The Zabara Foundation has awarded a $100,000 grant to UF Health sports medicine physician Sara Gould, M.D., to study the intersection of concussion, depression and treatment using transcranial magnetic stimulation (TMS) in female equestrian athletes, a group Gould says is historically overlooked in this field.
“The generous support of the Zabara Foundation and having them recognize the burden of mental health and actually do something that’s going to have clinical meaning is just incredible,” Gould said. “It’s not just the opportunity to conduct this research, but the opportunity to provide treatment that has been proven effective.”
TMS is a noninvasive neuromodulation technique that uses magnetic pulses to stimulate targeted brain circuits and is increasingly used to treat major depression. Gould’s research focuses on athletes experiencing both mild traumatic brain injury (TBI) and co-occurring mental health challenges — an area of growing clinical need.
According to a study on traumatic brain injuries in equestrian sports, co-authored by Gould, the high risk of injury requires constant investigation into protective equipment. Equestrian sports stand out for their connection with the highest incidence of head injuries, surpassing contact sports like American football and rugby. These injuries account for 20% to 48% of all horse-related injuries.
In addition to TBI, the study found equestrian sports are responsible for a large number of spinal cord injuries seen in female riders. Previous studies have reported anywhere from 63.7% to 84.6% of injured riders are female.
“There’s a lot of concussions happening in this sport,” Gould said. “There’s a huge need for people to really look at the equestrian as an athlete, and there’s an opportunity for us to do better through the helmets.”
This project reflects a broader shift in neuromodulation toward precision — matching interventions to specific neural pathways, injury profiles and patient characteristics.
“As brain stimulation becomes more precise, our research has to follow,” said Erik Herzfeld, trustee of the Zabara Foundation. “You can’t claim to be advancing targeted therapies while overlooking the majority of the population. Focusing on women in this context isn’t just about parity — it’s about accuracy. If we want better outcomes, we need research that reflects who is actually being treated.”
Thanks to a separate grant from the American Medical Society for Sports Medicine (AMSSM), Gould is also studying advances in helmet technology that reduce rotational forces on impact, a key driver of concussion severity.
As a sports medicine physician, Gould is passionate about improving human performance through safety and injury prevention. She is the director of the equestrian sports medicine program at the University of Florida, a program developed to address the unique needs of equestrian athletes. Gould has worked with athletes of all kinds, including serving as medical provider for the NBA. She completed her residency in emergency medicine at NYU Langone Medical Center in New York and pursued a fellowship in sports medicine at North Shore University Hospital in Manhasset, N.Y.
Since joining UF Health — World Equestrian Center in Ocala last summer, her faculty-led lecture series on equestrian safety and research has attracted large groups and now has a waiting list. Her love for horses and equestrian sport inspired her to advance safety standards in a sport that has lacked a focus on medical infrastructure.
Together, this work aims to improve both prevention and treatment in a sport that has historically lacked robust medical infrastructure while helping to define a more precise, inclusive future for neuromodulation.
“I think the reason we do all of this is the potential to help,” Gould said. “Being able to do something to prevent some of the burden of mental health and effect change in that area is huge. We can be saving lives with this treatment.”
The Zabara Foundation is a 501(c)(3) nonprofit dedicated to advancing medical science through investment in innovative research and technologies. Its founder, neuroscientist Jacob Zabara, Ph.D., is widely recognized as the inventor of modern vagus nerve stimulation (VNS).
To learn more about how you can support Dr. Gould’s research, please contact Callie Wilkes, director of development for the department of orthopaedic surgery and sports medicine.
For more information about the study visit clinicaltrials.gov.
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