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Erik J. T. Matser, MSc; Alphons G. Kessels, MD; Muriel D. Lezak, PhD; Barry D. Jordan, MD; Jaap Troost, MD

JAMA. 1999;282:971-973.

Context  Soccer players incur concussions during matches and training sessions, as well as numerous subconcussive blows to the head from impacts with the soccer ball (headers). The combination of soccer-related concussions and the number of headers may be a risk for chronic traumatic brain injury (CTBI).

Objective  To determine whether amateur soccer players have evidence of CTBI.

Design, Setting, and Participants  Cross-sectional study of 33 amateur soccer players and 27 amateur athletes involved in swimming and track (controls) in the Netherlands who underwent interviews and neuropsychological testing.

Main Outcome Measures  Performance of soccer players vs controls on 16 neuropsychological tests having 27 outcomes.

Results  Compared with control athletes, amateur soccer players exhibited impaired performance on tests of planning (39% vs 13%; P=.001) and memory (27% vs 7%; P=.004). Among soccer players, 9 (27%) had incurred 1 soccer-related concussion and 7 (23%) had had 2 to 5 concussions during their career. The number of concussions incurred in soccer was inversely related to the neuropsychological performance on 6 of the neuropsychological tests.

Conclusions  Our results indicate that participation in amateur soccer in general and concussion specifically is associated with impaired performance in memory and planning functions. Due to the worldwide popularity of soccer, these observations may have important public health implications.

Author Affiliations: Department of Neuropsychology and Sports Neurology, St Anna Hospital, Geldrop, the Netherlands (Dr Matser); Department of Anatomy, Faculty of Medicine and Health Sciences, Erasmus University, Rotterdam, the Netherlands (Dr Matser); Research Unit Patient Care (Dr Kessels) and Department of Neurology (Dr Troost), University Hospital of Maastricht, Maastricht, the Netherlands; Department of Neurology, Oregon Health Sciences University, Portland (Dr Lezak); and Traumatic Brain Injury Program, Burke Rehabilitation Hospital, White Plains, NY (Dr Jordan).

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