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Article History

Accepted: 3 June 2026

First Online: 30 June 2026

Declarations

:

: Z. Zhang, J.L. Reiter, D. Lai, P.F. Pasquina, J. Ren, and Y. Liu have no relevant financial or non-financial interests to disclose. K.N.H. Nudelman has current research funding from the National Institutes of Health, the Alzheimer’s Association, the Department of Defense, the Michael J. Fox Foundation for Parkinson’s Research, and the National Collegiate Athletic Association. S.P. Broglio has current research funding from the Centers for Disease Control and Prevention; Department of Defense—USA Medical Research Acquisition Activity, and National Collegiate Athletic Association. He has past research funding from the National Institutes of Health; National Athletic Trainers’ Association Foundation; National Football League/Under Armour/GE; Simbex; and ElmindA. He has consulted for US Soccer (paid), US Cycling (unpaid), University of Calgary SHRed Concussions external advisory board (unpaid), and is the President of the Concussion in Sport Group (unpaid). He has received compensation for medico-legal litigation, and received speaker honorarium and travel reimbursements for talks given. He is co-author of “Biomechanics of Injury (3rd edition, Human Kinetics),” holds a patents on “Brain Metabolism Monitoring Through CCO Measurements Using All-Fiber-Integrated Super-Continuum Source” (U.S. US 11, 529, 091 B2) and “Organ Or Tissue Hemodynamic And Metabolic Function Measured Using Super-Continuum Light Sources” (US 12,089,945 B2), and is on the scientific advisory board for C3Logix (stock options). He is/was on the editorial boards (all unpaid) for Journal of Athletic Training (2015 to present), Concussion (2014 to present), Athletic Training & Sports Health Care (2008 to present), British Journal of Sports Medicine (2008 to 2019). M.A. McCrea reports research funding to the Medical College of Wisconsin from the National Institutes of Health, U.S. Department of Defense, Department of Veterans Affairs, Centers for Disease Control and Prevention, National Football League, National Collegiate Athletic Association, and Abbott Laboratories. He is a clinical consultant to the Green Bay Packers, Milwaukee Brewers, and Milwaukee Bucks. He also reports honoraria and travel support for professional speaking engagements. T.W. McAllister reports current or prior grant support from National Institutes of Health, U.S. Department of Defense, and National Collegiate Athletic Association, as well as textbook royalties from the ‘Textbook of Traumatic Brain Injury’ from the American Psychiatric Association Publishing, Inc., and is an unpaid member for the concussion Scientific Advisory Committee for the Australian-Rules Football Conference.

: This study was completed following approval from the respective local Institutional Review Boards and the United States Army Human Research Protection Office. This study was conducted in accordance with the Declaration of Helsinki.

: Conceptualization: Jie Ren, Yunlong Liu; data curation: Kelly Nudelman; formal analysis: Zhiqi Zhang, Jie Ren; funding acquisition: Thomas McAllister, Michael McCrea, Steven Broglio, Paul Pasquina; methodology: Zhiqi Zhang, Dongbing Lai, Jie Ren, Yunlong Liu; project administration: Jill Reiter, Jie Ren, Yunlong Liu; resources: Kelly Nudelman, Thomas McAllister, Michael McCrea, Steven Broglio, Paul Pasquina; supervision: Jill Reiter, Jie Ren, Yunlong Liu; validation: Zhiqi Zhang, Jie Ren; visualization: Zhiqi Zhang, Jie Ren; writing—original draft: Zhiqi Zhang, Jie Ren; writing—review and editing: all authors. All authors read and approved the final version of the article.

: The genotyping and GWAS data generated in this study were deposited in the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System under the study name: Concussion Assessment, Research and Education (CARE) Consortium. The dataset names and IDs are: CARE1_GWAS_final_n546_Biomarker, ID 17733; and CARE2_GWAS_Biomarker, ID 17972.