtained by clinical staff has already confirmed several long-suspected truths.

Athletes with more fights experience a loss of fibers in the brain, which translates into decreased cognitive abilities. Brain scans also revealed veteran fighters endure a decrease in emotional self-control, becoming increasingly inclined to act impulsively.

But it’s only a start. Dr. Charles Bernick, a Ruvo Center neurologist serving as the chief researcher on the project, envisions a day when he’s able to give fighters more comprehensive reports on their brain health.

“It’s our responsibility to inform fighters where they stand and help their judgment,” Bernick said. “At this point, we don’t have anything to tell people. That’s got to change, particularly in this day and age with this technology.”

Click to enlarge photo

Research Coordinator Triny Cooper, left, talks with neurologist Charles Bernick, principal investigator of the Professional Fighters Clinical Research Study, at the Cleveland Clinic Lou Ruvo Center for Brain Health Friday, February 10, 2012.

The Ruvo Center’s goal is to have 600 fighters signed up within four years. They’re ahead of schedule, on pace for about 170 in the first year.

Overwhelming support from the Nevada State Athletic Commission and perhaps the three most powerful fight promoters in the world — Top Rank Boxing, Golden Boy Promotions and the UFC — has gone a long way in attracting participants.

“Whenever a kid is signing on with us, particularly if they’re fighting here in Las Vegas or other West Coast locations, we’re going to enlist them in the program,” Top Rank CEO Bob Arum said. “Our matchmakers have a lot of influence on these kids. We’re 100 percent on board.”

Kizer said the commission suggested the study to every fighter seeking a license in Nevada. The commission’s office maintains a stock of pamphlets and posters for information.

It’s also taken a grass-roots approach to spread the word. Researchers have visited gyms across the Las Vegas Valley to educate fighters on their causes and dispel any preconceived notions that they were looking to ruin the sport.

“A lot of fighters didn’t have any idea what to think about it,” said Triny Cooper, a research assistant who was assigned to visit gyms. “When we started explaining it to them, they’d understand. When we went to Xtreme Couture (mixed martial arts training facility) and talked to fighters, they were really excited.”

The MRI administered at the Ruvo Center measures connectivity, scarring and blood flow through the brain.

The scan is more extensive than most, according to Bernick, and is far more affordable. Kizer said the cheapest MRI available to fighters before the Cleveland Clinic’s free service was around $450 after a major discount.

“For a four-round fighter, that might be a whole fight for free,” Kizer said. “That’s a direct monetary benefit right off the bat.”

Anthony Hamilton, a heavyweight MMA fighter who went through the study last week, originally was attracted to the Ruvo Center because it was free and his manager suggested it.

But Hamilton, who is 6-0 as a professional and hopes to break into the Ultimate Fighting Championship this year, became more interested in the study as he uncovered more details.

“I’ve been watching the sport for a long time, and I’m familiar with head injuries,” Hamilton said. “I don’t want anything like that to happen to me. I want to be able to play with my kids when I’m older. I take pride in my health. I don’t want to be disabled down the road.”

Bernick and Cooper said Hamilton’s attitude was common among fighters. They realize there’s life after their time in the ring and want to protect it.

“The kids we’re working with are great,” Arum said. “They aren’t stupid. They realize that they are getting free monitoring that’s going to protect them from disastrous circumstances.”

Among Top Rank’s fighters who have joined the program are brothers Diego and Jesse Magdaleno, who are a combined 24-0. Because the Magdalenos live and train locally, they should find no problem coming back every year for their checkup.

Click to enlarge photo

Trish Lake, an MRI technician, prepares MMA fighter Anthony Hamilton for a brain scan at the Cleveland Clinic Lou Ruvo Center for Brain Health Tuesday, February 7, 2012. Hamilton was getting a scan as part of the Professional Fighters Clinical Research Study.

It’s seemingly more difficult for someone like Hamilton, who trains in Albuquerque, N.M. But Hamilton said the distance wouldn’t stop him from coming back.

He visits Las Vegas a few times a year, anyway.

“It’s the fight capital of the world,” Bernick said. “If this study was going to be successful, this is where we needed it. There’s nowhere else in the world where this could work better.”

Bernick, however, believes the work can help several other parts of the world. Ultimately, the study could go beyond fighting.

It’s already crossed over with other sports. The clinic is adapting a mouthpiece that measures the impact of every hit to the head for fighting. The technology was originally designed for football, with an external battery placed in the helmet.

Clinic researchers also have developed an iPad application that records the balance of a fighter during a sparring session or bout. It should help enhance research into concussions for other sports.

“The work we’re doing now sets the stage to go after larger funding and expand the project,” Bernick said. “What we want to do is look at other things with this — blood, genetics and anything that can help us understand why some people are prone to get these injuries and others are not.”

The prospect of an expansion is one of the most exciting aspects of the study to Kizer.

“You may not be a fight fan, but that doesn’t mean you can’t benefit from this,” he said. “Some of this stuff could help any head injury. It could help someone who gets in a car wreck one day. In addition, it might even lead to dementia or Parkinson’s advances.”

Starting with fighters was natural. Unlike in other sports, it’s relatively easy to quantify when fighters endure head trauma and to what extent. Researchers can compare brain scans with such fight statistics as knockouts, knockdowns and shots landed.

The study gives the brains of boxers and mixed martial artists the attention they’ve long deserved.

“If we can detect changes in the brain early, before significant symptoms and intervene, the hope is we can prevent long-term problems,” Bernick said. “That’s really what it comes down to. We’re not trying to get rid of a sport. We’re trying to identify people who may be starting to have brain damage.”

Case Keefer can be reached at 948-2790 or [email protected]. Follow Case on Twitter at

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