Soccer Move Raises Brain Injury Risk

Soccer is the world's most popular sport, with more than 265 million active players. Heading, in which players field the soccer ball with their head, is an essential part of the game. Players head the ball, on average, six to 12 times during competitive games, where balls can travel at velocities of 50 miles per hour or more. Michael L. Lipton, from the Albert Einstein College of Medicine (New York, USA), and colleagues report that soccer players who “head” the ball with high frequency demonstrate poorer performance on memory tests and have brain abnormalities similar to those found in traumatic brain injury patients. Enrolling 37 amateur adult soccer players (median age 31 years), the researchers conducted diffusion tensor imaging (DTI), an advanced MRI technique, to assess microscopic changes in the brain's white matter. DTI produces a measurement, called fractional anisotropy (FA), abnormally low values within white matter are associated with cognitive impairment in patients with traumatic brain injury.  Participants reported having played soccer for an average of 22 years and played an average of 10 months over the past year. The researchers estimated how often each player headed the ball on an annual basis and identified regions in the brain where FA changed in relation to prior heading. This analysis identified areas of the brain where FA values were significantly lower in players who headed more. The players also underwent cognitive testing.  The team found that most frequent headers showed abnormalities of white matter similar to that seen in patients with concussion. Calculating that soccer players who head the ball above a threshold of 885 to 1,550 times a year had significantly lower FA in three areas of the temporal-occipital white matter, the study authors warn that players with more than 1,800 headings per year were more likely to demonstrate poorer memory scores. The study authors warn that: "Heading is associated with abnormal white matter microstructure and with poorer neurocognitive performance.”