Neuroanatomia

eISSN 1303-1775 • pISSN 1303-1783

Neuroanatomy (2010) 9: 5–7

Review Article

The neuroanatomical relationship of Dementia Pugilistica and Alzheimer’s Disease
Published online 17 October, 2010 © http://www.neuroanatomy.org

Pedro PINEDA Douglas J. GOULD

ABSTRACT Dementia Pugilistica is a neurodegenerative disorder commonly attributed to the sport of boxing. More commonly referred toas ‘punch drunk syndrome’, it is most often caused by repetitive trauma to the brain. Symptoms of Dementia Pugilistica include a wide-range of motor disturbances and cognitive difficulties. The most prevalent and identifiable pathological characteristic of Dementia Pugilistica is amyloid plaque deposition and subsequent neurofibrillary tangle formation, which are indistinguishable to those seen inAlzheimer’s disease. Although Dementia Pugilistica and Alzheimer’s disease do not share similar etiologies, there is considerable overlap in the developmental processes and progression and potentially treatment. © Neuroanatomy. 2010; 9: 5–7.

The Ohio State University, College of Medicine, Division of Anatomy, Columbus, OH, USA.

Douglas J. Gould, Ph.D. 279 Hamilton Hall 1645 Neil AvenueColumbus, OH 43210, USA. +1 614-292-7805 +1 614-292-7651 gould.97@osu.edu

Received 17 June 2009; accepted 11 October 2010

Key words [Dementia Pugilistica] [Alzheimer’s disease] [amyloid plaque] [neurofibrillary tangles] [punch drunk syndrome]

Dementia Pugilistica Dementia Pugilistica, more commonly known as ‘Punch Drunk Syndrome’, is a degenerative brain disorder resulting from head trauma.Dementia Pugilistica (DP) is typically associated with the sport of boxing; although symptoms of DP may appear immediately after a single traumatic brain injury, they are typically described following the cessation of exposure to chronic brain injury. Although DP has been described primarily in boxers, it may be caused in any manner in which the head is exposed to repetitive trauma [1]. Cases of DPin boxers show a positive correlation between the number of matches and the severity of symptoms; more bouts leads to more trauma, and results in more severe symptoms [2-4]. DP may be categorized as a late-onset disease with many boxers not exhibiting symptoms until years after retirement [2,5,6]. Symptoms of DP may include; gait ataxia, slurred speech, impaired hearing, tremors, disequilibrium,neurobehavioral disturbances, and progressive cognitive decline [2,5]. Further, most cases of DP present with early onset cognitive deficits [2]. Behavioral signs exhibited by patients include; premorbid personality traits, aggression, hypertension, suspiciousness, paranoia, childishness, hypersexuality, depression, and restlessness [1,2,5-8]. The progression of DP leads to more prominentbehavioral symptoms such as; difficulty with impulse control, irritability, inappropriateness, and explosive outbursts of aggression [2,5,6]. Studies also indicate that patients

with DP display difficulties with: memory, information processing, attention, concentration, sequencing abilities, judgment, reasoning, future planning, organization, and slowed finger tapping speed [2,5-7]. Boxers with DP canalso exhibit symptoms resembling other degenerative disorders, including: Parkinsonism, Dementia, Alzheimer’s disease, Wernicke-Korsakoff syndrome, and Kluver-Bucy syndrome [2,5-7]. Neuroimaging and post-mortem examination are used to provide anatomical and physiological evidence for potential causes of the clinical signs exhibited by patients diagnosed with DP. Neuropathological examination ofthe brain’s of DP patients have revealed neurofibrillary tangles, neuritic plaques, cerebral infarcts, fenestrated septum pellucidae, atrophic and gliotic mammillary bodies, pale substantia nigrae and locus ceruleae, thalamic gliosis, loss of Purkinje cells in the cerebellum, cerebral and cerebellar atrophy and lesions, and fornix degeneration and degradation [2,5-7,9,10]. Damage to the superior...