[{"doi":"10.1136/bmjsem-2025-002636","article_number":"e002636","language":[{"iso":"eng"}],"publication_status":"published","date_updated":"2026-01-19T13:01:46Z","intvolume":" 11","year":"2025","title":"High-magnitude headers are not associated with structural and functional brain changes in active high-level football (soccer) players","author":[{"full_name":"Mund, Franziska Katharina","first_name":"Franziska Katharina","last_name":"Mund"},{"full_name":"Feddermann-Demont, Nina","first_name":"Nina","last_name":"Feddermann-Demont"},{"first_name":"Goetz H","last_name":"Welsch","full_name":"Welsch, Goetz H"},{"full_name":"Schuenemann, Carsten","last_name":"Schuenemann","first_name":"Carsten"},{"first_name":"Jens","last_name":"Fiehler","full_name":"Fiehler, Jens"},{"first_name":"Christian","last_name":"Thaler","full_name":"Thaler, Christian"},{"full_name":"Meyer, Lukas","first_name":"Lukas","last_name":"Meyer"},{"full_name":"Reeschke, Rebecca","last_name":"Reeschke","first_name":"Rebecca"},{"last_name":"Reinsberger","first_name":"Claus","full_name":"Reinsberger, Claus"}],"publication_identifier":{"issn":["2055-7647"]},"type":"journal_article","department":[{"_id":"176"},{"_id":"35"}],"date_created":"2026-01-19T12:52:36Z","abstract":[{"lang":"eng","text":"\r\n Objectives\r\n To date, consistent evidence for consequences of heading in football (soccer) on the structure and function of the brain is lacking, but first studies indicate a potential effect of specific high-magnitude headers. The purpose of this longitudinal, prospective study was to investigate whether potential structural and/or functional alterations within the brain were associated with (high-magnitude) heading.\r\n \r\n \r\n Methods\r\n 3T MRI sequences were obtained from active high-level male players before and after an observation period of 17.2 months (median). Cortical thickness and grey matter (GM) volume were investigated on a whole-brain level. Functional connectivity (FC) was analysed in the default mode network (DMN) and salience network (SN). During the observation period, each training and each match was videotaped and evaluated regarding the heading exposure. Significant structural and functional findings were subsequently correlated with specific header characteristics.\r\n \r\n \r\n Results\r\n 14 included participants (mean age: 20.36±3.34 years) played 5822 headers. GM volume remained unchanged, whereas cortical thickness decreased minimally from pre-measurement to post-measurement in a left precentral region (mean change: 0.048±0.128 mm; clusterwise p=0.0416). Within the SN, FC increased in one cluster (false discovery rate corrected p=0.026). FC remained stable within the DMN and between DMN and SN. Change from pre-measurement to post-measurement for the significant results did not correlate with heading variables.\r\n \r\n \r\n Conclusion\r\n Our findings may indicate no cumulative effect of heading during the observation period. As these results contrast with cross-sectional findings, more longitudinal, prospective studies with a greater sample size are urgently needed to understand potential heading effects.\r\n "}],"publication":"BMJ Open Sport & Exercise Medicine","issue":"4","user_id":"63237","volume":11,"_id":"63659","publisher":"BMJ","status":"public","citation":{"bibtex":"@article{Mund_Feddermann-Demont_Welsch_Schuenemann_Fiehler_Thaler_Meyer_Reeschke_Reinsberger_2025, title={High-magnitude headers are not associated with structural and functional brain changes in active high-level football (soccer) players}, volume={11}, DOI={10.1136/bmjsem-2025-002636}, number={4e002636}, journal={BMJ Open Sport & Exercise Medicine}, publisher={BMJ}, author={Mund, Franziska Katharina and Feddermann-Demont, Nina and