Heading Soccer Balls Tied to Damaging Brain Changes06/11/13
TUESDAY, June 11 (HealthDay News) -- Sophisticated scans reveal
that soccer players who head the ball a lot show changes in the
white matter of their brain that mirror those seen in traumatic
In addition, they face a higher risk of developing thinking and
memory problems, the researchers report.
"We looked at the relationship between heading and changes in the brain and changes in cognitive functions [thinking and memory], and we found that the more heading people do, the more likely we are to find microscopic structural abnormalities in the brain, and they're more likely to do poorly on cognitive tests, particularly in terms of memory," said study author Dr. Michael Lipton, associate director of the Gruss Magnetic Resonance Research Center at Albert Einstein College of Medicine and medical director of magnetic resonance imaging at Montefiore Medical Center, both in New York City.
However, Lipton noted, "We cannot say heading caused these
changes. We found an association, but in no way can we infer
causation. You need a longitudinal study that follows people over
time to prove causation."
Results of the study were released online June 11 in the journal
Soccer is the world's most popular sport. More than 265 million
people play the game worldwide, and heading is a common move in
soccer. Heading a soccer ball means using your head instead of your
feet to play the ball. In competitive games, players head the ball
between an average of six and 12 times, according to background
information in the study. In this elite level of play, the ball can
travel at velocities of 50 miles per hour or more, according to the
This isn't the first study to link heading and changes in the
white matter in the brain. In an issue of the
Journal of the American Medical Associationlate last year,
Harvard researchers compared soccer players to swimmers, and found
changes in the white matter in soccer players.
White matter is the communication network in the brain; it sends
messages between neurons (gray matter).
For the current study, Lipton and his colleagues recruited 37
adult amateur soccer players. Their ages ranged from 21 to 44 years
old, and the average age was nearly 31. Twenty-eight of the
volunteers were men. They played at least one competitive game of
soccer each week, and practiced an average of two times a week,
according to Lipton. Most had been playing since they were
All underwent a special imaging technique called diffusion
tensor magnetic resonance imaging that produces detailed images
that show microscopic changes in the white matter of the brain.
The players also filled out a questionnaire about such factors
as frequency of heading and prior concussions, and completed a
number of tests to measure their thinking and memory skills.
The researchers found that there appears to be a threshold for
harm from heading. Below that threshold, there wasn't as much risk,
but there was significantly more risk of brain changes above it. In
this study, the threshold was between 885 and 1,550 headers a year
for brain changes, and higher than 1,800 headings a year for
changes in memory scores.
Lipton said these findings were independent of past
"People can take some degree of trauma. Not everyone who bumps their head on a cabinet will have concussion symptoms. The question is how much does it take to have a lasting injury? And, that remains an open question, especially in children," said Lipton.
Because kids' brains are developing, they might be more
susceptible to injuries, noted Lipton. But, on the other hand, he
pointed out, children's brains are also quite adaptable and can
recover more easily from conditions such as stroke than adult
One expert noted that the study showed that even minor insults
to the brain can have lasting effects.
"This study shows that even if you don't have a concussion or a noticeable injury, if you look close enough at the brain, you can see changes. The evidence from these adults seems reasonably compelling that these minor heading events accumulate over time," said Dr. Michael Bell, director of pediatric neurocritical care at Children's Hospital of Pittsburgh.
For parents who may be wondering if they should keep their kids
from heading soccer balls, Lipton said the evidence isn't clear-cut
enough yet to make a firm recommendation one way or the other.
"Parents have to weigh the evidence and make their own decisions. Our study provides very preliminary evidence that lines up with many of the concerns that parents have, but that needs to be balanced against the fact that this isn't yet a closed book," Lipton said.
Bell agreed, and added a counterpoint.
"The data is evolving, and any sort of mild traumatic brain injury may have consequences we don't understand yet," Bell said, adding that parents also have to remember that they don't want to discourage their children from being physically active, because a sedentary lifestyle has other health risks.
Learn more about mild brain injuries from the
Brain Injury Association.
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