Hostname: page-component-5f745c7db-2kk5n Total loading time: 0 Render date: 2025-01-06T13:19:56.408Z Has data issue: true hasContentIssue false
  • English
  • Français

Recent and Long-Term Soccer Heading Exposure Is Differentially Associated With Neuropsychological Function in Amateur Players

Published online by Cambridge University Press:  22 August 2017

Cara F. Levitch Open the ORCID record for Cara F. Levitch [Opens in a new window] ,
Molly E. Zimmerman ,
Naomi Lubin ,
Namhee Kim ,
Richard B. Lipton ,
Walter F. Stewart ,
Mimi Kim  and
Michael L. Lipton
Cara F. Levitch
Affiliation:
Fordham University, Department of Psychology, Bronx, New York
Molly E. Zimmerman
Affiliation:
Fordham University, Department of Psychology, Bronx, New York Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, Bronx, New York
Naomi Lubin
Affiliation:
Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, Bronx, New York Albert Einstein College of Medicine and Montefiore Medical Center, Gruss Magnetic Resonance Research Center, Bronx, New York
Namhee Kim
Affiliation:
Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, Bronx, New York Albert Einstein College of Medicine and Montefiore Medical Center, Gruss Magnetic Resonance Research Center, Bronx, New York
Richard B. Lipton
Affiliation:
Albert Einstein College of Medicine and Montefiore Medical Center, Department of Neurology, Bronx, New York Albert Einstein College of Medicine and Montefiore Medical Center, Department of Epidemiology & Population Health, Bronx, New York
Walter F. Stewart
Affiliation:
Sutter Health Research, Walnut Creek, California
Mimi Kim
Affiliation:
Albert Einstein College of Medicine and Montefiore Medical Center, Department of Epidemiology & Population Health, Bronx, New York
Michael L. Lipton*
Affiliation:
Albert Einstein College of Medicine and Montefiore Medical Center, Department of Radiology, Bronx, New York Albert Einstein College of Medicine and Montefiore Medical Center, Gruss Magnetic Resonance Research Center, Bronx, New York Albert Einstein College of Medicine and Montefiore Medical Center, Department of Psychiatry & Behavioral Sciences, Bronx, New York The Dominick P. Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York
*
Correspondence and reprint requests to: Michael L. Lipton, Albert Einstein College of Medicine, 1300 Morris Park Avenue, MRRC, Room 219C, Bronx, NY 10461. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: The present study examined the relative contribution of recent or long-term heading to neuropsychological function in amateur adult soccer players. Participants and Methods: Soccer players completed a baseline questionnaire (HeadCount-12m) to ascertain heading during the prior 12 months (long-term heading, LTH) and an online questionnaire (HeadCount-2w) every 3 months to ascertain heading during the prior 2 weeks (recent heading, RH). Cogstate, a battery of six neuropsychological tests, was administered to assess neuropsychological function. Generalized estimating equations were used to test if LTH or RH was associated with neuropsychological function while accounting for the role of recognized concussion. Results: A total of 311 soccer players completed 630 HeadCount-2w. Participants had an average age of 26 years. Participants headed the ball a median of 611 times/year (mean=1,384.03) and 9.50 times/2 weeks (mean=34.17). High levels of RH were significantly associated with reduced performance on a task of psychomotor speed (p=.02), while high levels of LTH were significantly associated with poorer performance on tasks of verbal learning (p=.03) and verbal memory (p=.04). Significantly better attention (p=.02) was detectable at moderately high levels of RH, but not at the highest level of RH. One hundred and seven (34.4%) participants reported a lifetime history of concussion, but this was not related to neuropsychological function and did not modify the association of RH or LTH with neuropsychological function. Conclusion: High levels of both RH and LTH were associated with poorer neuropsychological function, but on different domains. The clinical manifestations following repetitive exposure to heading could change with chronicity of exposure. (JINS, 2018, 24, 147–155)

