Efforts to reduce long-term brain injuries among soccer players should focus more on frequent ball heading rather than unintentional head impacts due to collisions, suggest researchers from Albert Einstein College of Medicine.

“Unintentional head impacts are generally considered the most common cause of diagnosed concussions in soccer, so it’s understandable that current prevention efforts aim at minimizing those collisions,” says study leader, Michael Lipton, MD, PhD, FACR, professor of radiology and of psychiatry and behavioral sciences at Einstein and medical director of MRI Services at Montefiore.

“But intentional head impacts—that is, soccer ball heading—are not benign. We showed in a previous study that frequent heading is an underappreciated cause of concussion symptoms. And now we’ve found that heading appears to alter cognitive function as well, at least temporarily,” he adds, in a media release.

Their study, published recently in Frontiers in Neurology, Lipton’s team included 308 amateur soccer players from New York City, ranging in age from 18 to 55 (78% male).

The participants detailed their recent (previous 2 weeks) soccer activity via questionnaires. They also completed neuropsychological tests of verbal learning, verbal memory, psychomotor speed, attention and working memory.

According to the results, explains a media release from Albert Einstein College of Medicine, players headed soccer balls an average of 45 times during the 2 weeks covered by the questionnaire. During that time, about one-third of the players suffered at least one unintentional head impact (eg, kicks to the head or head-to head, head-to-ground, or head-to-goalpost collisions).

Players who reported the most headings had the poorest performance on psychomotor speed and attention tasks, which are areas of functioning known to be affected by brain injury. Heading frequency also correlated with poorer performance on the working memory task, although the association was of borderline significance. In contrast, unintentional head impacts were not related to any aspect of cognitive performance.

The changes in cognitive function did not cause overt clinical impairment, the researchers note.

“However, we’re concerned that subtle, even transient reductions in neuropsychological function from heading could translate to microstructural changes in the brain that then lead to persistently impaired function. We need a much longer-term follow-up study of more soccer players to fully address this question,” Lipton states.

In the meantime, soccer players should consider reducing heading during practice and soccer games, Lipton advises. “Heading is a potential cause of brain injury,” he says, “and since it’s under control of the player, its consequences can be prevented.”

[Source(s): Albert Einstein College of Medicine, Science Daily]