Cognitive Risk-Benefit Analysis of Playing Soccer—New Grant

More than 25 million Americans play soccer, the world’s most popular sport. Soccer significantly benefits brain health by boosting aerobic capacity and oxygen and blood flow to the brain, but it also has a downside: Recent studies show that highly repetitive heading of the ball is associated with structural brain changes and worse cognitive performance similar to brain damage caused by concussion.

Researchers at Albert Einstein College of Medicine have now received a five-year, $3.4 million grant from the National Institutes of Health (NIH) to fund a study employing neuroimaging, exercise testing and cognitive testing that assesses the trade-offs between soccer’s aerobic brain benefits and the adverse effects from heading.

Soccer players and their parents have been rightly warned about the potential risks of heading in soccer, but it leads to mixed messages about the wisdom of playing the sport,” said Michael L. Lipton, MD, PhD, Professor of Radiology and Psychiatry and Behavioral Sciences; Associate Professor, Dominick P. Purpura Department of Neuroscience; Associate Director, Gruss Magnetic Resonance Research Center; and Medical Director, MRI Services, Montefiore Einstein. “This grant will allow us to determine soccer’s trade-offs with respect to brain health so that people can make informed decisions, and we can establish evidence-based guidelines for heading.”

Dr. Lipton’s previous studies have found that adult amateur soccer players who head more than a thousand times in a year exhibit worse cognitive performance and structural brain changes not found in those who head much less or not at all. Additional findings by Dr. Lipton have shown that heading is worse for women’s brainsthan for men’s.

What we want to determine in our new study is whether soccer’s benefits mitigate the adverse effects of heading for cognitive performance—and, if so, whether a threshold level of aerobic activity is required to confer protection,” he said.

The new study will enroll 280 young men and women—a group including 140 soccer players with high (70) and low (70) exposure to heading, 70 non-collision athletes and 70 nonathletes. At the start of the study and again two years later, participants will be tested to measure their aerobic capacity, undergo MRI brain scans to determine their white-matter structure, and will complete detailed surveys and testing to assess their cognitive status. Based on their results, Dr. Lipton and his colleagues will determine whether soccer’s aerobic benefits counterbalance the damage sustained from heading. The researchers will also investigate whether genetic factors and gender may explain individual differences in the results.

The grant, titled “Heading and Soccer: understanding cognitive risks, benefits, and the potential mediating role of white matter,” was provided by the National Institute of Neurological Disorders and Stroke, part of the NIH. (R01NS123374)