Long-Term Cognitive Decline in MMA Fighters

The medical question

Do fighters who spar and compete lose cognitive function faster than people who train without head contact?

The Fight Medicine Research Institute uses this evidence to frame questions about sparring exposure, cognitive testing over time and what routine monitoring of fighters could detect. The study’s two small groups, which already differed at the start, and its reliance on test scores alone determine which questions it can inform.

Summary

In a two-year study, 26 MMA fighters who sparred and competed scored worse on tests of executive function than 26 recreational practitioners, and the authors report that their scores declined more over time.

What the work reports

• Two groups of MMA practitioners took neuropsychological tests of processing speed, inhibitory control, cognitive flexibility and working memory at baseline, after one year and after two years. The competitive group sparred with head strikes at least twice a week and competed; the recreational group trained without sparring or competition. Head strikes in sparring were counted from video recordings and athletes’ own reports.
• The competitive group received a mean of 15.0 blows to the head per session; the recreational group received 2.4, which the article describes as accidental. The competitive group already scored worse on most measures at baseline. In processing-speed time, the difference between the groups was 1.7 seconds at baseline, 4.6 seconds at one year and 14.6 seconds at two years.
• The authors report a significant interaction between time and group on every measure, and at two years the competitive group scored significantly worse than the recreational group on all of them. They conclude that MMA athletes exposed to frequent sparring show progressive impairment in executive functions, and they call for routine neuropsychological monitoring.

Limits to keep in mind

• Observational: the groups were not assigned at random and differed at baseline in age, body mass, training sessions per week and most test scores. The study shows an association and cannot show that head strikes caused the differences.
• Small: 26 people in each group, from two training centers. Only people who completed every stage of the protocol were included.
• The outcomes were scores on two neuropsychological tests. The study did not include brain imaging.
• The limitations the authors list are the scarcity of comparable long-term studies and the lack of a standard set of cognitive tests for combat sports.

Source issues recorded

• The inclusion criteria require at least five years of MMA practice. Table 2 of the article reports a mean practice time of 47.8 months in the competitive group and 46.9 months in the recreational group.
• The abstract presents several figures as declines in the competitive group after 1 year and 2 years, for example 4.6 seconds and 14.6 seconds for processing speed. In the Results section the same figures are the differences between the two groups at those time points, which is how this record reports them.
• The abstract and the Results section print a confidence interval of 11.6 to 11.4 around a between-group difference of 10.0 in inhibitory control errors at 2 years. The interval does not contain the estimate.
• The article prints one author’s name as Diego Ignácio Vanezuela Pérez, while the correspondence email address in the same article spells the surname Valenzuela. This record gives the name as printed.

Publication status and notices

Published in International Journal of Environmental Research and Public Health, a peer-reviewed journal. Original research article in International Journal of Environmental Research and Public Health.

Form of this work: Version of record. The version of record is the final article as issued by its publisher.

No correction or retraction notice was found in Crossref or Europe PMC when this record was checked.

Fight Medicine Research Institute contribution

Fight Medicine Research Institute selected and catalogued this study, prepared an original research summary, verified its bibliographic details, and maintains the associated citation record.

PDF files

Article details

Relationship

External research catalogued by the Fight Medicine Research Institute. The original authors, journal and DOI are unchanged.

Published online

26 June 2025

Repository date

26 June 2025 (Europe PMC first-publication date)

Date used here

26 June 2025 (Crossref publisher deposit, online publication date)

Rights

CC BY 4.0. Open access under a Creative Commons Attribution licence (CC BY 4.0), as recorded by Europe PMC and the licence link in the source record. The summary on this page is Fight Medicine Research Institute’s own wording. No text or figure from the article is reproduced here. Licence terms.

Source check

12 November 2026, against PubMed Central full text, Crossref and Europe PMC. Checked under the direction of Casey C. Sears, Founder. An LLM was utilized as a research tool with direct human oversight.

Appraisal

The check covered bibliographic details, links, licence and notices. It is not a formal critical appraisal of the full paper.

Clinical review

None. This record is a research summary, not clinical education.

Funding and conflicts

The article states that the research was supported by the Vicerrectoría de Investigación, Desarrollo e Innovación, USACH, and by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), and that the authors declare no conflicts of interest.

Catalog

FH-049, added 12 November 2026

Cite the original work

These files cite the work by its own authors, journal and DOI. Fight Medicine Research Institute appears only in a note, as curator of this catalog page.

Michele Andrade de Brito, José Raimundo Fernandes, Keveenrick Ferreira Costa, Clóvis Albuquerque Maurício, Aleksandro Ferreira Gonçalves, Otávio de Toledo Nóbrega, et al.. Long-Term Cognitive Decline in MMA Fighters: A Two-Year Cohort Study on Executive Function Impairments Due to Repetitive Head Strikes. International Journal of Environmental Research and Public Health. 2025;22(7):1004. https://doi.org/10.3390/ijerph22071004

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Related on this website

• Research program: Chronic traumatic encephalopathy (CTE)
• Research priority: Repetitive head impacts and CTE
• Fighter Health: Repetitive head impacts, brain imaging, CTE pathology and TES research