Doctors raise concern over quick brain function decline in soccer players

New research links heading in soccer/football to a measurable decline in brain function among young adult amateur players over a period of just two years.

The research is being presented at the annual meeting of the Radiological Society of North America.

“There is enormous worldwide concern for brain injury in general and in the potential for soccer heading to cause long-term adverse brain effects in particular,” says senior author Michael L. Lipton, professor of radiology at Columbia University’s Vagelos College of Physicians and Surgeons. “A large part of this concern relates to the potential for changes in young adulthood to confer risk for neurodegeneration and dementia later in life.”

Cosmos has tracked sports injury specialists from all over the world who are concerned about head injuries leading to neurodegenerative diseases. They struggle with how to get kids to play the sport, without lifelong injury.

The new research included 148 young adult amateur football players. The mean age of the participants was 27 and a little more than a quarter were women.

A questionnaire helped researchers determine how much each player hit the ball with their head. Over the course of two years, exposure to heading was categorised as low, moderate or high. High exposure correlated to more than 1,500 headers in two years.

Players were assessed for verbal learning and memory. They also underwent diffusion tensor imaging (DTI) – an MRI technique which assesses brain microstructure by tracking the movement of water molecules through the tissue.

The analysis adjusted for variables including age, sex, education and concussion history.

High-heading players showed deterioration in frontal white matter and decreased brain organisation in certain regions.

“Our analysis found that high levels of heading over the two-year period were associated with changes in brain microstructure similar to findings seen in mild traumatic brain injuries,” says Lipton. “High levels of heading were also associated with a decline in verbal learning performance. This is the first study to show a change of brain structure over the long term related to sub-concussive head impacts in soccer.”

In a second study, Lipton’s team analysed heading among 353 amateur football players (age 18–53; 27% female) before DTI and verbal learning tests. Instead of focusing on white matter regions of the brain, the study tested the interface between grey and white matter closer to the skull.

The team believe this interface may play a role in the adverse association between repetitive head impacts and cognitive performance.

“These findings add to the ongoing conversation and contentious debate as to whether soccer heading is benign or confers significant risk,” Lipton adds.

In a conversation with Cosmos in July, Dr Alan Pearce, a neuroscientist Alan Pearce, an adjunct professor at La Trobe University in Melbourne said exposure to repeated head knocks at a young age can have an effect.

He suggests that sports be modified to reduce kids’ exposure to head knocks that can lead to cognitive issues and brain diseases in later life.

“We don’t want parents take their kid out of footy or soccer which will happen because as parents start to get more worried about this. We’re not wanting to put kids into cotton wool. We’re just want to reduce this exposure. You don’t give kids cigarettes or alcoholic drinks because it can affect the brain. It’s all the same.”

Pearce notes international examples where modified sports are legislated to reduce risk for young people as well as older and professional athletes.

“In the UK, they’re trialling a two-year ban on headers for children 12 years and under. In Scotland, they’ve banned heading for all players the day before and the day after their match. In America, they have modified versions of American football, called ‘flag football’, up to the age of 14 years of age. What we’ve seen in the data is that it’s not actually to the detriment of their skill acquisition.”

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