Female Athletes Are Closing The Gender Gap When It Comes To Concussions | KERA News

Female Athletes Are Closing The Gender Gap When It Comes To Concussions

Jul 24, 2017
Originally published on July 26, 2017 3:33 pm

Gina Mazany grew up in Anchorage, Alaska. And that's where she had her first fight.

"It was right after I turned 18," she recalls.

A local bar had a boxing ring, and Mazany decided to give it a shot. Her opponent was an older woman with a "mom haircut."

"She beat the crap out of me," Mazany says. "Like she didn't knock me out, she didn't finish me. But she just knocked me around for three rounds. And I remember, later that night I was very, very nauseous. I was throwing up that night."

It was her first concussion.

Thanks to research on boxers and football players, both athletes and the public are becoming more aware of the dangers of sports-related head injuries. Yet there is little data on participants like Mazany. That's because, unlike the vast majority of athletes studied, she is a woman.

"We classically have always known the male response to brain injury," says Mark Burns, at Georgetown University. But there have been remarkably few studies of females. The bias runs throughout the scientific literature, even in studies of mice.

"Male mice have been used historically in research and not really been compared to female mice," he says.

That's changing now. The National Institutes of Health recently began to require scientists to include female animals.

Burns' lab has begun using both sexes in research on head injuries. And they're finding some differences. This summer, Burns published a study in the journal Glia that looked at mice with severe brain injuries. He says the brains of male mice showed a massive immune response within a day, but the female response was much slower — up to seven days.

There have been hints of differences in people as well. Just this year, a study of college athletes found that women are more likely than men to get concussions.

But to find out more, scientists want to study fighters like Mazany. She is 28 now and lives in Las Vegas. She's a professional mixed martial arts fighter who competes in Ultimate Fighting Championship events.

Her nickname is "Danger." Mazany has begun worrying about her brain.

"One day I want to get married and have a family. And I want to be able to take care of my babies and like all that kind of stuff," she says. "So I'm not going to get the s*** kicked out of me for nothing, if that makes sense."

So Mazany volunteered to be part of a study of fighters at the Cleveland Clinic Lou Ruvo Center for Brain Health, in Vegas. For six years now, professional fighters have been coming to the center for brain scans and blood work. They also complete tests of mental functions.

On the day of Mazany's annual checkup, she is subjected to a battery of tests that assess her balance, reaction time, memory, and thinking.

After about 40 minutes, Mazany meets with Dr. Charles Bernick, the scientist in charge of the fighters study. They move to a quiet room. Bernick scans a chart. It shows Mazany's test results over the past few years.

"Well you're pretty stable," Bernick says. There's no obvious sign of trouble from her fighting career, at least not yet.

Bernick says the study of fighters like Mazany now includes nearly 700 men and about 60 women.

"So, [the women are] still a minority, because they are a minority in the sport," he says. "But I think it's a very important group to evaluate because we really don't know if there are differences between men and women."

Bernick does believe that there's now enough evidence to suggest real differences between the ways men and women respond to head injuries.

"Women may be more likely to suffer concussion. Their symptoms may linger longer," he says. "The question is: Is that because women are just more likely to report injuries, or is there a biological higher vulnerability."

Researchers have suggested some reasons women might be more vulnerable. They tend to have weaker neck muscles. So a head impact might shake the brain more violently. And hormonal differences might affect the brain's response to an impact or injury.

Bernick says the fighters' study offers a way to directly compare men and women who compete in combat sports where a concussion is often the goal.

He says the study has already shown that brain scans and other tests can show who's been getting hit a lot.

"You can detect changes in brain structure even over a year's period," he says. "The question really is in the long run, are those changes predictors of somebody who is going to have a neurodegenerative disease later in life."

Bernick says an answer is still years away.

In the meantime, Gina Mazany is trying to stay safe while also staying competitive.

During her training sessions at the Xtreme Couture mixed martial arts center, Mazany tries not to give anyone a head injury, though things can happen during sparring: "I have knocked out another girl in my gym on accident," she says. "Sorry, Hannah."

