The ninety-seventh edition of the Giro d’Italia was officially launched on May 9th in Belfast. The startlist of the cycling event includes 22 teams for a total of 219 runners, cycling for about 3465 km in 21 stages. The first Italian stages started from Giovinazzo the 13th of May to reach Bari, covering a distance of about 200km.

On this occasion, we had the pleasure to interview Professor Guido Cavaletti, neurologist and member of the Scientific Committee of the Gianni Benzi Pharmacological Research Foundation. Professor Cavaletti is member of the medical staff of the Giro d’Italia.

Professor Cavaletti has already spoken on the doping phenomenon during the scientific conference event ‘Art and Science … together against Doping’ organised by the Gianni Benzi Foundation (Bari, 27th-30th May 2012). During this interview, he clarifies some aspects of this matter, that still heavily affects the world of sport.

• What are the main risks at neurologic level of doping?

Most of known doping substances do not have direct main effects on the nervous system, but they can indirectly interfere with its normal functioning.

We can think, for example, to the risk of ischemic vascular accidents (and therefore also cerebrovascular) that can be associated to an increase in blood viscosity in subjects with excessively high values of hematocrit, induced by the intake of erythropoietin or similar products.

Some stimulants and other substances inducing an addiction can also cause significant increases in blood pressure, with consequent risk of bleeding.

I remember one of my first patients in the emergency room, when I was a young neurologist, was a 50-years-old amateur who had taken a performance-enhancing amphetamine and had suffered a severe brain hemorrhage.

• It is known the plausible existence of a correlation between the Amyotrophic Lateral Sclerosis and professional football activity. What are the latest scientific findings on this aspect?

This point is still debated and is subject of research studies that, to date, have not achieved conclusive results. It is a very difficult problem to study, since there are many variables that can lead to wrong conclusions, not always easy to identify and to correctly evaluate.

• Gene doping is constantly changing and molecules considered as lifesaving agents, but with a positive effect on athletes performance, are often used. Do you believe that sport is helpless facing this phenomenon?

Unfortunately, from a technical point of view, gene doping is a reality and not just a possibility. The development of genetic manipulation technologies is one of the most promising frontiers of biomedical research and could lead to the treatment of incurable diseases. We are aware, however, of how this can be turned to performance-enhancing purposes, as was the case for the use of essential drugs such as erythropoietin or growth hormone. The sport is not entirely defenseless against gene doping, but it certainly is a very tough battle: in fact, the fight against these high-technological activities requires advanced technical and human resources, with a consequent increase in the costs and in the required commitment.

• How to implement truly effective plans to prevent doping, both at competitive and amateur levels?

In my opinion, the only way that can lead to an actual reduction of doping in sports is an ongoing and widespread information campaign, especially to the younger ones.

The doping should not be generically described as a malpractice and a danger: you must be able to explain the possible acute and long-term effects on health, trying to provide accurate, understandable and easily interpretable information with real data.

These actions must naturally be accompanied by

a strong opposition to any illegal practice, that should be constant for all sports: it is not fair that some sports are considered a sort of kingdom of doping only because controls are strong and intensive. It is more difficult to face this phenomenon in the amateur field, because the high number of practitioners makes more difficult efficacious controls and some initiatives seem to be only propagandistic: I smiled when the president of my club asked me, a very modest amateur cyclist, to sign the declaration on the mandatory sportsmanship regarding the use of doping, which specifies you have never been checked or tested positive by the World Anti-doping Agency (WADA).

The Gianni Benzi Foundation fully endorses the ideas of Prof. Cavaletti and sincerely thanks him for his strong commitment and attention to the world of young people.