Skip to main content
PMC home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1990 May;53(5):373–378. doi: 10.1136/jnnp.53.5.373

The occult aftermath of boxing.

G W Roberts 1, D Allsop 1, C Bruton 1
PMCID: PMC488051  PMID: 2191084

Abstract

The repeated head trauma experienced by boxers can lead to the development of dementia pugilistica (DP)--punch drunk syndrome. The neuropathology of DP in a classic report by Corsellis et al describes the presence of numerous neurofibrillary tangles in the absence of plaques, in contrast to the profusion of tangles and plaques seen in Alzheimer's disease (AD). The DP cases used in that report were re-investigated with immunocytochemical methods and an antibody raised to the beta-protein present in AD plaques. We found that all DP cases with substantial tangle formation showed evidence of extensive beta-protein immunoreactive deposits (plaques). These diffuse "plaques" were not visible with Congo-red or standard silver stains. The degree of beta-protein deposition was comparable to that seen in AD. Our data indicate that the present neuropathological description of DP (tangles but no plaques) should be altered to acknowledge the presence of substantial beta-protein deposition (plaques). The molecular markers present in the plaques and tangles of DP are the same as those in AD. Similarities in clinical symptoms, distribution of pathology and neurochemical deficits also exist. Epidemiological studies have shown that head injury is a risk factor in AD. It is probable that DP and AD share common pathogenic mechanisms leading to tangle and plaque formation.

