Sport-related neurocognitive performance and repetitive head-impact exposure in elite Muay Thai athletes: a matched athletic-control study

Information from the abstract

Background Repetitive head impacts (RHIs) are increasingly studied in combat sports, but evidence regarding neurocognitive performance in elite Muay Thai athletes remains limited. This study compared neurocognitive performance between elite Muay Thai athletes and sprint-athlete controls and explored associations between cumulative RHI exposure and neurocognitive outcomes within the Muay Thai cohort. Methods This cross-sectional athletic-control study included 44 elite male Muay Thai athletes and 42 male sprint-athlete controls aged 15–25 years. Controls were selected for group-level comparability in age, education, training years, and competitive level. Neurocognitive performance was assessed using the Rey Auditory Verbal Learning Test, Go/No-Go task, Stroop Colour–Word Test, Trail Making Test Parts A and B, Digit Span, and Symbol Digit Modalities Test. Task-specific outcomes and standardised domain-level indicators were examined using independent-group comparisons and covariate-adjusted ANCOVA models. Exploratory Spearman correlations examined associations between a cumulative RHI exposure score derived from self-reported proxy indicators and neurocognitive outcomes within the Muay Thai cohort. Results No significant between-group differences were observed in task-specific or domain-level neurocognitive outcomes (all p > 0.05), and adjusted ANCOVA models showed no significant group effects across the four domain-level indicators. Within the Muay Thai cohort, cumulative RHI exposure was associated with the executive-function composite ( ρ = −0.32, p = 0.036), TMT-A completion time ( ρ = −0.44, p = 0.003), TMT-B completion time ( ρ = −0.41, p = 0.006), and Stroop interference time ( ρ = 0.56, p < 0.001). No other associations were significant. Conclusions Elite Muay Thai athletes did not demonstrate significant group-level neurocognitive differences compared with sprint-athlete controls. Exploratory associations between cumulative RHI exposure and selected neurocognitive outcomes were observed within the Muay Thai cohort but were not consistent across the broader neurocognitive battery. These findings should not be interpreted as evidence of generalised neurocognitive impairment. Given the cross-sectional design, retrospective proxy-based exposure assessment, and exploratory correlations unadjusted for multiple comparisons, the findings are hypothesis-generating rather than causal or confirmatory. Prospective longitudinal studies incorporating objective head-impact monitoring and repeated neurocognitive assessment are needed.

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Related topics: Traumatic Brain Injury Research · Martial Arts: Techniques, Psychology, and Education · Sports injuries and prevention