Keywords

Brain injurySportCognitive impairmentSoccerHeadingRepetitive head trauma
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 2 , February 2018 , pp. 147 - 155
Copyright
Copyright © The International Neuropsychological Society 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Adams, J., Adler, C.M., Jarvis, K., DelBello, M.P., & Strakowski, S.M. (2007). Evidence of anterior temporal atrophy in college-level soccer players. Clinical Journal of Sport Medicine, 17(4), 304–306. doi: 10.1097/JSM.0b013e31803202c8 Google Scholar
Belanger, H.G., & Vanderploeg, R.D. (2005). The neuropsychological impact of sports-related concussion: A meta-analysis. Journal of the International Neuropsychological Society, 11(4), 345–357.Google Scholar
Benjamini, Y., & Hochberg, Y. (1995). Controlling the false discovery rate: A practical and powerful approach to multiple testing. Journal of the Royal Statistical Society. Series B (Methodological), 57(1), 289–300. doi: citeulike-article-id:1042553 doi: 10.2307/2346101 Google Scholar
Catenaccio, E., Caccese, J., Wakschlag, N., Fleysher, R., Kim, N., Kim, M., & Kaminski, T. (2016). Validation and calibration of HeadCount, a self-report measure for quantifying heading exposure in soccer players. Research in Sports Medicine, 24, 416–425.Google Scholar
Comstock, R.D., Currie, D.W., Pierpoint, L.A., Grubenhoff, J.A., & Fields, S.K. (2015). An evidence-based discussion of heading the ball and concussions in high school soccer. JAMA Pediatrics, 169(9), 830–837. doi: 10.1001/jamapediatrics.2015.1062 Google Scholar
Davidson, P.S., Troyer, A.K., & Moscovitch, M. (2006). Frontal lobe contributions to recognition and recall: Linking basic research with clinical evaluation and remediation. Journal of the International Neuropsychological Society, 12(2), 210–223. doi: 10.1017/S1355617706060334 Google Scholar
Di Virgilio, T.G., Hunter, A., Wilson, L., Stewart, W., Goodall, S., Howatson, G., & Ietswaart, M. (2016). Evidence for acute electrophysiological and cognitive changes following routine soccer heading. EBioMedicine, 13, 66–71. doi: 10.1016/j.ebiom.2016.10.029 Google Scholar
Downs, D.S., & Abwender, D. (2002). Neuropsychological impairment in soccer athletes. The Journal of Sports Medicine and Physical Fitness, 42(1), 103–107.Google Scholar
Echemendia, R.J., & Julian, L.J. (2001). Mild traumatic brain injury in sports: Neuropsychology’s contribution to a developing field. Neuropsychology Review, 11(2), 69–88.Google Scholar
FIFA. (2007). FIFA big count 2006. Retrieved from http://www.fifa.com/mm/document/fifafacts/bcoffsurv/bigcount.statspackage_7024.pdf.Google Scholar
Gavett, B.E., Stern, R.A., & McKee, A.C. (2011). Chronic traumatic encephalopathy: A potential late effect of sport-related concussive and subconcussive head trauma. Clinics in Sports Medicine, 30(1), 179–188, xi. doi: 10.1016/j.csm.2010.09.007 Google Scholar
Hardin, J.W. (2005). Generalized estimating equations (GEE). Wiley Online Library.Google Scholar
Janda, D.H., Bir, C.A., & Cheney, A.L. (2002). An evaluation of the cumulative concussive effect of soccer heading in the youth population. Injury Control and Safety Promotion, 9(1), 25–31. doi: 10.1076/icsp.9.1.25.3324 Google Scholar
Johnson, V.E., Stewart, W., & Smith, D.H. (2013). Axonal pathology in traumatic brain injury. Experimental Neurology, 246, 35–43. doi: 10.1016/j.expneurol.2012.01.013 Google Scholar
Kaminski, T.W., Cousino, E.S., & Glutting, J.J. (2008). Examining the relationship between purposeful heading in soccer and computerized neuropsychological test performance. Research Quarterly for Exercise and Sport, 79(2), 235–244. doi: 10.1080/02701367.2008.10599486 Google Scholar
Koerte, I.K., Ertl-Wagner, B., Reiser, M., Zafonte, R., & Shenton, M.E. (2012). White matter integrity in the brains of professional soccer players without a symptomatic concussion. JAMA, 308(18), 1859–1861. doi: 10.1001/jama.2012.13735 Google Scholar
Lezak, M.D. (2004). Neuropsychological assessment. New York: Oxford University Press.Google Scholar
Lingsma, H., & Maas, A. (2017). Heading in soccer: More than a subconcussive event? Neurology, 88(9), 822–823. doi: 10.1212/WNL.0000000000003679 Google Scholar
Lipton, M.L., Kim, N., Zimmerman, M.E., Kim, M., Stewart, W.F., Branch, C.A., & Lipton, R.B. (2013). Soccer heading is associated with white matter microstructural and cognitive abnormalities. Radiology, 268(3), 850–857. doi: 10.1148/radiol.13130545 Google Scholar
Maher, M.E., Hutchison, M., Cusimano, M., Comper, P., & Schweizer, T.A. (2014). Concussions and heading in soccer: A review of the evidence of incidence, mechanisms, biomarkers and neurocognitive outcomes. Brain Injury, 28(3), 271–285. doi: 10.3109/02699052.2013.865269 CrossRefGoogle ScholarPubMed
