Evidence for Acute Electrophysiological and Cognitive Changes Following Routine Soccer Heading

Abstract

IntroductionThere is growing concern around the effects of concussion and sub-concussive impacts in sport. Routine game-play in soccer involves intentional and repeated head impacts through ball heading. Although heading is frequently cited as a risk to brain health, little data exist regarding the consequences of this activity. This study aims to assess the immediate outcomes of routine football heading using direct and sensitive measures of brain function.MethodsNineteen amateur football players (5 females; age 22 ± 3 y) headed machine-projected soccer balls at standardized speeds, modelling routine soccer practice. The primary outcome measure of corticomotor inhibition measured using transcranial magnetic stimulation, was assessed prior to heading and repeated immediately, 24 h, 48 h and 2 weeks post-heading. Secondary outcome measures were cortical excitability, postural control, and cognitive function.ResultsImmediately following heading an increase in corticomotor inhibition was detected; further to these electrophysiological alterations, measurable reduction memory function were also found. These acute changes appear transient, with values normalizing 24 h post-heading.DiscussionSub-concussive head impacts routine in soccer heading are associated with immediate, measurable electrophysiological and cognitive impairments. Although these changes in brain function were transient, these effects may signal direct consequences of routine soccer heading on (long-term) brain health which requires further study.

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

“…Repetitive head impacts reported in soccer athletes have associations with neuropsychological impairment as well as abnormal white matter microstructure (Koerte, Ertl-Wagner, Reiser, Zafonte, & Shenton, 2012; Lipton et al, 2013), structural brain changes (Adams, Adler, Jarvis, DelBello, & Strakowski, 2007; Sortland & Tysvaer, 1989), and electro-physiological changes (Di Virgilio et al, 2016). Of these studies, there is a suggestion that the types of neuropsychological function impacted may vary depending on the duration of the exposure.…”

Concussion, dementia and CTE: are we getting it very wrong?

“…The message is that concussion is a dangerous condition that causes a complex neuropsychiatric disorder, chronic traumatic encephalopathy (CTE), with a neuropsychiatric phenotype of mood change, irritability and suicidal behaviour which develops over time into a neurodegenerative disorder and death 1. Increasing alarm has followed, and it has been suggested that this is not just a disorder of elite sportsman but a problem for youth sport and that even heading a football (soccer) may cause dementia,2 a terrifying prospect for those parents trying to decide whether to allow their children to participate in sports.…”

The Neurophysiological Response Following Sub-Concussive Soccer Heading

“…However, these limitations should not detract from the novel and innovative study presented by Di Virgilio et al (2016). Indeed the evidence from this study demonstrates that repeat sub-concussive head impacts affect the brain physiologically.…”

“…To address the issue of measuring the direct functional outcome effects of sub-concussion, Di Virgilio et al (2016) utilize the technique of single-pulse transcranial magnetic stimulation (TMS). A well-established and non-invasive technique to measure motor threshold, corticospinal conduction time, motor cortex excitability and intracortical inhibition (Kobayashi and Pascual-Leone, 2003), TMS has been used previously to determine neurophysiological changes following acute concussion events (Pearce et al, 2015) as well as long-term chronic neurological impairments in contact sport athletes with a history of multiple concussions (Pearce et al, 2014, Major et al, 2015).…”

“…The study by Di Virgilio et al (2016) presents important novel data demonstrating transient changes in neurophysiological function and cognitive performance following a single exposure repetitive sub-concussive head impacts via routine soccer heading. Their data demonstrates that, despite showing no clinical signs or symptoms of concussion, repetitive impacts to the head from routine soccer heading increased intracortical inhibition, as well as performance outcome declines in short- and long-term memory.…”