The neuropsychology of heading and head trauma in Association Football (soccer): a review

Neuropsychol Rev. 2003 Sep;13(3):153-79. doi: 10.1023/a:1025525613477.


Association Football (soccer) is the most popular and widespread sport in the world. A significant proportion of the injuries suffered in football are head injuries involving trauma to the brain. In normal play, head trauma frequently arises from collisions, but some researchers have claimed that it also may arise as a consequence of heading the ball. Although assessments based on biomechanical analyses are equivocal on the potential for brain injury due to football heading, a growing literature seems to support the claim that neuropsychological impairment results from general football play and football heading in particular. However, this review suggests a distinction is required between the neuropsychological effects of concussive and subconcussive head trauma and that all of the neuropsychological studies conducted so far suffer from methodological problems. At best, a few of these studies may be regarded as exploratory. The review concludes that presently, although there is exploratory evidence of subclinical neuropsychological impairment as a consequence of football-related concussions, there is no reliable and certainly no definitive evidence that such impairment occurs as a result of general football play or normal football heading. The neuropsychological consequences of football-related subconcussive effects await confirmatory investigation.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Alcoholism
  • Apolipoprotein E4
  • Apolipoproteins E / genetics
  • Brain Concussion / etiology
  • Brain Injuries / etiology
  • Confounding Factors, Epidemiologic
  • Craniocerebral Trauma* / diagnosis
  • Craniocerebral Trauma* / epidemiology
  • Craniocerebral Trauma* / etiology
  • Cumulative Trauma Disorders / etiology
  • Dementia
  • Diagnostic Imaging
  • Electroencephalography
  • Evaluation Studies as Topic
  • Head / physiopathology
  • Humans
  • Neuropsychological Tests
  • Soccer*


  • Apolipoprotein E4
  • Apolipoproteins E