Welsch, Goetz H and Schuenemann, Carsten and Fiehler, Jens and Thaler, Christian and Meyer, Lukas and Reeschke, Rebecca and Reinsberger, Claus}, year={2025} }","chicago":"Mund, Franziska Katharina, Nina Feddermann-Demont, Goetz H Welsch, Carsten Schuenemann, Jens Fiehler, Christian Thaler, Lukas Meyer, Rebecca Reeschke, and Claus Reinsberger. “High-Magnitude Headers Are Not Associated with Structural and Functional Brain Changes in Active High-Level Football (Soccer) Players.” BMJ Open Sport & Exercise Medicine 11, no. 4 (2025). https://doi.org/10.1136/bmjsem-2025-002636.","ama":"Mund FK, Feddermann-Demont N, Welsch GH, et al. High-magnitude headers are not associated with structural and functional brain changes in active high-level football (soccer) players. BMJ Open Sport & Exercise Medicine. 2025;11(4). doi:10.1136/bmjsem-2025-002636","short":"F.K. Mund, N. Feddermann-Demont, G.H. Welsch, C. Schuenemann, J. Fiehler, C. Thaler, L. Meyer, R. Reeschke, C. Reinsberger, BMJ Open Sport & Exercise Medicine 11 (2025).","ieee":"F. K. Mund et al., “High-magnitude headers are not associated with structural and functional brain changes in active high-level football (soccer) players,” BMJ Open Sport & Exercise Medicine, vol. 11, no. 4, Art. no. e002636, 2025, doi: 10.1136/bmjsem-2025-002636.","mla":"Mund, Franziska Katharina, et al. “High-Magnitude Headers Are Not Associated with Structural and Functional Brain Changes in Active High-Level Football (Soccer) Players.” BMJ Open Sport & Exercise Medicine, vol. 11, no. 4, e002636, BMJ, 2025, doi:10.1136/bmjsem-2025-002636.","apa":"Mund, F. K., Feddermann-Demont, N., Welsch, G. H., Schuenemann, C., Fiehler, J., Thaler, C., Meyer, L., Reeschke, R., & Reinsberger, C. (2025). High-magnitude headers are not associated with structural and functional brain changes in active high-level football (soccer) players. BMJ Open Sport & Exercise Medicine, 11(4), Article e002636. https://doi.org/10.1136/bmjsem-2025-002636"}},{"citation":{"short":"L. Weike, R. Reeschke, C. Reinsberger, BMJ Open Sport & Exercise Medicine 11 (2025).","chicago":"Weike, Lea, Rebecca Reeschke, and Claus Reinsberger. “Clinical Symptom Clusters, Neurocognitive Function, Balance and Vestibulo-Ocular Function in Athletes with Sport-Related Concussion.” BMJ Open Sport & Exercise Medicine 11, no. 3 (2025). https://doi.org/10.1136/bmjsem-2024-002447.","ieee":"L. Weike, R. Reeschke, and C. Reinsberger, “Clinical symptom clusters, neurocognitive function, balance and vestibulo-ocular function in athletes with sport-related concussion,” BMJ Open Sport & Exercise Medicine, vol. 11, no. 3, Art. no. e002447, 2025, doi: 10.1136/bmjsem-2024-002447.","apa":"Weike, L., Reeschke, R., & Reinsberger, C. (2025). Clinical symptom clusters, neurocognitive function, balance and vestibulo-ocular function in athletes with sport-related concussion. BMJ Open Sport & Exercise Medicine, 11(3), Article e002447. https://doi.org/10.1136/bmjsem-2024-002447","bibtex":"@article{Weike_Reeschke_Reinsberger_2025, title={Clinical symptom clusters, neurocognitive function, balance and vestibulo-ocular function in athletes with sport-related concussion}, volume={11}, DOI={10.1136/bmjsem-2024-002447}, number={3e002447}, journal={BMJ Open Sport & Exercise Medicine}, publisher={BMJ}, author={Weike, Lea and Reeschke, Rebecca and Reinsberger, Claus}, year={2025} }","ama":"Weike L, Reeschke R, Reinsberger C. Clinical symptom clusters, neurocognitive function, balance and vestibulo-ocular function in athletes with sport-related concussion. BMJ Open Sport & Exercise Medicine. 2025;11(3). doi:10.1136/bmjsem-2024-002447","mla":"Weike, Lea, et al. “Clinical Symptom Clusters, Neurocognitive Function, Balance and Vestibulo-Ocular Function in Athletes with Sport-Related Concussion.” BMJ Open Sport & Exercise Medicine, vol. 11, no. 3, e002447, BMJ, 2025, doi:10.1136/bmjsem-2024-002447."