Frequent ball heading rather than unintentional head impacts due to collisions causes cognition impairment said researchers at Albert Einstein College of Medicine have found. Efforts to reduce long-term brain injuries may be focusing too narrowly on preventing accidental head collisions. Heading has been associated with transient cognitive problems.

Three hundred and eight amateur soccer players in New York City filled questionnaires detailing their recent (previous two weeks) soccer activity, including heading and unintentional head impacts. Participants also completed neuropsychological tests of verbal learning, verbal memory, psychomotor speed, attention and working memory. The players ranged in age from 18 to 55, and 78 percent were male.

Players headed soccer balls an average of 45 times during the two weeks covered by the questionnaire. During that time, about one-third of the players suffered at least one unintentional head impact- kicks to the head or head-to head, head-to-ground, or head-to-goalpost collisions. Players who reported the most headings had the poorest performance on psychomotor speed and attention tasks, which are areas of functioning known to be affected by brain injury.

Heading frequency also correlated with poorer performance on the working memory task, although the association was of borderline significance. In contrast, unintentional head impacts were not related to any aspect of cognitive performance. The changes in cognitive function did not cause clinical impairment, subtle, even transient reductions in neuropsychological function from heading could translate to microstructural changes in the brain that lead to persistently impaired function. Heading is a potential cause of brain injury, soccer players should reduce heading during practice and soccer games.
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