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To the Editor: The article by Dr Matser and colleagues¹ is the latest in an increasingly worrisome series of studies documenting subtle brain injury among longtime soccer players. Brain atrophy,² electroencephalographic changes,³ and deficits in memory, concentration, and alertness⁴ have been documented in veteran professional soccer players. Matser et al found that amateur soccer players performed significantly worse in tests of memory and planning than did control runners and swimmers, and that the degree of cognitive impairment correlated with the number of concussions previously incurred, leading to chronic traumatic brain injury.

There are 2 explanations for subtle brain injury among soccer players. One is that soccer players sustain repeated mild concussions from impacts with other players, high kicks, or falling to the ground.^{1, 5} The other explanation is that repeated blows to the head occur because of legal "heading," in which a player deliberately redirects the ball with the head.^{2, 4} Data . . . [Full Text of this Article]

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Neuropsychological Impairment in Amateur Soccer Players
Erik J. T. Matser, Alphons G. Kessels, Muriel D. Lezak, Barry D. Jordan, and Jaap Troost
JAMA. 1999;282(10):971-973.
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