Head in the Game

The Centers for Disease Control and Prevention estimated that in 2014 alone 2.87 million people sought medical treatment for or died from a traumatic brain injury (TBI), a diagnosis that typically follows a violent or forceful bump, blow, or jolt to the head. Of these cases, more than 800,000 occurred in children and teenagers—groups more likely than adults to be involved in participatory sports. Repeat brain injuries are of particular concern in individuals age 17 and younger because their extensive participation in sports coincides with a time of critical cerebral development.

A concussion, classified as a mild TBI, is a clinical syndrome that transiently disturbs normal brain function causing neurological, cognitive, and behavioral signs and symptoms. Research suggests that 33 percent of adolescents with a history of one concussion will likely experience multiple concussions in the future, and the risk for subsequent TBIs increases with the number of previous incidents, as well as with age. Even more alarming is that children under 14 are twice as likely to sustain a second injury, and individuals between the ages of 15 and 24 are three times more likely than those never injured to do so.

While concussed male and female athletes are directed to abstain or limit themselves from sports until their symptoms completely subside, many wonder what is actually happening in their brains and when they can reclaim their positions on the field without causing further harm. Even After they have experienced a full recovery of their behavioral symptoms, they worry about whether their brains are still metabolically or neurovascularly vulnerable.

Michael M. Folkerts, associate professor of psychology at Seaver College, is part of a research team that seeks to answer these questions. By studying male and female sedentary adolescent rats and “rathletes,” Folkerts’ project is the first to examine the pre-TBI physical activity levels of adolescent athletes to determine when they can safely return to sports.

Folkerts’ team, which includes three faculty members at the David Geffen School of Medicine at the University of California, Los Angeles, set out to determine which behavioral paradigms assessed during a post-injury neurological examination would be appropriate for assessing specific changes in motor balance, headache, anxiety, memory, and social interaction. They examined return-to-play guidelines both immediately following multiple concussions and following three days’ rest and measured specific markers of brain plasticity and metabolism at different points in time.

“Growing evidence shows that the adolescent brains of athletes and rathletes are different from the brains of those who are sedentary, and these differences influence how an athlete’s brain responds to concussive injuries,” says Folkerts, whose deep interest in the relationship between biology and psychology shaped his lifelong scholarship of neuroscience. “Experimentally, no one has ever addressed these factors in a male or female adolescent rat or rathlete athlete model.”

In January 2019, after two years of establishing their experimental parameters, the National Institutes of Health awarded the UCLA-Pepperdine team with a $2.9 million grant, allotted over a five-year span, to fund their “Timing of Exercise in Concussed Rat Athletes” project.

Folkerts’ official partnership with his colleagues from UCLA, whom he met at the National Neurotrauma Symposium, began in 2017 during his research sabbatical. The group joined forces to develop a rat model that resembles adolescent athletes who have experienced multiple concussions.

“There is great strength in collaborative and interdependent research both within and between universities,” Folkerts explains. “Pepperdine’s commitment to a research laboratory in psychology and the funding for research sabbaticals have allowed me to re-energize, explore a new area of research with experts in my field, play a role in obtaining external funding, and conduct research that has direct applications to human ailments—all of which I will bring back to my students."

Saul Sandoval Estrada, a psychology major and student-athlete on the Waves basketball team, played an instrumental role in assisting Folkerts with the project during the spring 2019 semester, though the two have been working together on the brain trauma research for three years.

"Often athletes try to play through head injuries sustained during a game and put themselves at risk of getting another concussion during the same game,” Sandoval Estrada notes. “The objective of this neurotrauma research is to model real-life concussions that can occur more than once and see what we can learn from the many biological and behavioral variables involved.”

Sandoval Estrada reveals that the research experience has taught him valuable leadership, critical investigation, and teamwork skills. His role in the lab involved data collection and analysis of voluntary running wheel behavior, as well as training new student assistants on the behavioral and injury paradigms.

“I have seen how conducting research changes the way students ask critical questions, the strategies they develop to tackle new problems, and the hypotheses they form that take them into the future,” shares Folkerts, who believes that undergraduate student participation is a crucial benefit to the project.

“Research experiences also allow students to more fully comprehend what it means to be a scientist and to present and publish research alongside faculty, which may propel them with the maturation and motivation toward a graduate program and, perhaps, a lab of their own down the road.”