Boxing, Parkinson ’s disease

Medical Files By Rafael Castillo M.D. Philippine Daily Inquirer

The ordinary man on the street does not know much of Parkinsons disease or PD. An elderly patient who was recently diagnosed to have PD thought it was a disease related to boxing.

Muhammad Ali has somehow become the face of PD. Known for his agility and nimbleness in his youth as a heavyweight boxing champion, he is now seen in news features and documentaries with full-blown features of PDresting hand tremors as if hes rolling a pill or marble with his fingers, stiffness of the limbs, decrease in facial expression, shuffling or small steps when walking.

A related concern was raised for Manny Pacquiao after his knockout loss to Juan Marquez, hence the unsolicited advice that he hang up his gloves for good before its too late.

Although PD and Parkinsonism are sometimes interchanged, theyre not exactly the same and some brain experts explain that its actually Parkinsonism that is linked more to boxing. Parkinsonism is actually the general condition and PD is just a type of it.

Repetitive head trauma

Permanent injury to the brain cells results from repetitive head trauma. The brain cells or neurons in an area of the brain called substantia nigra deteriorate; hence unable to produce a vital brain chemical known as dopamine. Dopamine serves as a chemical messenger responsible for coordinating smooth and balanced muscle movement. When theres dopamine deficiency, one loses the ability to control body movements.

In boxing, the head is hit at a high speed and with great force, causing shear movement between different brain tissues, resulting in small bleeding areas called microhemorrhages. This could not be detected with the old CT scans but with modern brain imaging techniques, theyre able to identify these.

Some correlate the risk of developing Parkinsonism in a boxer with the number of boxing matches and the duration of his boxing career. Its the additive effect of all the fights that hes been through, and all the head punches that he has endured through the years. So if Manny Pacquiao were to ask me if he should quit boxing at this point, Id probably tell him that another fight or two wont likely make a difference anymore because what matters is the cumulative effect. But lining up boxing matches indefinitely til hes able to throw a punch would be unwise and foolhardy.

Although linked to boxing, PD or Parkinsonism could develop as a degenerative disease in anyone. Being a degenerative disease, its more common in the elderly. Aside from repetitive head trauma, it can also be caused by prolonged intake of some drugs like major tranquilizers, anti-psychotic drugs and some medicines for nausea and vomiting. Street drugs like heroin derivatives, blood-vessel disorders leading to repeated strokes and infections like HIV-AIDS and encephalitis have also been reported to cause PD-like signs and symptoms.

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Boxing, Parkinson ’s disease