},"status":"public","volume":11,"user_id":"33213","_id":"61006","publisher":"BMJ","abstract":[{"lang":"eng","text":"\r\n Objective\r\n This cross-sectional study aimed to investigate subjective and objective deficits of neurocognitive function, balance and vestibulo-ocular performance in athletes with sport-related concussion (SRC) compared with healthy control athletes.\r\n \r\n \r\n Methods\r\n 72 patients with SRC and 72 matched healthy controls were included. All participants performed computerised testing of neurocognitive function, device-assisted balance testing and objective evaluation of vestibulo-ocular function (video head impulse and dynamic visual acuity test). Clinical symptom clusters (headache/migraine, anxiety/mood, fatigue, cognitive, vestibular, ocular) were determined for each patient using the Sport Concussion Assessment Tool, 5th edition symptom evaluation. Independent t-tests or Mann-Whitney U tests were calculated to test for group differences in the whole cohort and according to clinical symptom clusters.\r\n \r\n \r\n Results\r\n When investigating the whole cohort, significant differences between patients with SRC and control subjects were found in one parameter of balance testing (sway velocity double-firm), with lower performance in the SRC group (p<0.001, r=0.345). The number of symptom clusters assigned to the SRC patients ranged from 0 (no definite cluster) to 6 (all clusters), and all clusters were frequent in the investigated cohort. Patients with vestibular, cognitive and fatigue symptom clusters demonstrated significantly lower performance in balance testing compared with SRC patients without those clusters (p<0.001 to p=0.005, r=0.368–0.439). Additionally, SRC patients presenting with symptoms of the fatigue cluster demonstrated significantly worse performance in vestibulo-ocular testing compared with SRC patients without the fatigue cluster (p=0.006, d=0.781).\r\n \r\n \r\n Conclusion\r\n SRC patients presented with variable numbers and qualities of clinical symptom clusters. Some subjective clusters were associated with abnormal objective tests of other clusters (vestibular, cognitive and fatigue with abnormal balance; and fatigue with abnormal vestibulo-ocular performance). Clinical symptom clusters and their overlap should be considered when examining patients with SRC.\r\n "}],"publication":"BMJ Open Sport & Exercise Medicine","issue":"3","department":[{"_id":"35"},{"_id":"176"},{"_id":"17"}],"type":"journal_article","date_created":"2025-08-25T15:45:20Z","intvolume":" 11","date_updated":"2025-08-27T08:41:19Z","publication_status":"published","publication_identifier":{"issn":["2055-7647"]},"author":[{"full_name":"Weike, Lea","last_name":"Weike","first_name":"Lea"},{"id":"44893","first_name":"Rebecca","last_name":"Reeschke","full_name":"Reeschke, Rebecca"},{"first_name":"Claus","last_name":"Reinsberger","full_name":"Reinsberger, Claus","id":"48978"}],"title":"Clinical symptom clusters, neurocognitive function, balance and vestibulo-ocular function in athletes with sport-related concussion","year":"2025","doi":"10.1136/bmjsem-2024-002447","language":[{"iso":"eng"}],"article_number":"e002447"},{"volume":7,"user_id":"46","_id":"32451","publisher":"BMJ","status":"public","citation":{"ama":"Gokeler A, Benjaminse A, Della Villa F, Tosarelli F, Verhagen E, Baumeister J. Anterior cruciate ligament injury mechanisms through a neurocognition lens: implications for injury screening. BMJ Open Sport & Exercise Medicine. 