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.
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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.
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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.
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.
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.
MAZANY: I'm pretty conscious about that because...
MAZANY: ...Just because of the whole brain health thing.
MAZANY: I don't want to have someone to feed me oatmeal when I'm 40...
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.
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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.
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HAMILTON: In the meantime, Gina Mazany is trying to stay safe while also staying competitive.
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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.
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