It’s a time-honored and somewhat romantic tale: The young fighter who rises from poverty to make a name for themselves.
But reality might take some shine off such stories, a new study says.
Participants in combat sports like boxing or mixed martial arts who grew up in poor neighborhoods might be more likely to suffer brain changes associated with degenerative brain disease, compared to fighters who come from affluent backgrounds, researchers report.
Specifically, they had smaller brain volumes in regions important for movement and memory, including the thalamus, cerebellum and hippocampus, according to findings published Aug. 13 in Neurology Open Access.
“It is well-known that high-impact sports such as professional fighting are at a greater risk of repetitive head injuries,” lead researcher Brooke Conway Kleven, a postdoctoral scholar at the University of Nevada, Las Vegas, said in a news release. “We found that socioeconomic status may influence how the brain responds to these repetitive impacts.”
For the study, researchers performed MRI brain scans on 100 professional combat sport athletes. All participants had a minimum of 10 professional fights and were currently active or recently retired from competition.
During five years of follow-up, 20% of the fighters developed thinking and memory problems.
Analysis revealed that athletes from impoverished neighborhoods had a thinner outer layer in certain brain areas, which can be a sign of early brain degeneration.
They also had experienced greater shrinking in several key brain regions, including the thalamus and hippocampus, compared to fighters from well-off neighborhoods.
This link remained even after accounting for factors like the fighters’ race, ethnicity, income and overall number of fights.
“Stressors related to income, employment, education and housing quality may compound the risks of repeated head trauma,” Conway Kleven concluded. “Athletes from marginalized or under-resourced communities may face a heavier burden when it comes to brain health.”
However, researchers noted that because this was an observational study, it could not prove a direct cause-and-effect link between a fighter’s economic background and their risk for brain disease, only an association.
Further study is needed to validate the results and explore why upbringing might play a role in risk of brain damage, researchers said.
“The findings support a broader understanding of brain health — one that considers not just training or fight history, but also the social and economic context in which people live,” Conway Kleven said. “Our study suggests that where someone grows up matters. Recognizing stressors can help inform more equitable approaches to protecting long-term brain health.”
More information
The National Institutes of Health has more on traumatic brain injury.
SOURCE: American Academy of Neurology, news release, Aug. 13, 2025