Soccer-Related Concussions Among Swedish Elite Soccer Players: A Descriptive Study of 1,030 Players

Hänni, Sofie; Vedung, Fredrik; Tegner, Yelverton; Marklund, Niklas; Johansson, Jimmy

doi:10.3389/fneur.2020.510800

Cited by 8 publications

(8 citation statements)

References 38 publications

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“…53,104 In a study of more than 1000 Swedish soccer players, about 35% experienced a concussion, of whom 10% were during the last season. 104 And 12 of 40 soccer players with evident white matter integrity only had a history of subconcussive head impact. 79 That raises the question whether soccer players, without symptomatic concussion,…”

Section: Discussionmentioning

confidence: 99%

“…96,101 A higher risk of persisting symptoms (headache, fatigue), and worse performance on neuropsychological testing is observed in soccer players with a history of previous concussion. 97,[102][103][104] If the symptoms of the soccer player combined with video-analysis suggest a concussion, there are specific diagnostic tools to substantiate the diagnosis: the Standardized Assessment of Concussion can be used directly, 103 the Sport Concussion Assessment Tool (SCAT5) is applied off-field. 105…”

Section: Diagnosismentioning

confidence: 99%

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Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases

Hageman,

Nihom

2023

Clinical Journal of Sport Medicine

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Objective: Exposure to repetitive sports-related concussions or (sub)concussive head trauma may lead to chronic traumatic encephalopathy (CTE). Which impact (heading or concussion) poses the greatest risk of CTE development in soccer players? Design: Narrative review. Setting: Teaching hospital and University of Applied sciences. Patients: A literature search (PubMed) was conducted for neuropathologic studies in the period 2005-December 2022, investigating soccer players with dementia and a CTE diagnosis, limited to English language publications. 210 papers were selected for final inclusion, of which 7 papers described 14 soccer players. Assessment: Magnetic resonance imaging studies in soccer players show that lifetime estimates of heading numbers are inversely correlated with cortical thickness, grey matter volume, and density of the anterior temporal cortex. Using diffusion tensor imaging–magnetic resonance imaging, higher frequency of headings—particularly with rotational accelerations—are associated with impaired white matter integrity. Serum neurofilament light protein is elevated after heading. Main Outcome Measures: Chronic traumatic encephalopathy pathology, history of concussion, heading frequency. Results: In 10 of 14 soccer players, CTE was the primary diagnosis. In 4 cases, other dementia types formed the primary diagnosis and CTE pathology was a concomitant finding. Remarkably, 6 of the 14 cases had no history of concussion, suggesting that frequent heading may be a risk for CTE in patients without symptomatic concussion. Rule changes in heading duels, management of concussion during the game, and limiting the number of high force headers during training are discussed. Conclusions: Data suggest that heading frequency and concussions are associated with higher risk of developing CTE in (retired) soccer players. However based on this review of only 14 players, questions persist as to whether or not heading is a risk factor for CTE or long-term cognitive decline.

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Section: Discussionmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases

Hageman,

Nihom

2023

Clinical Journal of Sport Medicine

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“…For example, in an experimental study in adult male rats given two traumatic head impacts, separated by either 24 h or 3 days [72], when the second mTBI was given during the first injury cerebral glucose metabolism recovery (CMRg) period (24 h) it prolonged the CMRg dysfunction and animal behavioural impairments compared to the longer time interval. It may take up to a week or more for symptoms to resolve following a concussion [73]. Merchant-Borna et al [74] developed a series of exposure metrics for an epidemiological study of American Football players based on a weighting of PLA and other measures of head impact by the inverse of the time between hits and/or the time interval from hit to post-season health assessment.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review of Head Impacts and Acceleration Associated with Soccer

Basinas

McElvenny

Pearce

et al. 2022

IJERPH

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Epidemiological studies of the neurological health of former professional soccer players are being undertaken to identify whether heading the ball is a risk factor for disease or premature death. A quantitative estimate of exposure to repeated sub-concussive head impacts would provide an opportunity to investigate possible exposure-response relationships. However, it is unclear how to formulate an appropriate exposure metric within the context of epidemiological studies. We have carried out a systematic review of the scientific literature to identify the factors that determine the magnitude of head impact acceleration during experiments and from observations during playing or training for soccer, up to the end of November 2021. Data were extracted from 33 experimental and 27 observational studies from male and female amateur players including both adults and children. There was a high correlation between peak linear and angular accelerations in the observational studies (p < 0.001) although the correlation was lower for the experimental data. We chose to rely on an analysis of maximum or peak linear acceleration for this review. Differences in measurement methodology were identified as important determinants of measured acceleration, and we concluded that only data from accelerometers fixed to the head provided reliable information about the magnitude of head acceleration from soccer-related impacts. Exposures differed between men and women and between children and adults, with women on average experiencing higher acceleration but less frequent impacts. Playing position appears to have some influence on the number of heading impacts but less so on the magnitude of the head acceleration. Head-to-head collisions result in high levels of exposure and thus probably risk causing a concussion. We concluded, in the absence of evidence to the contrary, that estimates of the cumulative number of heading impacts over a playing career should be used as the main exposure metric in epidemiological studies of professional players.

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“…13,[25][26] In some cases, athletes who sustain multiple untreated concussions may have poorer long-term outcomes and can be vulnerable to persistent symptoms such as memory loss and depression over 20 years after ending their careers. [27][28] The role of factors such as age, sex, and genetic makeup in concussion incidence and recurrence are not fully understood. 24,29 Neidecker et al showed that female adolescent athletes have a longer duration of symptoms following first-time concussion compared to male athletes, with women remaining symptomatic for a median of 28 days compared to 11 days for their male counterparts.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review and Meta-Analysis of Sex-Based Differences in Recurrent Concussion Incidence Across Sports

et al. 2022

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BACKGROUND: Disparities in concussion incidence exist on the basis of sex. This meta-analysis aimed to summarize the evidence for recurrent concussion incidence between male and female athletes across various sports. METHODS: Systematic review and meta-analysis. Data Sources - PubMed, EMBASE, and Cochrane Library databases. Eligibility Criteria for Selecting Studies - Studies written in English containing sex comparisons of recurrent concussion data published between January 2000 and June 2021 were included. RESULTS: A total of 1,509 records were identified, of which 114 studies were assessed for eligibility with full-text review. Six studies were ultimately included. Women were found to have more recurrent concussions than men across all sex-comparable sports, which included soccer, basketball, and baseball/softball [RR=2.16 (95% CI: 1.09-4.30)]. More specifically, women were found to have more recurrent concussions in soccer [RR=3.01 (95% CI: 2.08-4.35)] and basketball [RR=2.68 (95% CI: 1.39-5.17)], but inconclusive results were seen for baseball/softball [RR=2.54 (95% CI: 0.54-11.94)]. CONCLUSION: Recurrent concussion rates are greater in sex-comparable women’s sports than in men’s sports. Not all sports had sufficient evidence for inclusion in the meta-analysis. There are sex differences in recurrent concussion incidence in soccer and basketball.

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Soccer-Related Concussions Among Swedish Elite Soccer Players: A Descriptive Study of 1,030 Players

Cited by 8 publications

References 38 publications

Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases

Chronic Traumatic Encephalopathy in Soccer Players: Review of 14 Cases

A Systematic Review of Head Impacts and Acceleration Associated with Soccer

Systematic Review and Meta-Analysis of Sex-Based Differences in Recurrent Concussion Incidence Across Sports

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