Heading by Soccer Players Can Damage the Brain’s Learning Regions

The heading of a soccer ball—an intrinsic and routine feature of play in the world’s most popular field sport—causes long-term damage to areas of the brain associated with learning, according to a new study being presented next week at the annual meeting of the Radiological Society of North America.

“We show that adverse effects of heading are present at a location that corresponds to the location of pathology in CTE (chronic traumatic encephalopathy),” said Dr. Michael L. Lipton, the study’s senior author and a professor of radiology at Columbia University Irving Medical Center in New York.

“We show evidence that the brain changes seen with MRI (magnetic resonance imaging) are in fact a causal link between heading and worse brain function,” Lipton told Newsweek.

“We assessed heading over the prior 12 months in adult amateur players in New York,” he said, adding, “We conducted MRI and cognitive tests. A special type of MRI—diffusion tensor imaging—was used to measure brain microstructure at the depths of crevices in the brain surface called sulci. We then tested the associations of heading and cognitive function.”

Lipton said that, based on the available evidence to date, some amount of heading is safe for most soccer players. However, the exact level at which heading becomes harmful is not known with precision and is likely to vary from individual to individual, he added.

If heading is associated with imbalance, nausea, persistent headache, disorientation or trouble functioning, Lipton advised caution, rest and perhaps medical assessment.

What Is the Long-Term Risk From Soccer Heading?

The looming concern on people’s minds, Lipton said, is that sport-related head impacts sustained by players could lead to neurodegenerative disease later in life, such as Alzheimer’s disease.

“While young amateur soccer players have been reported to have CTE, we do not yet know the long-term risk,” Lipton said.

He added: “Our finding that brain effects occur in a distribution in the brain similar to CTE certainly should not be taken to indicate that players have or will develop CTE.

“However, it does provide the first in vivo evidence that repeated head impacts lead to traumatic effects in the locations where CTE pathology ultimately develops.”

The researchers compared brain MRI scans of 352 male and female amateur soccer players, ranging in age from 18 to 53, to brain MRIs of 77 non-collision-sport athletes, such as runners, to identify how repeated head impacts affected the brain.

Most of the participants of the study had never sustained a concussion or been diagnosed with a traumatic brain injury.

Soccer players who headed the ball at high levels showed abnormality of the brain’s white matter adjacent to sulci, which are deep grooves in the brain’s surface. Abnormalities in this region of the brain are known to occur in severe traumatic brain injuries.

The abnormalities were most prominent in the frontal lobe of the brain, an area most susceptible to damage from trauma and frequently affected during soccer heading.

More repetitive head impacts were also associated with poorer verbal learning.

“The study identifies structural brain abnormalities from repeated head impacts among healthy athletes,” Lipton said. “The abnormalities occur in the locations most characteristic of CTE, are associated with worse ability to learn a cognitive task and could affect function in the future.”