Impact of repetitive soccer heading on brain health outcomes: a narrative review.

Abstract

Repetitive head impacts (RHIs) from soccer heading pose significant risks to brain health and cognitive function. While concussions are well-recognized, RHIs often lack immediate symptoms, potentially leading to gradual neurocognitive decline over time. This narrative review synthesizes current research on the effects of soccer heading on brain structure, cognitive skills, and mental well-being. Advanced neuroimaging studies reveal that frequent heading is linked to microstructural changes in white matter, impaired neurovascular coupling, and an increased risk of neurodegenerative conditions, such as chronic traumatic encephalopathy (CTE). Athletes with high exposure to heading frequently experience cognitive and psychological difficulties, including memory problems, executive dysfunction, anxiety, and depression. The variability in research findings indicates that factors such as age, sex, heading technique, and overall exposure may influence individual vulnerability to RHIs. The review explores potential preventive strategies, including protective headgear, neck strengthening exercises, behavioural training, and policy changes to limit heading in youth soccer. Despite these efforts, inconsistencies in the literature highlight the urgent need for longitudinal studies and standardized research methods to evaluate the long-term effects of soccer heading. This review emphasizes the critical need for awareness and regulatory measures to enhance player safety while maintaining the integrity of the sport.