Researchers studying the effects of "heading" a soccer ball noted that players may also injure their brains by slamming into one another or hitting the ground or a goal post. (Alexander Gallardo / Los Angeles Times / November 14, 2012)
Scans
of 12 pros show damage resembling that of patients with mild traumatic brain
injury, scientists say. But it's not certain that heading caused the damage.
Soccer players who repeatedly strike the ball with their heads may be
causing measurable damage to their brains, even if they never suffer a
concussion, according to a study published Tuesday by the Journal of the
American Medical Assn. By examining brain scans of a dozen professional soccer players from
Germany, researchers found a pattern of damage that strongly resembled that of
patients with mild traumatic brain injury, said Dr. Inga Katharina Koerte, a
neuroradiologist at Boston's Brigham and Women's Hospital, who led the study.
Koerte and her colleagues focused on the athletes' white matter, the
interior portion of the brain that carries signals from nerve cells to the
spinal cord. They tracked the movement of individual water molecules within the
brain tissue to see whether the atoms moved in a narrow linear pattern or in a
random, diffuse pattern. Movement along a narrow track suggested the molecules
were being hemmed in by healthy fibers. Diffusion, however, suggested that
brain tissue had suffered some form of damage and could no longer restrict the
movement of water molecules.
Using a high-resolution MRI technique called diffusion tensor imaging,
the researchers observed microscopic changes in the frontal, temporal and
occipital lobes — regions that control attention, visual processing, higher
thinking and memory. The research team also scanned the brains of 11
professional swimmers, who served as controls. Their brains showed much less
damage. "The origin of these results is not clear," said senior study
author Martha Shenton, a neuroscience researcher at the VA Boston Healthcare
System. Although frequent "heading" of the ball may be to blame,
other factors — such as falling to the ground or hitting goal posts or crashing
into other players — could play a role as well, she said.
According to the U.S. Consumer Product Safety Commission, which
maintains a national database of injuries, 40% of soccer concussions are the
result of collisions between players, while roughly 13% are because of players
heading the ball. Though the study is small and preliminary, it is likely to
fuel an already heated debate. While the danger of concussion among football
has been widely studied, only recently have researchers begun to examine the
risks faced by soccer players.
Statistics offered by the American Assn. of Neurological Surgeons
suggest that soccer players, particularly young ones, are much less likely to
suffer concussions than other athletes. In 2009, soccer players under the age
of 15 suffered 8,392 concussions, according to the group. In contrast,
bicyclists in that age group suffered 40,272 concussions; football players,
21,878; and baseball and softball players, 18,246. However, the JAMA study focused
on "sub-concussive" injuries, impacts that were not strong enough to
cause a concussion. In selecting their soccer-player subjects, researchers
included only men who had never reported suffering a concussion and had never
been diagnosed with one by a physician.
None of the abnormalities seen in the study were apparent on
conventional MRIs. Diffusion tensor imaging is revealing previously
unobservable brain injuries, but it's unclear whether the white matter changes
seen in this study would cause any problems, said Dr. Robert Harbaugh, director
of the Penn State Institute of the Neurosciences, who was not involved in the
study. "It's way too early to make that next step and say, 'Well, if we
see this, we should really worry about people playing soccer because they're
going to get dementia at age 50,'" Harbaugh said. "I don't think
we've got anything like that kind of information." At the American Youth
Soccer Organization, which oversees some 900 soccer groups nationwide, safety
officials said head injuries and concussions were the hottest topic of late.
Karen Mihara, director of AYSO's Safe Haven program, said the
organization had adopted recommendations put forth by the Centers for Disease
Control and Prevention to deal with head injuries. Players, parents, coaches
and officials must get instructions on how to identify concussion symptoms.
When signs of concussion are recognized, players must be removed from play for
the day and parents are urged to take their child to a physician for treatment.
Players must obtain a medical release before being allowed to play again. AYSO
has also experimented with special helmets for heading, but they did not
provide added protection, Mihara said. "What we've found in some cases is
the opposite effect, especially with younger children," she said.
"They feel they're protected and play with reckless abandon more than they
might if they didn't have it."
Source: Chicago Tribune
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