Full text

PDF
378

Images in this article

375Image
on p.375
376Image
on p.376
377Image
on p.377

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams C. W., Bruton C. J. The cerebral vasculature in dementia pugilistica. J Neurol Neurosurg Psychiatry. 1989 May;52(5):600–604. doi: 10.1136/jnnp.52.5.600. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Allsop D., Landon M., Kidd M., Lowe J. S., Reynolds G. P., Gardner A. Monoclonal antibodies raised against a subsequence of senile plaque core protein react with plaque cores, plaque periphery and cerebrovascular amyloid in Alzheimer's disease. Neurosci Lett. 1986 Jul 24;68(2):252–256. doi: 10.1016/0304-3940(86)90152-7. [DOI] [PubMed] [Google Scholar]
  3. COURVILLE C. B. Punch drunk. Its pathogenesis and pathology on the basis of a verified case. Bull Los Angel Neuro Soc. 1962 Dec;27:160–168. [PubMed] [Google Scholar]
  4. Chandra V., Bharucha N. E., Schoenberg B. S. Conditions associated with Alzheimer's disease at death: case-control study. Neurology. 1986 Feb;36(2):209–211. doi: 10.1212/wnl.36.2.209. [DOI] [PubMed] [Google Scholar]
  5. Corsellis J. A., Bruton C. J., Freeman-Browne D. The aftermath of boxing. Psychol Med. 1973 Aug;3(3):270–303. doi: 10.1017/s0033291700049588. [DOI] [PubMed] [Google Scholar]
  6. Flood D. G., Buell S. J., Defiore C. H., Horwitz G. J., Coleman P. D. Age-related dendritic growth in dentate gyrus of human brain is followed by regression in the 'oldest old'. Brain Res. 1985 Oct 21;345(2):366–368. doi: 10.1016/0006-8993(85)91018-2. [DOI] [PubMed] [Google Scholar]
  7. Flood D. G., Buell S. J., Horwitz G. J., Coleman P. D. Dendritic extent in human dentate gyrus granule cells in normal aging and senile dementia. Brain Res. 1987 Feb 3;402(2):205–216. doi: 10.1016/0006-8993(87)90027-8. [DOI] [PubMed] [Google Scholar]
  8. French L. R., Schuman L. M., Mortimer J. A., Hutton J. T., Boatman R. A., Christians B. A case-control study of dementia of the Alzheimer type. Am J Epidemiol. 1985 Mar;121(3):414–421. doi: 10.1093/oxfordjournals.aje.a114013. [DOI] [PubMed] [Google Scholar]
  9. Glenner G. G., Wong C. W. Alzheimer's disease: initial report of the purification and characterization of a novel cerebrovascular amyloid protein. Biochem Biophys Res Commun. 1984 May 16;120(3):885–890. doi: 10.1016/s0006-291x(84)80190-4. [DOI] [PubMed] [Google Scholar]
  10. Guterman A., Smith R. W. Neurological sequelae of boxing. Sports Med. 1987 May-Jun;4(3):194–210. doi: 10.2165/00007256-198704030-00004. [DOI] [PubMed] [Google Scholar]
  11. Ihara Y. Massive somatodendritic sprouting of cortical neurons in Alzheimer's disease. Brain Res. 1988 Aug 30;459(1):138–144. doi: 10.1016/0006-8993(88)90293-4. [DOI] [PubMed] [Google Scholar]
  12. Ikeda S., Allsop D., Glenner G. G. Morphology and distribution of plaque and related deposits in the brains of Alzheimer's disease and control cases. An immunohistochemical study using amyloid beta-protein antibody. Lab Invest. 1989 Jan;60(1):113–122. [PubMed] [Google Scholar]
  13. Ikeda S., Yanagisawa N., Allsop D., Glenner G. G. Evidence of amyloid beta-protein immunoreactive early plaque lesions in Down's syndrome brains. Lab Invest. 1989 Jul;61(1):133–137. [PubMed] [Google Scholar]
  14. Kang J., Lemaire H. G., Unterbeck A., Salbaum J. M., Masters C. L., Grzeschik K. H., Multhaup G., Beyreuther K., Müller-Hill B. The precursor of Alzheimer's disease amyloid A4 protein resembles a cell-surface receptor. Nature. 1987 Feb 19;325(6106):733–736. doi: 10.1038/325733a0. [DOI] [PubMed] [Google Scholar]
  15. Kitamoto T., Ogomori K., Tateishi J., Prusiner S. B. Formic acid pretreatment enhances immunostaining of cerebral and systemic amyloids. Lab Invest. 1987 Aug;57(2):230–236. [PubMed] [Google Scholar]
  16. Lewin W., Marshall T. F., Roberts A. H. Long-term outcome after severe head injury. Br Med J. 1979 Dec 15;2(6204):1533–1538. doi: 10.1136/bmj.2.6204.1533. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Masters C. L., Simms G., Weinman N. A., Multhaup G., McDonald B. L., Beyreuther K. Amyloid plaque core protein in Alzheimer disease and Down syndrome. Proc Natl Acad Sci U S A. 1985 Jun;82(12):4245–4249. doi: 10.1073/pnas.82.12.4245. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Perry R. H. Recent advances in neuropathology. Br Med Bull. 1986 Jan;42(1):34–41. doi: 10.1093/oxfordjournals.bmb.a072096. [DOI] [PubMed] [Google Scholar]
  19. Roberts G. W. Immunocytochemistry of neurofibrillary tangles in dementia pugilistica and Alzheimer's disease: evidence for common genesis. Lancet. 1988 Dec 24;2(8626-8627):1456–1458. doi: 10.1016/s0140-6736(88)90934-8. [DOI] [PubMed] [Google Scholar]
  20. Roberts G. W., Lofthouse R., Allsop D., Landon M., Kidd M., Prusiner S. B., Crow T. J. CNS amyloid proteins in neurodegenerative diseases. Neurology. 1988 Oct;38(10):1534–1540. doi: 10.1212/wnl.38.10.1534. [DOI] [PubMed] [Google Scholar]
  21. Rodgers-Johnson P., Garruto R. M., Yanagihara R., Chen K. M., Gajdusek D. C., Gibbs C. J., Jr Amyotrophic lateral sclerosis and parkinsonism-dementia on Guam: a 30-year evaluation of clinical and neuropathologic trends. Neurology. 1986 Jan;36(1):7–13. doi: 10.1212/wnl.36.1.7. [DOI] [PubMed] [Google Scholar]
  22. Rudelli R., Strom J. O., Welch P. T., Ambler M. W. Posttraumatic premature Alzheimer's disease. Neuropathologic findings and pathogenetic considerations. Arch Neurol. 1982 Sep;39(9):570–575. doi: 10.1001/archneur.1982.00510210040009. [DOI] [PubMed] [Google Scholar]
  23. Saija A., Hayes R. L., Lyeth B. G., Dixon C. E., Yamamoto T., Robinson S. E. The effect of concussive head injury on central cholinergic neurons. Brain Res. 1988 Jun 14;452(1-2):303–311. doi: 10.1016/0006-8993(88)90034-0. [DOI] [PubMed] [Google Scholar]
  24. Stiller J. W., Weinberger D. R. Boxing and chronic brain damage. Psychiatr Clin North Am. 1985 Jun;8(2):339–356. [PubMed] [Google Scholar]
  25. Walker A. E., Blumer D. The fate of World War II veterans with posttraumatic seizures. Arch Neurol. 1989 Jan;46(1):23–26. doi: 10.1001/archneur.1989.00520370025013. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES