The Grapevine

Women Soccer Players More Prone To Brain Damage Than Men, Study Suggests

Female soccer players may be more vulnerable to injury from heading the ball compared to their male counterparts, according to researchers from the Albert Einstein College of Medicine, New York.

The study titled "MRI-defined White Matter Microstructural Alteration Associated with Soccer Heading Is More Extensive in Women than Men" was published in Radiology on July 31.

Around 30 million women and girls around the world play soccer, as per estimates from a survey conducted by the International Federation of Association Football.

"Researchers and clinicians have long noticed that women fare worse following head injury than men, but some have said that's only because women are more willing to report symptoms,” said lead author Dr. Michael L. Lipton, professor of radiology and of psychiatry and behavioral sciences at Einstein.

"Based on our study, which measured objective changes in brain tissue rather than self-reported symptoms, women do seem more likely than men to suffer brain trauma from heading soccer balls."

Heading refers to a popular but risky technique used in the game, as it involves the player using their unprotected head to pass, shoot or clear the ball. 

"In general, men do a lot more heading than women, but we wanted to specifically examine if men and women fare similarly or differently with a similar amount of exposure to repeated impacts to the head," said Dr. Lipton.

The research team recruited 98 amateur soccer players (49 male players and 49 female players) who all had many years of soccer and heading exposure.

An advanced MRI technique was used to examine fractional anisotropy (FA), which is the measurement of how water molecules move in the brain.

When the white matter of the brain is in healthy condition, the FA measure is high, indicating that the water movement is uniform. But a decline in the FA may indicate something inflammation or loss of neurons.

All the participants provided FA measurements for analysis, revealing a link between lower FA values and more repetitive heading. While this was observed among both male and female players, the latter appeared to be more sensitive to the impact of heading.

"In both groups, this effect we see in the brain's white matter increased with greater amounts of heading," Dr. Lipton said. "But women exhibit about five times as much microstructural abnormality as men when they have similar amounts of heading exposure."

In 2015, the United States Soccer Federation recommended a ban on heading for players at or under the age of 10, which was later implemented in the player safety guidelines.

However, Dr. Lipton stated the new study only provided preliminary support, requiring more research to establish clear gender differences in brain tissue sensitivity.

"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," he said.