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Inside the laboratory of Dean Sicking, a mechanical engineering professor who is studying the effectiveness of helmets in preventing concussions.

(UAB)

Concussion care has improved in Alabama since the passage of a 2011 law that requires school-age athletes to see a doctor before they return to the playing field, according to a study conducted by a pediatric neurosurgeon at UAB.

The movie "Concussion," based on the true story of a pathologist who became concerned about brain damage suffered by NFL athletes, has brought the issue of concussions back into the headlines.

But despite everything doctors have learned about the long-term risks for pro football players, there's still a lot to learn, said Dr. James Johnston, a UAB neurosurgeon and co-director of the Alabama Concussion Task Force. Several researchers at UAB are conducting research that could help diagnose, treat and even prevent concussions in some contact sports.

One of the biggest questions is also one of the most basic: What is the best way to diagnose a concussion?

"The diagnosis of concussion is kind of a gray area," Johnston said. "I could see a concussion where someone else might not."

Not every athlete who suffers a concussion loses consciousness, Johnston said. Athletes who receive violent blows to the head receive evaluations for concussions that may not catch all injuries.

Researchers in the Vestibular and Oculomotor Research Clinic (VORClinic) in the UAB School of Optometry are trying to develop tests to measure physical changes in eye-tracking after concussion. If the lab can find quantifiable physical changes for concussions, it could help with diagnosis and in determining when patients have recovered.

Studies have recently shown that a large number of hits may cause more brain damage than a handful of concussions, Johnston said.

"People are really moving toward impact exposure," Johnston said. "That's sort of where we're going too."

But how many hits are too many? Johnston and the VORClinic are trying to find out.

Investigators are measuring how athletes' pupils react to light over the course of a season, according to UAB. Athletes who show signs of minor brain damage may be asked to rest to prevent further injury.

Athletes who suffer concussions may have to refrain from play and study for weeks, until their symptoms have subsided. As Al.com reported in 2013, UAB researcher Candace Floyd has been testing a compound that could potential stop the process that causes brain cells to die during a concussion.

A substance that was developed to reduce rejection after organ transplant may hold the key to preventing more damage, according to UAB. If the compound proves to be effective in preventing brain cell death, then Floyd and her team may try to develop a treatment that can be administered on the sidelines, possibly as an inhaler or spray.

Outside the medical school, an engineering team is also working on ways to prevent concussions through improved equipment.

Dean Sicking, a mechanical engineering professor, developed safer barriers for use in car racing. How he has turned his attention to football helmets.

At his laboratory at Barber Motorsports Park, Sicking and his assistants have been testing different helmets currently on the market to determine how well they protect the brain. His team is also working on a new contraption, a helmet specifically designed to for concussion prevention.

But even without new equipment, tests or treatment, researchers can have an impact on the safety of young players. Increased awareness of concussions is already changing the way the game is practiced and played, Johnston said.

Many college and professional coaches have reduced the amount of tackling in practice, he said. Those changes haven't always filtered down to high school teams and younger, Johnston said.

"Junior high and high school teams that are led by well-meaning but uneducated coaches are still running a lot of outdated drills," Johnston said. "We know now that most of the concussions happen in practice."