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Marcus Ball still remembers his first concussion.
It was 2011, and the now 20-year-old Arizona State University linebacker was playing high school football in his native Ohio when he collided with another player. He recalls seeing stars flash before his eyes.
“Stars just blinking,” he says. “Unfortunately, my team needed me, so I kept playing. But I definitely had a concussion.”
Ball’s experience isn’t unusual: a 2013 study by the National Academy of Sciences estimated that high school football players suffer 11.2 concussions for every 10,000 games and practices—the highest reported concussion rate among male athletes at that level.
These stats—and experiences like Ball’s—drive the ongoing controversy over concussions in football.
“The controversy is around what’s called CTE, or chronic traumatic encephalopathy,” says neurologist Javier Cárdenas, medical director of the Barrow Concussion and Brain Injury Center in Phoenix.
Chronic traumatic encephalopathy is a degenerative brain disease associated with aggression, memory loss and depression that has been found in people with a history of repetitive brain trauma, including concussions. In 2015, researchers from the Department of Veterans Affairs and Boston University reported that 87 out of 91 former NFL players who donated their brains to science tested positive for chronic traumatic encephalopathy.
To better understand the connection between concussions and CTE, Cárdenas says scientists must improve techniques for diagnosing concussions themselves.
“Right now, there’s a lot of subjectivity in the diagnosis of concussion,” he says. “Whether or not they have symptoms, whether or not you can detect an error in their balance or an error in thinking—that’s very subjective. So identifying a marker that tells us they’ve been concussed or not is most important.”
That’s where the ASU football team comes in.
Cárdenas and colleagues at the Phoenix-based Translational Genomics Research Institute, or TGen, teamed up with the Sun Devils to search for markers, or biological signs, of damage to the brain.
Student-athletes, like Marcus Ball, who volunteer for the study wear special helmets that record every impact they experience by sending signals to a computer on the sidelines. They also provide blood, urine and saliva samples before and after games, and whenever they suffer a major hit that could cause a concussion.
The idea is to search the samples for biological clues to how collisions on the field alter the brain, says Matt Huentelman, head of the TGen Neurobehavioral Research Unit.
“To try to connect what we’re seeing today, for example, in a college-aged athlete and what might happen years from now, decades from now, is actually a really, really difficult research question,” Huentelman says. “But it’s a really important one.”
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