But Mazany says these days, most fighters know what they're doing is risky.

"My theory to it all is yeah, there's brain damage. Yeah, this sport is not safe. I don't care who you are, it's not safe," she says. "But a lot of things that we do aren't safe."

Copyright 2017 NPR. To see more, visit http://www.npr.org/.

RACHEL MARTIN, HOST:

Today in Your Health, we take a look at female athletes and concussions. Most of what scientists know about these injuries comes from studies of men, even as more women are competing in contact sports. NPR's Jon Hamilton has the story of a female fighter who is helping scientists learn more about concussions in women, while trying to protect her own brain.

JON HAMILTON, BYLINE: Gina Mazany grew up in Anchorage, Ala. And that's where she had her first fight.

GINA MAZANY: This was, like, right after I turned 18. So I was legally allowed to fight.

HAMILTON: She knew a bar with a boxing ring.

MAZANY: So you go to this bar, and you weigh in. And then there's this other chick. And she had, like, the mom haircut, like short hair, had, like, you know, the jacket with, like, shoulder pads in. And she's, like, wanting to fight. And I was like, yeah, it's cool.

HAMILTON: Except it wasn't.

MAZANY: She beat the crap out of me. She didn't knock me out. She didn't finish me. But she just knocked me around for three rounds. And I remember later that night, I was very, very nauseous. I was throwing up that night.

HAMILTON: It was her first concussion.

MAZANY: The next day, I just felt like crap. But I came back in the gym because I was like, I don't want people to think that I'm not tough.

HAMILTON: Mazany is 28 now and lives in Las Vegas.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED ANNOUNCER #1: Introducing to you first, fighting out of the blue corner...

HAMILTON: She's a professional mixed-martial-arts fighter who competes in Ultimate Fighting Championship events.

UNIDENTIFIED ANNOUNCER #1: ...Here is the undefeated Gina Danger Mazany.

(SOUNDBITE OF CHEERING)

HAMILTON: Her nickname is Danger, and she doesn't worry about looking tough. But Mazany has begun worrying about her brain.

MAZANY: My thought is like, one day, I want to get married and have a family. And I want to be able to take care of my babies and, like, all that kind of stuff. So I'm not going to get the [expletive] kicked out of me for nothing, if that makes sense.

HAMILTON: Mazany has reason to worry. She knows retired fighters whose brains are really messed up. But they're all men. Nobody knows much about what combat sports do to a woman's brain. Mark Burns of Georgetown University says that's because scientists simply haven't done much research on females.

MARK BURNS: We classically have always known the male response to brain injury...

HAMILTON: ...Even when it comes to mice.

BURNS: Male mice have been used historically in research and not really being compared to female mice.

HAMILTON: That's changing. The National Institutes of Health is requiring scientists to include female animals. And Burns' lab has begun using both genders in their research on head injuries. He says, first, they give the mouse an anesthetic. Then they put the animal in a device that delivers a precise blow to the head.

BURNS: And that would lead to about 30 seconds worth of a loss of consciousness.

HAMILTON: This summer, Burns published a study in the journal Glia that looked at mice with severe brain injuries. He says the brains of male mice showed a massive immune response within a day.

BURNS: But in terms of females, it took them up to seven days to start reacting to this trauma.

HAMILTON: A huge difference - in mice. And there have been hints of differences in people. Just this year, a study of college athletes found that women were more likely than men to get concussions. But to find out for sure, scientists are looking to long-term studies of women like Gina Mazany.

It's a blistering summer day in Las Vegas.

UNIDENTIFED WOMAN #1: Hi.

HAMILTON: And Mazany has just arrived at the Lou Ruvo Center for Brain Health.

UNIDENTIFED WOMAN #2: Gina, hi, it's so nice to meet you.

HAMILTON: The center is run by the Cleveland Clinic. And for six years now, professional fighters have been coming here to take part in a brain health study. Each year, they get an exam that includes a brain scan and blood work. They also complete tests of mental functions.

