Heading a football may cause more damage to the brain than previously believed, according to new research.
Evidence has been building of a link between head injuries in sport and chronic traumatic encephalopathy (CTE), a progressive brain disease with symptoms including memory loss, confusion, mood changes and behavioural problems.
Scientists were keen to know whether heading the ball would cause brain injuries, so they used MRI scans to analyse microstructure close to the surface of the organ, comparing the results of 352 male and female amateur footballers, with those of 77 non-collision-sport athletes, such as runners.
Most had never suffered from concussion or been diagnosed with a traumatic brain injury. But the scans showed evidence of brain damage in areas where it is seen in CTE.
“This raises concern for delayed adverse effects of head impacts,” said senior study author, Dr Michael Lipton, a professor of radiology at Columbia University Irving Medical Centre in New York.
“The abnormalities occur in the locations most characteristic of CTE, are associated with worse ability to learn a cognitive task and could affect function in the future.”
Footballers who headed the ball regularly showed abnormalities in the brain’s white matter, near the deep grooves in the brain’s surface – damage known to occur in very severe traumatic brain injuries.
They were worst in the brain’s frontal lobe – the area most susceptible to damage from trauma and frequently impacted during heading. More headers were associated with poorer verbal learning, according to the findings which will be presented next week at the annual meeting of the Radiological Society of North America.
The researchers said the results suggest that abnormalities in white matter represent a mechanism by which heading leads to worse cognitive performance.
The next phase of the study is under way, he added, and examines brain mechanisms underlying the MRI findings and potential protective factors.
In 2020, England World Cup legend Sir Geoff Hurst called for a ban on children heading footballs after four of his former teammates died of dementia. A fifth, Bobby Charlton, has since died of the disease.
The Football Association brought in a phased ban of deliberate heading in grass-roots youth football across England in April for all under-seven to under-nine matches, to be expanded to under-10s in 2025-26 and under-11s the season after. Deliberately heading the ball results in the opposing team being awarded an indirect free-kick under the new rule.
Concussion and head injuries have also been linked to brain diseases in other sports, including rugby and American football. A study released this week linked concussion with the slowing of brain activity in high school American football players, which was "strongly associated" with worse post-concussion cognitive symptoms and test scores.
A number of sports people who have suffered brain injuries have sued their governing bodies for not doing enough to protect them from known harm. Steve Thompson is among a group of dozens of rugby players suing his sport's authorities for negligence over brain injuries they have suffered. Mr Thompson was diagnosed with early onset dementia in his early 40s in 2020 and has said he cannot remember playing in England’s World Cup final win over Australia in 2003 or receiving a MBE from Queen Elizabeth II afterwards.
