Relationship of soccer heading to computerized neurocognitive performance and symptoms among female and male youth soccer players. 

 Kontos AP, Dolese A, Elbin RJ, Covassin T, Warren BL. Brain Inj. 2011;25(12):1234-41.

Soccer has grown in popularity in the United States this past decade and the number of youths and high school participants has increased as well. This has resulted in a higher number of injuries in youth soccer, with 2% being concussions. These head injuries can result from head-to-head collisions, contact with the ground or goalposts, and with heading the ball. Previous studies have had mixed results linking the effects of soccer heading and neurocognitive impairment and symptoms. Not many studies have focused on youth soccer players or compared males and females directly. The primary purpose of this study was to compare the effects of low, moderate, and high heading exposure among male and female youth soccer players on neurocognitive performance and testing. The differences between sexes were examined, as well as, comparing results to 10th percentile norms. A total of 63 youth soccer players (27 F, 36 M) were divided into 3 groups based on observed soccer heading exposure recorded by the researchers over a 2 hour period of play: low (0-5 headers/game), moderate (6-10), and high (>10). Players underwent ImPACT testing prior to the final practice of the season. No significant differences were found between the three groups with ImPACT scores or symptoms. The players in the study scored significantly higher on all ImPACT scores compared to the 10th percentile (unusually low) of age- and sex-matched published normative data. Females significantly outperformed males on verbal memory, visual memory, and motor processing speed scores. No differences between sexes were found with reaction time or symptoms.

The importance of how concussions affect our youth in the United States has been increasing both with research and in the media. This study looked at the potentially at-risk population of male and female youth soccer players. The authors did not find a relationship between observed headers and neurocognitive performance among any of the different heading exposure groups in this study. The authors found that the players scored significantly higher when compared to the 10th percentile norms, which unless they were having moderate symptoms, would be expected. An improvement to this study could be to use players who have baseline ImPACT scores and compare changes at the end of a season. This would be a more accurate and precise assessment of any changes in players neurocognitive performance and/or symptoms. This could also give more information to the differences found between males and females in this study and tell us if it’s due to increased heading exposure or gender. A larger picture question is if negative changes are found to be associated with repetitive heading in youths, what changes would be made to the sport? We need to continue to obtain more research about repetitive sub-concussive blows to the head, such as headers, and how it affects brain health over time, especially with our youth beginning competitive sports at younger ages.

Written by: Kris Fayock, MD, and Peter Vitanzo, MD
Reviewed by: Stephen Thomas

Related Posts:
Cumulative Head Impact Burden in High School Football
Reliability of the Online Version of ImPact in High School Athletes

Kontos AP, Dolese A, Elbin RJ, Covassin T, & Warren BL (2011). Relationship of soccer heading to computerized neurocognitive performance and symptoms among female and male youth soccer players. Brain Injury, 25 (12), 1234-41 PMID: 21902552