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Frequent soccer heading associated with brain injury
Brain abnormalities and diminished neurocognitive function, similar to that among patients with traumatic brain injury, were associated with soccer players who repeatedly headed the ball in a recent study.
Researchers assessed 37 amateur soccer players (mean age, 30.9 years; 78% men) who played for an average of 22.4 years, including an average of 10.2 months in the year preceding the study. A questionnaire asked players to report their history of concussions and to quantify the number of headers they performed in the previous year. Heading ranged between 32 and 5,400 times per participant with a median of 432.
“Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibers in the brain,” researcher Michael L. Lipton, MD, PhD, associate director of the Gruss Magnetic Resonance Research Center at Albert Einstein College of Medicine in New York, said in a press release. “But repetitive heading could set off a cascade of responses that can lead to degeneration of brain cells over time.”
Participants underwent diffusion-tensor magnetic resonance imaging that revealed axonal injury in three areas of temporo-occipital white matter where significantly lower water movement, or fractional anisotropy (FA), existed among players who reached thresholds of 885 to 1,550 headers annually (P<.00001). Researchers also observed an association between lower FA levels and poorer memory scores on cognition tests among participants who logged more than 1,800 headers per year (P<.00001) compared with those performing fewer headers.
“High frequency of soccer heading in otherwise healthy adult mature players is associated with lower white matter fractional anisotropy and worse memory performance than in players who performed less heading,” the researchers concluded. “This relationship is not explained by a history of concussion.
“Further research is required to confirm and characterize threshold effects and possible modifiers that are applicable to specific settings and populations. Prospective monitoring of exposure at the team level … could identify a point at which a player’s heading should be curtailed for a specific recovery period.”