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A well-used soccer tactic may be causing more harm to players than initially thought.

A new report being presented this week at the Radiological Society of North America’s annual meeting says that heading a ball may be more damaging to the brain than previous studies have shown.

The report looked at links between heading and neurodegenerative diseases like chronic traumatic encephalopathy (CTE), which has gained attention over the years in contact sports like football and hockey.

While past reports have raised concerns about repeatedly using the head to pass the ball, take a shot on net or defend an attempt, the new study found that players who employ the tactic at a higher level than others “showed abnormality of the brain’s white matter.

“Abnormalities in this region of the brain are known to occur in very severe traumatic brain injuries,” the reports says.

“The abnormalities were most prominent in the frontal lobe of the brain, an area most susceptible to damage from trauma and frequently impacted during soccer heading.”

The study compared the brain MRIs of 352 male and female amateur soccer players between the ages of 18 and 53 to those of 77 “non-collision sport” athletes, including runners.

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Researchers also used a new approach to the advanced brain imaging technique of diffusion MRI to “analyze microstructure close to the surface of the brain.

“The potential effects of repeated head impacts in sport are much more extensive than previously known and affect locations similar to where we’ve seen CTE pathology,” said senior study author Michael L. Lipton, a professor of radiology at Columbia University Irving Medical Center in New York. “This raises concern for delayed adverse effects of head impacts.”

The study found that “more repetitive head impacts” were linked to poorer verbal learning and cognitive performance, Lipton said.

More concerning was that most participants had never sustained a concussion or been diagnosed with a traumatic brain injury, suggesting that repeated blows to the head that don’t result in a serious injury may still be damaging to the brain.

“Characterizing the potential risks of repetitive head impacts can facilitate safer sport engagement to maximize benefits while minimizing potential harms,” said Lipton, who added the next phase of the study examines the “brain mechanisms underlying the MRI effects and potential protective factors.”

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