Maruff, P., Thomas, E., Cysique, L., Brew, B., Collie, A., Snyder, P., & Pietrzak, R.H. (2009). Validity of the CogState brief battery: Relationship to standardized tests and sensitivity to cognitive impairment in mild traumatic brain injury, schizophrenia, and AIDS dementia complex. Archives of Clinical Neuropsychology, 24(2), 165–178. doi: 10.1093/arclin/acp010 CrossRefGoogle ScholarPubMed
Matser, E.J., Kessels, A.G., Lezak, M.D., Jordan, B.D., & Troost, J. (1999). Neuropsychological impairment in amateur soccer players. JAMA, 282(10), 971–973.CrossRefGoogle ScholarPubMed
Matser, J.T., Kessels, A.G., Jordan, B.D., Lezak, M.D., & Troost, J. (1998). Chronic traumatic brain injury in professional soccer players. Neurology, 51(3), 791–796.Google Scholar
Matser, J.T., Kessels, A.G., Lezak, M.D., & Troost, J. (2001). A dose-response relation of headers and concussions with cognitive impairment in professional soccer players. Journal of Clinical and Experimental Neuropsychology, 23(6), 770–774. doi: 10.1076/jcen.23.6.770.1029 Google Scholar
Orme, D.R., Johnstone, B., Hanks, R., & Novack, T. (2004). The WRAT-3 reading subtest as a measure of premorbid intelligence among persons with brain injury. Rehabilitation Psychology, 49(3), 250–253. doi: 10.1037/0090-5550.49.3.250 Google Scholar
Putukian, M., Echemendia, R.J., & Mackin, S. (2000). The acute neuropsychological effects of heading in soccer: A pilot study. Clinical Journal of Sport Medicine, 10(2), 104–109.Google Scholar
Rodrigues, A.C., Lasmar, R.P., & Caramelli, P. (2016). Effects of soccer heading on brain structure and function. Frontiers in Neurology, 7, 38. doi: 10.3389/fneur.2016.00038 Google Scholar
Rutherford, A., Stephens, R., Fernie, G., & Potter, D. (2009). Do UK university football club players suffer neuropsychological impairment as a consequence of their football (soccer) play? Journal of Clinical and Experimental Neuropsychology, 31(6), 664–681. doi: 10.1080/13803390802484755 Google Scholar
Rutherford, A., Stephens, R., & Potter, D. (2003). The neuropsychology of heading and head trauma in Association Football (soccer): A review. Neuropsychological Review, 13(3), 153–179.CrossRefGoogle ScholarPubMed
Rutherford, A., Stephens, R., Potter, D., & Fernie, G. (2005). Neuropsychological impairment as a consequence of football (soccer) play and football heading: Preliminary analyses and report on university footballers. Journal of Clinical and Experimental Neuropsychology, 27(3), 299–319. doi: 10.1080/13803390490515504 CrossRefGoogle ScholarPubMed
Sharp, D.J., Scott, G., & Leech, R. (2014). Network dysfunction after traumatic brain injury. Nature Reviews. Neurology, 10(3), 156–166. doi: 10.1038/nrneurol.2014.15 CrossRefGoogle ScholarPubMed
Sortland, O., & Tysvaer, A.T. (1989). Brain damage in former association football players. An evaluation by cerebral computed tomography. Neuroradiology, 31(1), 44–48.Google Scholar
Spiotta, A.M., Bartsch, A.J., & Benzel, E.C. (2012). Heading in soccer: Dangerous play? Neurosurgery, 70(1), 1–11; discussion 11. doi: 10.1227/NEU.0b013e31823021b2 Google Scholar
Stephens, R., Rutherford, A., Potter, D., & Fernie, G. (2005). Neuropsychological impairment as a consequence of football (soccer) play and football heading: A preliminary analysis and report on school students (13-16 years). Child Neuropsychology, 11(6), 513–526. doi: 10.1080/092970490959629 CrossRefGoogle ScholarPubMed
Stephens, R., Rutherford, A., Potter, D., & Fernie, G. (2010). Neuropsychological consequence of soccer play in adolescent U.K. School team soccer players. The Journal of Neuropsychiatry and Clinical Neurosciences, 22(3), 295–303. doi: 10.1176/appi.neuropsych.22.3.295 10.1176/jnp.2010.22.3.295 Google Scholar
Stewart, W.F., Kim, N., Ifrah, C.S., Lipton, R.B., Bachrach, T.A., Zimmerman, M.E., & Lipton, M.L. (2017). Symptoms from repeated intentional and unintentional head impact in soccer players. Neurology, 88, 901–908. doi: 10.1212/WNL.0000000000003657 Google Scholar
Tysvaer, A.T., & Lochen, E.A. (1991). Soccer injuries to the brain. A neuropsychologic study of former soccer players. The American Journal of Sports Medicine, 19(1), 56–60.Google Scholar
Webbe, F.M., & Ochs, S.R. (2003). Recency and frequency of soccer heading interact to decrease neurocognitive performance. Applied Neuropsychology, 10(1), 31–41. doi: 10.1207/S15324826AN1001_5 CrossRefGoogle ScholarPubMed
Wilkinson, G.S., & Robertson, G. (2006). Wide range achievement test (WRAT4). Lutz, FL: Psychological Assessment Resources.Google Scholar
Witol, A.D., & Webbe, F.M. (2003). Soccer heading frequency predicts neuropsychological deficits. Archives of Clinical Neuropsychology, 18(4), 397–417.Google Scholar
Supplementary material: File

Levitch supplementary material 1

Supplementary Table

Download Levitch supplementary material 1(File)
File 18 KB