Battling for the Brain

At the Ruvo Center, scientists are leveraging Las Vegas’ fight-capital status for a groundbreaking study

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By day, 25-year-old Nils Widlund is a presumably mild-mannered employee in the corporate sales support division of Nordea Bank in Stockholm. He crunches numbers on a computer, moves money around and wears nice clothes to work. Nights, weekends and on extended leave, he’s “Honeybadger” Widlund, the professional kickboxer who, just like the ferocious carnivore made infamous by the viral video, is “pretty badass and runs all over the place.”

“I’m really quick,” Widlund says. “I move around a lot. That’s from my kung-fu training. Many of the other fighters aren’t used to that.”

As a banker, Widlund is generally able to avoid getting punched in the face. As a kickboxer, head trauma comes with the job; he’s been hit hard enough to be stunned three or four times in his 70-15-0 career, which is what brought him to the Cleveland Clinic Lou Ruvo Center for Brain Health one recent Thursday. He’s in town for a fight at the Hard Rock hotel-casino on this mid-May weekend, and is also taking part of a long-term $1.5 million study to determine just how long fighters can go on getting hit in the head before bad things like memory loss and slurred speech start to occur. These are things a banker would want to avoid, if possible, and at this point Widlund has no plans to quit his day job. “I want to see how far I can take this,” he says, “but it is getting harder fighting against people who are training all the time.”

Widlund is one of a hoped-for 600 boxers, muay Thai and MMA fighters who will come to Ruvo annually for four years to take a battery of neurological tests and an MRI brain scan to track deterioration in brain function caused by repeated blows to the head. The idea, says study principal investigator Dr. Charles Bernick, is to detect small changes in the brain before they trigger big problems.

“What we are trying to see is the relationship between the amount of exposure to head trauma, which in this case is the number of fights these fighters have, and the structure of the brain and how people perform on the cognitive tests,” Bernick says.

The study began a year ago with about 170 fighters. Bernick divided the fighters into three groups: those who have fought less than six years, those who have six to 12 years in the ring, and those who have more than 12. It’s early yet, but findings indicate that the longer a person fights, and thus the more times the fighter gets hit in the head, the smaller the brain becomes. Decreased brain volume is associated with diseases such as Parkinson’s, Alzheimer’s and chronic traumatic encephalopathy, the symptoms of which include depression, aggression and dementia.

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Bernick wants to know if the deterioration attributed to repeated head trauma accumulates slowly and steadily, or if it accrues undetected until fighters suddenly drop off a cognitive cliff. So far, the data point to the latter, meaning fighters might think they’re fine right until they’re suddenly not. At that point, there’s no treatment to reverse the damage.

“If we are going to make any impact protecting athletes, we need to start monitoring earlier. We can’t wait until they start showing symptoms because by that time they have accumulated a lot of damage.”

Knowing how brain damage progresses could lead to new guidelines for licensing bodies such as the Nevada Athletic Commission. Older fighters might be required to be tested more thoroughly and often, for example, or the number of fights allowed in a year might be restricted. The brain can heal itself, given enough time between injuries, Bernick says. But as it stands, regulators don’t have a lot to go on when deciding if someone should be granted a license to fight.

“Right now, it is just arbitrary,” he says. “They factor in the person’s record, how they have done in the last few fights how much they fought before. There is nothing objective about it.”

Fighters make an almost perfect study group. They come from all races and both sexes, they aren’t all hulking bruisers like football players, some are educated while others barely graduated high school, and they get smacked in the head a lot. Las Vegas, being the boxing capital of the world and all, offers unparalleled access to this group, perhaps one reason why no one else has done something similar. “No one else is really following people over time, having the diversity of measures we have and having the numbers we have,” Bernick says. “By having things done at one facility you have a little more quality control, a more reliable result. That could only happen in Las Vegas.”

Widlund, according to his test results, is no worse for wear so far. He scored in the 70th percentile in verbal memory, in the 50th percentile in mental-processing speed, the 82nd percentile in psychomotor speed and the 47th percentile in reaction time. He’s still agile, fast and badass, like a honeybadger, though he’s convinced he can do better next year. He’s an athlete, after all.

“I’m really slow,” he laughs, looking over his results. “It must be all the punches in the head.”

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