CNN
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Mike Tyson steps into the ring. His youthful appearance belies the strength he possesses.

It’s 1985 and the heavyweight is about to make his professional boxing debut. One minute and 47 seconds later, 18-year-old Tyson has already forced his opponent, Hector Mercedes, to retreat after a series of devastating blows to his body and head.

It was the start of a formidable in-ring career for Tyson, filled with the highest of highs and the lowest of lows. Now, 39 years later, “Iron Mike” is stepping back into the ring at the age of 58.

On Friday, Tyson will don his gloves again for a professional fight against 27-year-old YouTuber Jake Paul at AT&T Stadium, home of the Dallas Cowboys, more than 7,000 days since his last professional appearance.

His last professional fight ended in a loss to Kevin McBride more than 19 years ago, and his last exhibition fight was four years ago, when, coincidentally, Paul was fighting in only his second professional fight on the undercard of that same event.

The pair were initially scheduled to fight in July this year, although the fight was postponed when Tyson developed a stomach ulcer.

Competing at the highest level brings challenges as athletes age, with physical and mental fitness becoming more difficult to regain. But in a sport like boxing it also poses neurological challenges.

Since his entire professional life has revolved around a blow to the head, Tyson could be at greater risk of neurological damage when he steps back into the ring, according to Dr. Nitin K Sethi – Clinical Associate Professor of Neurology at Weill Cornell Medical High School.

In particular, boxing committees often categorize fighters as being at “high risk” of further injury if they fight over the age of 40.

“When you talk about fighters who are now over 40, you worry about two things,” Sethi, who also works as a ringside doctor, told CNN. “First of all, I’m concerned about the fighting in the ring itself because is that fighter, because of his or her age, more susceptible to serious traumatic brain injury while I’m in the ring?

“The second thing I’m concerned about is that this is a fighter who has many, many years of professional boxing under his belt. You worry about the chronic neurological injuries.”

CNN has reached out to Tyson to offer him the opportunity to comment on any health concerns he may have ahead of the fight against Paul.

As Sethi explains, boxing is “unique.” The concept of a sport where the aim is to hit the opponent – ​​mainly in the head – and cause a knockout means that boxing poses very specific health problems.

In his role as a ringside doctor, where he is used to evaluating the fitness of fighters in the ring, Sethi sees firsthand the frequency with which concussions occur in boxing. He says that if he steps in and stops a fight every time he sees a boxer exhibiting concussion-like symptoms, “there will be no more boxing at all.”

But the real danger of the sport doesn’t just come from the big, explosive knockouts that get fans on their feet. Long-term consequences can arise from the repeated blows that the main boxers receive during a fight and during the training process.

“When you have someone whose profession involves frequent exposure to head impacts — whether in training, sparring or in the ring — these head injuries and head impact exposures add up,” Sethi said. “That’s why when you’re talking about chronic neurological injuries in boxing, I personally feel like that’s the bigger problem.”

However, unlike the knockouts and obvious signs of concussions, the cumulative effect of these prolonged blows only occurs after the “bright lights aren’t shining on them, so no one cares,” Sethi explained.

Boxers can develop symptoms or conditions such as an inability to sleep, chronic dizziness, chronic post-concussion symptoms, chronic Parkinson’s symptoms and chronic traumatic encephalopathy (CTE) long after they retire.

But Sethi believes equal attention should be paid to the impact that repeated blows to the head can have on a boxer’s brain during his career, as well as learning how to protect him from long-term neurological problems.

And the susceptibility to neurological complications only increases with age.

For example, the New York State Athletic Commission’s Medical Standards Manual lists numerous factors that can categorize boxers as “high-risk fighters,” such as if they are over 40 and have had more than a year of inactivity after starting their professional career. career, among other things.

Many boxers have continued fighting past the age of 40, and legends like Sugar Ray Robinson, George Foreman, Evander Holyfield and Larry Holmes all fought after that point.

“The reason 40 is used as a cutoff is because there is concern that when older fighters enter the ring or cage, they are more susceptible to being injured or that an older brain, for example, processes a concussion less (well) than, for example, a younger brain ,” explains Sethi.

“You can look at it from both sides. One of them is the chance that they will get hurt. And even if they do sustain the injury, is it the fact that age itself is detrimental to the healing process?”

Tyson falls into both categories because he will be fighting at age 58 and hasn’t fought professionally since 2005.

According to the Texas Department of Licensing and Regulation (TDLR) – the commission that sanctions professional fighting – boxers over the age of 36 must provide recent electroencephalogram or electrocardiogram test results – which measure brain and heart activity – leading up to a fight . .

The TDLR told CNN that the test results “must be favorable to allow (fighters) to compete.”

The TDLR told CNN it had approved a professional fight between Tyson and Paul with certain waivers, meaning the fight will last eight rounds, with two minutes for each round and both boxers will wear 14-ounce gloves.

Brain injury in boxing is not a recent phenomenon.

They were studied in sports as early as 1928 when American scientist Harrison Martland described boxers as “drunk” if they showed symptoms of concussion, while other terms to describe a fighter’s neurological state after a major match include dementia pugilistica and slug are. nutty.

In addition to additional neurological tests performed on fighters throughout their careers, Sethi believes much more can be done to protect fighters and prevent long-term neurological damage.

“A lot of change in boxing has to come from the boxers themselves, their families, the retired boxers. They need to say, ‘Make the sport safer for us,’” he said. “The culture of boxing is such that no one ever says, ‘No mas (not anymore).”

“No boxer will ever say, ‘I’ve had enough. I’m quitting.’ And I always say, ‘There’s no harm in saying it no mas.’ There are going to be days where you step into the ring and it’s not your day and you decide, ‘Okay, fine. I don’t think I can continue with this boxing.’”

Despite all the obvious health risks, boxing has faced opposition, and some medical associations – including the World Medical Association – around the world have taken it upon themselves to call for a complete ban on boxing.

But despite these calls, it remains one of the most popular sports in the world for obvious reasons. The explosive nature of the sport, the storylines and the colorful personalities ensure that you have to watch TV every now and then.

Tyson has brought all that into boxing during his long and often controversial career, but when he steps into the ring on Friday, the neurological impact he could feel could outweigh the positives.