MRI Study Suggests Repetitive Soccer Heading May Lead to Brain Abnormalities in ‘Locations Most Characteristic of CTE’

Emerging research with diffusion magnetic resonance imaging (dMRI) indicates that frequent soccer heading may result in significant brain abnormalities.

In a new study, which will be presented at the Radiological Society of North America (RSNA) conference, researchers reviewed estimated repetitive head impacts (RHI) data and diffusion MRI results from 380 healthy adult soccer players (ranging between 18-53 years of age) and 82 athletes playing non-collision sports (ranging between 18-50 years of age).

When examining dMRI findings in the highest quartile of RHI, the researchers noted associations with lower fractional anisotropy (FA), higher radial diffusivity (RD) and a higher orientation dispersion index (ODL) in the frontal lobe (FL), orbitofrontal cortex (OFC), parietal lobe (PL), temporal lobe (TL) and occipital lobe (OL).¹

The researchers also emphasized that the majority of the cohort had no history of concussion or a previous diagnosis of traumatic brain injury.

"The study identifies structural brain abnormalities from repeated head impacts among healthy athletes," noted Michael L. Lipton, M.D., Ph.D., a senior author of the study and a professor of radiology at Columbia University Irvine Medical Center in New York, N.Y. "The abnormalities occur in the locations most characteristic of CTE (chronic traumatic encephalopathy), are associated with worse ability to learn a cognitive task and could affect function in the future."

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Noting that RHI-related microstructural injuries were particularly prominent in the depths of sulci (DoS) and juxtacortical white matter (jWM), the study authors said jWM and ODI in the OFC provided partial mediation of the association between worse verbal learning and more frequent RHI.

"Our analysis showed that the white matter abnormalities represent a mechanism by which heading leads to worse cognitive performance," noted Dr. Lipton.

Reference

1. Demessie B, Stewart WF, Lipton R, et al. In vivo detection of pathology at the depths of cortical sulci in sports repetitive head impacts. Poster to be presented at the Radiological Society of North America (RSNA) 2024 110th Scientific Assembly and Annual Meeting Dec. 1-5, 2024. Available at: https://www.rsna.org/annual-meeting .