Heading in soccer more dangerous for women, brain study finds

Soccer injuries are sending soaring numbers of U.S. kids to emergency rooms, a trend driven in part by young players with concussions seeking urgent medical care, a study found.

Female soccer players are more susceptible to heading-induced brain damage compared to their male counterparts, according to a new study published Tuesday.

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Headers are common soccer techniques that involve using the head to control the ball, typically for passing or shooting.

For the recent findings, researchers from New York's Albert Einstein College of Medicine used MRI techniques to assess changes in brain white matter in 98 amateur soccer players, 49 men and 49 women. The average age of the players was 25.8 years.

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According to the study, all of the 98 participants had several years of soccer experience and exposure to heading, including 12 months of frequent heading before the study. On average, men were exposed to 487 headers per year compared to 469 per year for women.

The MRI technique used by the researchers — diffusion tensor imaging — tracks the movement of water molecules in the brain, a measurement known as fractional anisotropy (FA).

When someone has healthy white matter in the brain, water molecule movement is “fairly uniform,” Science Daily reported. Healthy white matter measures high in FA.

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"A decline in FA is an indicator of changes in the white matter microstructure that may be indicative of inflammation or loss of neurons, for example," lead researcher Michael L. Lipton said in a news release.

According to Lipton, greater amounts of heading were associated with declining FA for both men and women, “but women exhibit about five times as much microstructural abnormality as men when they have similar amounts of heading exposure.”

Additionally, compared to men, who experienced lower FA in three brain regions, the researchers identified eight brain regions with lower FA due to heading.

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While further research is necessary to understand gender differences in this realm and to establish protection guidelines, the “study provides preliminary support that women are more sensitive to these types of head impacts at the level of brain tissue microstructure,” Lipton said.

Last year, Lipton and his colleagues found that soccer players who frequently head the ball are three times are likely to experience concussion symptoms than players who don’t.

But the new research is not about concussions. It’s about subconcussive injuries.

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Subconcussive or repeat blows (common in contact sports like soccer) are believed to lead to the neurodegenerative disease chronic traumatic encephalopathy, or CTE. While immediate problems may not be easily identifiable, over time, damage may lead to personality changes, mood disorders and other behavioral issues.

Currently, headers are not permitted for athletes 10 and younger. But Richard Blackwell of Tucker hopes headers will be eliminated for teens as well, he told The Atlanta Journal-Constitution.

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Blackwell’s 16-year-old daughter died of suicide last year after battling months of depression and anxiety, personality shifts he believes were intensified by subconcussive soccer injuries.

“What the data tells us is that there’s something unique about being hit in the head more than once,” said Dr. Russell Gore, a neurologist at Shepherd Complex Concussion Clinic in Atlanta, told The AJC earlier this year. “The risk for secondary symptoms automatically goes up and gets exacerbated after the injury.”

Read the full study published in the journal Radiology.