UNIDENTIFED WOMAN #3: So this next one is animals.

MAZANY: Animals?

UNIDENTIFED WOMAN #3: I will make you do...

MAZANY: Oh, God, I hate this. (Laughter) OK.

HAMILTON: A researcher tells Mazany to name as many animals as she can in a minute.

MAZANY: Aardvark, antelope, bee, buffalo.

HAMILTON: After about 40 minutes of testing, Mazany meets with Dr. Charles Bernick.

UNIDENTIFED WOMAN #3: OK, so here's Dr. Bernick.

MAZANY: Hi, Dr. Bernick.

HAMILTON: He's the scientist in charge of the fighter study.

CHARLES BERNICK: Yeah, so how'd you do?

MAZANY: I don't know.

BERNICK: (Laughter).

MAZANY: How did I do?

BERNICK: I don't know. Let's look.

HAMILTON: They move to a quiet room. Bernick scans a chart. It shows Mazany's test results over the past few years.

BERNICK: Well, you're pretty stable. These are different tests you've had. And, actually, the ones that are going down are better. It means you're doing things faster.

HAMILTON: So there's no obvious sign of trouble from her fighting career. But then, Dr. Bernick looks up when Mazany tells him she's been sparring with men who weigh a lot more than she does.

BERNICK: The times you get clipped, like you mentioned, is that a common event or uncommon?

MAZANY: Pretty uncommon.

BERNICK: OK.

MAZANY: I'm pretty conscious about that because...

BERNICK: Yeah.

MAZANY: ...Just because of the whole brain health thing.

BERNICK: Sure.

MAZANY: I don't want to have someone to feed me oatmeal when I'm 40...

BERNICK: Yeah.

MAZANY: ...You know (laughter).

HAMILTON: Bernick says the fighter study now includes nearly 700 men and about 60 women.

BERNICK: So there's still a minority because they are a minority in the sport. But I think it's a very important group to evaluate because we really don't know if there are differences between men and women.

HAMILTON: But he says there's now enough evidence to suggest there might be.

BERNICK: Women may be more likely to suffer concussion. Their symptoms may linger longer. And the question is, is that because women are just more likely to report injuries, or is there a biological higher vulnerability?

HAMILTON: Researchers have suggested some reasons women might be more vulnerable. They tend to have weaker neck muscles. So a head impact might shake the brain more violently. And hormonal differences might affect the brain's response to an impact or injury. Bernick says the fighter study offers a way to directly compare men and women who compete in events where concussion is often the goal.

(SOUNDBITE OF ARCHIVED RECORDING)

UNIDENTIFIED ANNOUNCER #2: Oh.

UNIDENTIFIED ANNOUNCER #3: Oh, wow, big knockout there - he's probably hurt.

HAMILTON: Bernick says knockouts like this one actually show up in a fighter's brain scan.

BERNICK: You can detect changes in brain structure even over a year's period.

HAMILTON: But it's not so clear what those changes mean.

BERNICK: The question really is, in the long run, are those changes predictors of somebody who's going to have a neurodegenerative disease later in life?

HAMILTON: Bernick says an answer is still years away.

(SOUNDBITE OF BELL)

HAMILTON: In the meantime, Gina Mazany is trying to stay safe while also staying competitive.

(SOUNDBITE OF STRIKING)

MAZANY: Yes.

HAMILTON: During her training sessions, Mazany tries not to hurt anyone.

MAZANY: I have knocked out another girl in my gym on accident. Sorry, Hannah (ph).

HAMILTON: But Mazany says, these days, most fighters know what they're doing is risky.

MAZANY: So it's kind of scary. But it's just - I don't know. My theory to it all is like, yeah, there's brain damage. Yeah, this sport is not safe. I don't care who you are; it's not safe. But a lot of things that we do aren't safe...

HAMILTON: For men or for women. Jon Hamilton, NPR News.

(SOUNDBITE OF EVIL NEEDLE'S "ASSEMBLY") Transcript provided by NPR, Copyright NPR.