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      Concussion in soccer: a comprehensive review of the literature

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          Abstract

          Sports-related concussion has been examined extensively in collision sports such as football and hockey. However, historically, lower-risk contact sports such as soccer have only more recently garnered increased attention. Here, we review articles examining the epidemiology, injury mechanisms, sex differences, as well as the neurochemical, neurostructural and neurocognitive changes associated with soccer-related concussion. From 436 titles and abstracts, 121 full texts were reviewed with a total of 64 articles identified for inclusion. Concussion rates are higher during competitions and in female athletes with purposeful heading rarely resulting in concussion. Given a lack of high-level studies examining sports-related concussion in soccer, clinicians and scientists must focus research efforts on large-scale data gathering and development of improved technologies to better detect and understand concussion.

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          Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury.

          Ann C McKee, Robert Cantu, Christopher J Nowinski … (2009)
          Since the 1920s, it has been known that the repetitive brain trauma associated with boxing may produce a progressive neurological deterioration, originally termed dementia pugilistica, and more recently, chronic traumatic encephalopathy (CTE). We review 48 cases of neuropathologically verified CTE recorded in the literature and document the detailed findings of CTE in 3 profession althletes, 1 football player and 2 boxers. Clinically, CTE is associated with memory disturbances, behavioral and personality changes, parkinsonism, and speech and gait abnormalities. Neuropathologically, CTE is characterized by atrophy of the cerebral hemispheres, medial temporal lobe, thalamus, mammillary bodies, and brainstem, with ventricular dilatation and a fenestrated cavum septum pellucidum. Microscopically, there are extensive tau-immunoreactive neurofibrillary tangles, astrocytic tangles, and spindle-shaped and threadlike neurites throughout the brain. The neurofibrillary degeneration of CTE is distinguished from other tauopathies by preferential involvement of the superficial cortical layers, irregular patchy distribution in the frontal and temporal cortices, propensity for sulcal depths, prominent perivascular, periventricular, and subpial distribution, and marked accumulation of tau-immunoreactive astrocytes. Deposition of beta-amyloid, most commonly as diffuse plaques, occurs in fewer than half the cases. Chronic traumatic encephalopathy is a neuropathologically distinct slowly progressive tauopathy with a clear environmental etiology.
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            Epidemiology of mild traumatic brain injury and neurodegenerative disease.

            Raquel Gardner, Kristine Yaffe (2015)
            Every year an estimated 42 million people worldwide suffer a mild traumatic brain injury (MTBI) or concussion. More severe traumatic brain injury (TBI) is a well-established risk factor for a variety of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS). Recently, large epidemiological studies have additionally identified MTBI as a risk factor for dementia. The role of MTBI in risk of PD or ALS is less well established. Repetitive MTBI and repetitive sub-concussive head trauma have been linked to increased risk for a variety of neurodegenerative diseases including chronic traumatic encephalopathy (CTE). CTE is a unique neurodegenerative tauopathy first described in boxers but more recently described in a variety of contact sport athletes, military veterans, and civilians exposed to repetitive MTBI. Studies of repetitive MTBI and CTE have been limited by referral bias, lack of consensus clinical criteria for CTE, challenges of quantifying MTBI exposure, and potential for confounding. The prevalence of CTE is unknown and the amount of MTBI or sub-concussive trauma exposure necessary to produce CTE is unclear. This review will summarize the current literature regarding the epidemiology of MTBI, post-TBI dementia and Parkinson's disease, and CTE while highlighting methodological challenges and critical future directions of research in this field. This article is part of a Special Issue entitled SI:Traumatic Brain Injury.
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              Epidemiology of Sports-Related Concussion in NCAA Athletes From 2009-2010 to 2013-2014: Incidence, Recurrence, and Mechanisms.

              Scott Zuckerman, Zachary Kerr, Aaron Yengo-Kahn … (2015)
              The epidemiology of sports-related concussion (SRC) among student-athletes has been extensively researched. However, recent data at the collegiate level are limited.
              Article 0 comments Cited 158 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Concussion
                Journal ID (iso-abbrev): Concussion
                Journal ID (publisher-id): CNC
                Title: Concussion
                Publisher: Future Medicine Ltd (London, UK )
                ISSN (Electronic): 2056-3299
                Publication date (Electronic, pub): 01 July 2020
                Publication date (Electronic, collection): September 2020
                Publication date PMC-release: 01 July 2020
                Volume: 5
                Issue: 3
                Electronic Location Identifier: CNC76
                Affiliations
                [1 ]Department of Neurosurgery, University of Alabama at Birmingham, 1813 6th Ave S #516, Birmingham, AL 35233, USA
                [2 ]Department of Neurosurgery, Mayo Clinic, 4500 San Pablo Rd S, Jacksonville, FL 32224, USA
                [3 ]Department of Neurosurgery, Brigham & Women’s Hospital, Harvard Medical School, 75 Francis St, Boston, MA 02115, USA
                Author notes
                [* ]Author for correspondence: Tel.: +1 205 996 0071; Fax: +1 205 975 8439; jamesmooney@ 123456uabmc.edu
                Author information
                https://orcid.org/0000-0003-1897-1879
                Article
                DOI: 10.2217/cnc-2020-0004
                PMC ID: 7506470
                PubMed ID: 33005435
                SO-VID: 14a6463d-c445-4971-9b4c-429584926b03
                Copyright © © 2020 James Mooney
                License:

                This work is licensed under the Creative Commons Attribution 4.0 License

                History
                Date received : 02 April 2020
                Date accepted : 22 May 2020
                Date: 01 July 2020
                Page count
                Pages: 15
                Categories
                Subject: Review

                Keywords: football,repetitive subconcussive head impact,soccer,sport injuries,sport-related concussion,traumatic brain injury
                Data availability:
                Keywords: football, repetitive subconcussive head impact, soccer, sport injuries, sport-related concussion, traumatic brain injury

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