MMA Science Weekly: Volume 1 - This is your brain on MMA

A weekly update on the current state of MMA science.

Illustration by BE Art Director Chris Rini.

Regarding Spencer’s independent contractor agreement ending on April 30, 2017, unfortunately the new company is not going to renew the agreement. That decision is nothing personal regarding Spencer, the new company is simply trying to cut costs.

Roughly four years after receiving this e-mail from UFC’s chief legal officer, Spencer “The King” Fisher went on the record with MMA Fighting about the brain trauma he sustained during his fighting career and how it was affecting his life. As Dana White so accurately quipped, he’s not the first and he’s definitely not going to be the last. Damn straight.

According to Mr. White, however, despite cases like Fisher, MMA is safe compared to other head trauma-inducing sports. In one clip White tells a reporter, "That’s what’s so great about MMA, it’s not all about just punching in the head."

Fair point. There’s also elbowing in the head, kneeing in the head, kicking in the head, and cutting blood flow off to the head. But could White actually be correct on this one?

A 2016 study that compared the post-fight medical examinations of 1,181 MMA competitors and 550 boxers between 2000 and 2013 (that’s a big sample!) found that boxers were almost twice as likely to be separated from consciousness during competition. MMA News recently reported on the 2022 British Journal of Sports Medicine study that investigated traumatic encephalopathy syndrome (TES) in combat athletes.

TES is not CTE, but they’re both related to head trauma. MMA News misinterpreted the study’s findings and reported that: a shocking 72% of the fighters in the study came up as TES positive. That’s not accurate. Seventy-two total fighters were TES positive, not 72% of fighters. Bloody Elbow’s Trent Reinsmith accurately reported on these findings writing: the study found that 41 percent of the fighters were TES positive.

Lost in these headlines was the real story of the data, however, that MMA fighters were faring much better than their face-punching counterparts. In fact, of the MMA fighters that were tested, only 18% were TES positive compared to 55% of boxers. That’s a huge freaking difference. And the TES+ group had lower regional brain volumes and poorer scores on psychomotor tests.

Cleveland Clinic’s 10+ year study on brain damage in combat sports only strengthens the case that MMA fighters suffer less brain trauma than boxers. In 2021 the study’s principal investigator concluded that— compared to boxers—in most everything we look at, the MMA fighters do better. It should be noted that the Cleveland Clinic’s research is partially funded by the UFC. They are also a highly reputable medical institution. But in a recent follow-up study this group suggests that the negative effects of MMA-derived head trauma improve once someone stops fighting. And they’re right.

They did find clear evidence that not getting punched in the head for two years reduced inflammation and improved cognitive performance. It's better, right? You can hear UFC brass talking to some 16-year old’s parents right now: 'look, brain damage is way lower than boxing, and once you stop your brain heals right up. Come on, you got nothing to lose!'

But these findings are not as rosy as they appear at first glance. The researchers from Cleveland Clinic do not conclude that cognitive abilities return to pre-fight normal. In fact, they do not show how these scores compare to normal at all, only to people still getting punched in the head. They also do not conclude that improvement happens for everyone, or even for most people. They also acknowledge that they cannot rule out that simply less fatigue from not training or less stress can explain these cognitive improvements.

They also make it clear that continuing to fight makes things worse. With all of that said, Dana White is still right. MMA fighters do fare better than boxers, and it shouldn't really be up for debate at this point.

Not all brain trauma leads to TES or CTE. Many fighters experience trauma-induced changes to their cognitions that don’t meet the definition of a specific disease, and many don’t report their symptoms or slip through the cracks once they are out of the spotlight. A new study takes a different look at brain trauma by investigating the role that weight-class might play.