MUHAMMAD ALI’S ILLNESS:

Chronic traumatic encephalopathy (CTE), or Parkinson disease?

Many, including myself, doubted the nineteen-eighties diagnosis of Muhammad Ali’s disabling illness as Parkinson’s disease. Instead, I assumed he must have had Chronic Traumatic Encephalopathy (CTE) as a result of many blows to his head during his stellar boxing career. CTE in those days was known as ‘dementia pugilistica’ or ‘punch-drunk syndrome’. This tragic condition has now been found to be more common than previously thought in association with several contact sports.
A recent article* by Okun, Mayberg and DeLong has forced me to revise my opinion. They present detailed and convincing information about Ali’s presentation with “young-onset tremor-dominant idiopathic Parkinson’s disease. The clinical pattern of his symptoms revealed his disease was prolonged, progressive, bilateral but asymmetric, dopa responsive, and was accompanied by serial and classic FDG and DOPA PET imaging” among a deal of other evidence.
Many of us remember the poignant moment when Ali, despite his considerable disability at the time, lit the Atlanta Olympic torch in 1996.
The truth about this great man is important but it should not detract from the brutal truth that repeated brain injuries in boxing and elsewhere can and do cause CTE.
And may I mention a Glasgow study** about which I wrote a post in August last year. This study drew attention to the high rate of ‘neurodegenerative diseases’ in professional ‘soccer’ footballers who frequently headed the ball. These neurodegenerative diseases included Parkinson’s disease.
* doi:10.1001/jamaneurol.2022.3584
** doi:10.1001/jamaneurol.2021.2403