The neurological, neuroimaging and neuropsychological effects of playing professional football: Results of the UK five-year follow-up study

Abstract

Background: Whilst the scientific understanding of mild traumatic brain injury sequelae has advanced, the consequences of neurological insults sustained during football play in the form of multiple concussions and heading remains unclear.

Method: To the authors’ knowledge, this is the first longitudinal prospective study to follow-up a group of footballers and controls over time. Thirty-two elite young professional footballers were recruited and 24 were identified at follow-up. Thirty-three controls were recruited and 17 identified at follow-up. Medical examination, MRI (brain) imaging and detailed neuropsychological data were collected on the footballers at baseline and 5-year follow-up. Medical examination and detailed neuropsychological data were collected on the controls at baseline and 5-year follow-up.

Results: All participants had normal neurological examination at both time points. At baseline, 37% of the footballers had sustained minor neurological insults. Between baseline and 5 years, 66% of the footballers had sustained minor neurological insults. No MRI (brain) abnormalities were identified among the footballers at either time point. Regarding the neuropsychology, there was a 6-point IQ difference between footballers and controls, with the footballers being low. Test–re-test analysis on a range of carefully selected neurocognitive tests revealed a picture of good stability in cognitive functioning over this 5-year period.

Conclusions: These longitudinal prospective data indicate no significant neurological, structural brain imaging or neuropsychological change among a sample of young elite professional footballers over the first 5 years of their professional career.

Keywords:

• Heading
• concussion
• football
• neuropsychology
• neurology

Acknowledgements

The authors would like to thank Dr. Andrew Rutherford, Keele University for his guidance on the preparation of this manuscript. They would also like to thank Dr. Tufail Patankar, Consultant Neuroradiologist, for reviewing the MRI (brain) scans in conference with the research team post peer review. The work was initiated by an award from the Football Association (FA).

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.