Research Reports - Soccer heading is associated with white matter microstructural and cognitive abnormalities

Radiology. 2013 Jun 20

Lipton ML, Kim N, Zimmerman ME, Kim M, Stewart WF, Branch CA, Lipton RB

Purpose:To investigate the association of soccer heading with subclinical
evidence of traumatic brain injury.Materials and Methods:With institutional
review board approval and compliance with HIPAA guidelines, 37 amateur soccer
players (mean age, 30.9 years; 78% [29] men, 22% [eight] women) gave written
informed consent and completed a questionnaire to quantify heading in the prior
12 months and lifetime concussions. Diffusion-tensor magnetic resonance (MR)
imaging at 3.0 T was performed (32 directions; b value, 800 sec/mm(2); 2 × 2 ×
2-mm voxels). Cognitive function was measured by using a computerized battery of
tests. Voxelwise linear regression (heading vs fractional anisotropy [FA]) was
applied to identify significant regional associations. FA at each location and
cognition were tested for a nonlinear relationship to heading by using an inverse
logit model that incorporated demographic covariates and history of
concussion.Results:Participants had headed 32-5400 times (median, 432 times) over
the previous year. Heading was associated with lower FA at three locations in
temporo-occipital white matter with a threshold that varied according to location
(885-1550 headings per year) (P < .00001). Lower levels of FA were also
associated with poorer memory scores (P < .00001), with a threshold of 1800
headings per year. Lifetime concussion history and demographic features were not
significantly associated with either FA or cognitive
performance.Conclusion:Heading is associated with abnormal white matter
microstructure and with poorer neurocognitive performance. This relationship is
not explained by a history of concussion.

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