2021;7(2). doi:10.1136/bmjsem-2021-001091","bibtex":"@article{Gokeler_Benjaminse_Della Villa_Tosarelli_Verhagen_Baumeister_2021, title={Anterior cruciate ligament injury mechanisms through a neurocognition lens: implications for injury screening}, volume={7}, DOI={10.1136/bmjsem-2021-001091}, number={2e001091}, journal={BMJ Open Sport & Exercise Medicine}, publisher={BMJ}, author={Gokeler, Alli and Benjaminse, Anne and Della Villa, Francesco and Tosarelli, Fillippo and Verhagen, Evert and Baumeister, Jochen}, year={2021} }","mla":"Gokeler, Alli, et al. “Anterior Cruciate Ligament Injury Mechanisms through a Neurocognition Lens: Implications for Injury Screening.” BMJ Open Sport & Exercise Medicine, vol. 7, no. 2, e001091, BMJ, 2021, doi:10.1136/bmjsem-2021-001091.","short":"A. Gokeler, A. Benjaminse, F. Della Villa, F. Tosarelli, E. Verhagen, J. Baumeister, BMJ Open Sport & Exercise Medicine 7 (2021).","chicago":"Gokeler, Alli, Anne Benjaminse, Francesco Della Villa, Fillippo Tosarelli, Evert Verhagen, and Jochen Baumeister. “Anterior Cruciate Ligament Injury Mechanisms through a Neurocognition Lens: Implications for Injury Screening.” BMJ Open Sport & Exercise Medicine 7, no. 2 (2021). https://doi.org/10.1136/bmjsem-2021-001091.","apa":"Gokeler, A., Benjaminse, A., Della Villa, F., Tosarelli, F., Verhagen, E., & Baumeister, J. (2021). Anterior cruciate ligament injury mechanisms through a neurocognition lens: implications for injury screening. BMJ Open Sport & Exercise Medicine, 7(2), Article e001091. https://doi.org/10.1136/bmjsem-2021-001091","ieee":"A. Gokeler, A. Benjaminse, F. Della Villa, F. Tosarelli, E. Verhagen, and J. Baumeister, “Anterior cruciate ligament injury mechanisms through a neurocognition lens: implications for injury screening,” BMJ Open Sport & Exercise Medicine, vol. 7, no. 2, Art. no. e001091, 2021, doi: 10.1136/bmjsem-2021-001091."},"doi":"10.1136/bmjsem-2021-001091","language":[{"iso":"eng"}],"article_number":"e001091","intvolume":" 7","publication_status":"published","date_updated":"2022-12-16T15:46:56Z","publication_identifier":{"issn":["2055-7647"]},"author":[{"full_name":"Gokeler, Alli","first_name":"Alli","last_name":"Gokeler"},{"last_name":"Benjaminse","first_name":"Anne","full_name":"Benjaminse, Anne"},{"first_name":"Francesco","last_name":"Della Villa","full_name":"Della Villa, Francesco"},{"full_name":"Tosarelli, Fillippo","last_name":"Tosarelli","first_name":"Fillippo"},{"full_name":"Verhagen, Evert","first_name":"Evert","last_name":"Verhagen"},{"first_name":"Jochen","last_name":"Baumeister","full_name":"Baumeister, Jochen"}],"year":"2021","title":"Anterior cruciate ligament injury mechanisms through a neurocognition lens: implications for injury screening","department":[{"_id":"17"}],"keyword":["Physical Therapy","Sports Therapy and Rehabilitation","Orthopedics and Sports Medicine"],"type":"journal_article","date_created":"2022-08-01T19:13:37Z","abstract":[{"text":"Athletes in team sports have to quickly visually perceive actions of opponents and teammates while executing their own movements. These continuous actions are performed under time pressure and may contribute to a non-contact ACL injury. However, ACL injury screening and prevention programmes are primarily based on standardised movements in a predictable environment. The sports environment provides much greater cognitive demand because athletes must attend their attention to numerous external stimuli and inhibit impulsive actions. Any deficit or delay in attentional processing may contribute to an inability to correct potential errors in complex coordination, resulting in knee positions that increase the ACL injury risk. In this viewpoint, we advocate that ACL injury screening should include the sports specific neurocognitive demands.","lang":"eng"}],"issue":"2","publication":"BMJ Open Sport & Exercise Medicine"}]