Concussion: Women football players' brains at greater risk from headers

Microscopic abnormalities in tissue which can disrupt normal flow five times more abundant in women

Former professional players have called for more research on long-term health effects of repeated head knocks

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Women may be at a greater risk of harming their brains while playing football than their male counterparts, according to a study on the long-term changes in brain tissue caused by heading the ball.

Abnormalities in the brain’s white matter were five times as pronounced in women after a year of intensive football where the average number of balls headed by men was 487 per year and 469 per year for women.

If further studies confirm the long-term health impacts of these findings, the authors suggest there may be cause for gender-specific guidelines on safe play.

“In both groups, this effect we see in the brain’s white matter increased with greater amounts of heading,” said Dr Michael Lipton, a professor of radiology who led the study at Montefiore Medical Centre in New York.

“But women exhibit about five times as much microstructural abnormality as men when they have similar amounts of heading exposure.”

The findings are part of a growing body of research which has been called for by former players, including ex-England star Alan Shearer, to understand the long-term health effects of repeated minor head impacts.

Traumatic brain injuries, which include concussion, cause damage and abnormalities to the brain’s white matter that are associated with significantly increased risks of dementia and other conditions.

While heading a football is less serious than a concussion or other serious brain injury, there is measurable impact on the brain’s structures from repeated blows.

Football is the world’s most popular sport by participation and, according to a 2014 survey of women’s football by Fifa, there are more than 30 million female players globally – so a small impact could affect lots of people.

Using an advanced form of MRI scanning known as diffusion tensor imaging (DTI), the researchers were able to assess these microscopic changes in 98 amateur football players’ brains.

DTI scanners provide a measure of how freely water molecules can move around the brain, a measure called fractional anisotropy (FA). In healthy white matter, the tissue which connects the bundles of nerve cells in the grey matter and allows signals to jump between brain regions, water flows uniformly. In abnormal brain tissue these molecules are scattered, giving a lower FA score.

“A decline in FA is an indicator of changes in the white matter microstructure that may be indicative of inflammation or loss of neurons, for example,” Dr Lipton said.

The results, published in the journal Radiology on Tuesday, also found these abnormalities affect a larger proportion of women’s brain regions, compared to men. However the study did not test what health effects were experienced in later life and whether these increased in people with more abnormalities.

“We don’t have enough information yet to establish guidelines to protect the players,” Dr Lipton added. “But by understanding these relationships – how different people have different levels of sensitivity to heading – we can get to the point of determining the need for gender-specific recommendations for safer soccer play.”