Cognitive Assessment in Grappling Athletes Following Choke versus Nonchoke Submissions

Participation in Brazilian jiu-jitsu and mixed martial arts has increased over the last three decades. These sports feature submission attacks, including strangles. These strangles, termed "chokes" in this context, primarily limit blood flow to the brain via compression of neck vasculature. There has been discussion in literature of the possibility of measurable cognitive effects following transient choking episodes. The present study used the King-Devick test (KDT) platform, a tablet-based reaction time and accuracy task designed to measure participants' number recognition, cognition, and verbal expression. This task requires functional vision, saccadic eye movements, comprehension, and expression.

Volunteer participants were screened for exclusion (prior brain injury) criteria and survey information before testing. Athletes were tested with the KDT immediately before a Brazilian jiu-jitsu training session, again immediately after succumbing to either a choke ("Choke" arm) or nonchoke ("Non-Choke" arm) submission while sparring, and again after a 10-min rest period following the postsubmission test. Analysis was done on test failures, total test times, and individual difference scores between baseline and subsequent testing.

Sixty-two (32 Choke, 30 Non-Choke) participants were analyzed. There was no significant difference between Choke and Non-Choke in test failures ( χ2 (1,62) = 1.25, P = 0.263), total times ( t (60) = 0.62, P = 0.540; 95% CI, -3.44 to 6.51), and individual difference scores ( t (60) = 0.29, P = 0.776; 95% CI, -2.41 to 3.21).

There were no significant differences between study arms in any of the three analyzed measures. This suggests that cognitive functioning, as measured by the KDT, is not affected by transient choking episodes.