Soccer players may face risk of CTE, research suggests

The degenerative brain condition Chronic Traumatic Encephalopathy may pose a serious threat to soccer players, a group typically not considered at particular risk for the disorder, researchers at the Boston University CTE Center recently discovered.

CTE is commonly found in otherwise healthy, high-intensity athletes with histories of multiple head impacts or concussions. Over time, CTE causes severe brain degeneration that can lead to memory and information processing problems, personality changes and an increased risk of suicide, said Ann McKee, BU CTE Center’s neuropathologist and a professor of neurology and pathology at BU’s School of Medicine.

“Certainly there’s been a lot of resistance, that we’ve experienced at least, to the concept that individuals who play non-helmeted sports like soccer and rugby could be susceptible to CTE,” McKee said.

Until now, the condition was mostly seen as a threat to football players, boxers and other athletes in high-impact sports, McKee said.

The BU CTE Center recorded the first definitive diagnosis of CTE in a former soccer player. Patrick Grange, who played soccer in college, passed away in April 2012 at the age of 29 after a battle with amyotrophic lateral sclerosis, also known as ALSa and Lou Gehrig’s Disease.

Researchers at BU’s CTE Center then contacted Grange’s family and requested they consider donating his brain for study, which the family agreed to do. Postmortem studies by the BU researchers led to Grange’s diagnosis with CTE.

McKee said her team was “suspicious” that head impacts in soccer could possibly lead to CTE, and that motor neuron diseases such as ALS and CTE were correlated.

McKee and other researchers said the practice of heading the ball might account for a link between CTE and soccer.

“According to [Patrick’s parents], he headed the ball constantly, and even as early as three years old,” Dr. McKee said. “Of course, we can’t prove anything with this case, but it’s suspicious.”

Michael Lipton, associate director of the Gruss Magnetic Resonance Research Center at Yeshiva University’s Albert Einstein College of Medicine, has extensively studied the effects of repetitive head injury on soccer players.

Lipton said though Grange’s case was significant, he was not surprised by the BU CTE Center’s findings.

“Unfortunately there is still a very widespread sense that soccer is not really a collision or contact sport,” he said. “The increased recognition of the prevalence of head injury in soccer, and at least the potential that heading is a form of cumulative brain injury, that’s very important to put on the radar.”

Researchers said though some of the evidence in Grange’s case points to a correlation between heading a ball and CTE, they have been careful not to draw conclusions too quickly from their findings.

“My suspicion is that we will find out that over time, the multiple repetitive impacts from heading are not good for the brain, but whether that alone is able to support the development of CTE is really not known,” Lipton said. “The evidence does not yet exist to support a definitive rule change to avert the problem.”

Nancy Feldman, the head coach of BU’s women’s soccer team, said more research on the link between CTE and soccer should be conducted before any discussion about changing the game can take place.

“We all, in sports, need to be concerned about head injuries,” Feldman said. “But I don’t think we can say, based on one case, that we can make a link between long-term injuries and heading the ball.”

Feldman said due to existing concerns about concussions and other injuries, soccer players on her team are taught proper heading techniques and practice heading carefully to avoid brain trauma.

“The relationship between many sports and head injuries deserves more research,” she said. “If it’s something that can help us protect athletes more, then we need to get more information.”