December 24, 1997

APOE ∈4 Allele and Chronic Traumatic Brain Injury-Reply

Author Affiliations

University of California, Los Angeles
New York Hospital—Cornell University Medical College New York, NY

JAMA. 1997;278(24):2143. doi:10.1001/jama.1997.03550240033026

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We agree with Dr Gross that a sizable percentage of the professional boxers in our study exhibited abnormalities on neurologic examination. However, our cohort was not randomly selected, and our data cannot be used to accurately estimate the overall prevalence of neurologic impairments in professional boxers. Furthermore, not all abnormal neurologic findings in boxers are indicative of "significant brain injury." Signs and symptoms of chronic traumatic brain injury were mild (12/30) or absent (11/30) in the majority of the boxers we examined. To avoid hyperbole, we recommend that the term significant brain injury be reserved for those instances in which there is actual loss of functional status and/or overt parenchymal brain damage, neither of which was the case with most of the boxers we studied.

The purpose of our study was to determine if some boxers are genetically predisposed to chronic neurologic impairments. In our article, we elected not to