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49ers receiver Marquise Goodwin has suffered his fourth concussion in the last 14 months.

The 49ers confirmed that Goodwin suffered a concussion in Sunday’s loss to the Cardinals. Last year with the Bills he suffered a concussion in August in a training camp practice, in September in a game and in October in a game.

In all three cases last year, Goodwin quickly returned to action, missing only one game despite those three concussions. He’s currently in the concussion protocol and will have to be cleared by an independent neurologist before he can return to the field again.

Some neurologists have said repeated concussions can have a cumulative effect and that each additional concussion carries additional risk of long-term effects. For Goodwin, that has to be a concern.