---
_id: '63659'
abstract:
- lang: eng
  text: "<jats:sec>\r\n                    <jats:title>Objectives</jats:title>\r\n
    \                   <jats:p>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.</jats:p>\r\n                  </jats:sec>\r\n                  <jats:sec>\r\n
    \                   <jats:title>Methods</jats:title>\r\n                    <jats:p>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.</jats:p>\r\n
    \                 </jats:sec>\r\n                  <jats:sec>\r\n                    <jats:title>Results</jats:title>\r\n
    \                   <jats:p>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.</jats:p>\r\n
    \                 </jats:sec>\r\n                  <jats:sec>\r\n                    <jats:title>Conclusion</jats:title>\r\n
    \                   <jats:p>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.</jats:p>\r\n                  </jats:sec>"
article_number: e002636
author:
- first_name: Franziska Katharina
  full_name: Mund, Franziska Katharina
  last_name: Mund
- first_name: Nina
  full_name: Feddermann-Demont, Nina
  last_name: Feddermann-Demont
- first_name: Goetz H
  full_name: Welsch, Goetz H
  last_name: Welsch
- first_name: Carsten
  full_name: Schuenemann, Carsten
  last_name: Schuenemann
- first_name: Jens
  full_name: Fiehler, Jens
  last_name: Fiehler
- first_name: Christian
  full_name: Thaler, Christian
  last_name: Thaler
- first_name: Lukas
  full_name: Meyer, Lukas
  last_name: Meyer
- first_name: Rebecca
  full_name: Reeschke, Rebecca
  last_name: Reeschke
- first_name: Claus
  full_name: Reinsberger, Claus
  last_name: Reinsberger
citation:
  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. <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>.
    2025;11(4). doi:<a href="https://doi.org/10.1136/bmjsem-2025-002636">10.1136/bmjsem-2025-002636</a>
  apa: Mund, F. K., Feddermann-Demont, N., Welsch, G. H., Schuenemann, C., Fiehler,
    J., Thaler, C., Meyer, L., Reeschke, R., &#38; Reinsberger, C. (2025). High-magnitude
    headers are not associated with structural and functional brain changes in active
    high-level football (soccer) players. <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>,
    <i>11</i>(4), Article e002636. <a href="https://doi.org/10.1136/bmjsem-2025-002636">https://doi.org/10.1136/bmjsem-2025-002636</a>
  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={<a
    href="https://doi.org/10.1136/bmjsem-2025-002636">10.1136/bmjsem-2025-002636</a>},
    number={4e002636}, journal={BMJ Open Sport &#38;amp; 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.”
    <i>BMJ Open Sport &#38;amp; Exercise Medicine</i> 11, no. 4 (2025). <a href="https://doi.org/10.1136/bmjsem-2025-002636">https://doi.org/10.1136/bmjsem-2025-002636</a>.
  ieee: 'F. K. Mund <i>et al.</i>, “High-magnitude headers are not associated with
    structural and functional brain changes in active high-level football (soccer)
    players,” <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>, vol. 11, no. 4, Art.
    no. e002636, 2025, doi: <a href="https://doi.org/10.1136/bmjsem-2025-002636">10.1136/bmjsem-2025-002636</a>.'
  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.” <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>, vol. 11, no. 4, e002636,
    BMJ, 2025, doi:<a href="https://doi.org/10.1136/bmjsem-2025-002636">10.1136/bmjsem-2025-002636</a>.
  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 &#38;amp; Exercise
    Medicine 11 (2025).
date_created: 2026-01-19T12:52:36Z
date_updated: 2026-01-19T13:01:46Z
department:
- _id: '176'
- _id: '35'
doi: 10.1136/bmjsem-2025-002636
intvolume: '        11'
issue: '4'
language:
- iso: eng
publication: BMJ Open Sport &amp; Exercise Medicine
publication_identifier:
  issn:
  - 2055-7647
publication_status: published
publisher: BMJ
status: public
title: High-magnitude headers are not associated with structural and functional brain
  changes in active high-level football (soccer) players
type: journal_article
user_id: '63237'
volume: 11
year: '2025'
...
---
_id: '61006'
abstract:
- lang: eng
  text: "<jats:sec>\r\n                  <jats:title>Objective</jats:title>\r\n                  <jats:p>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.</jats:p>\r\n
    \              </jats:sec>\r\n               <jats:sec>\r\n                  <jats:title>Methods</jats:title>\r\n
    \                 <jats:p>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.</jats:p>\r\n               </jats:sec>\r\n               <jats:sec>\r\n
    \                 <jats:title>Results</jats:title>\r\n                  <jats:p>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&lt;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&lt;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).</jats:p>\r\n               </jats:sec>\r\n
    \              <jats:sec>\r\n                  <jats:title>Conclusion</jats:title>\r\n
    \                 <jats:p>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.</jats:p>\r\n
    \              </jats:sec>"
article_number: e002447
author:
- first_name: Lea
  full_name: Weike, Lea
  last_name: Weike
- first_name: Rebecca
  full_name: Reeschke, Rebecca
  id: '44893'
  last_name: Reeschke
- first_name: Claus
  full_name: Reinsberger, Claus
  id: '48978'
  last_name: Reinsberger
citation:
  ama: Weike L, Reeschke R, Reinsberger C. Clinical symptom clusters, neurocognitive
    function, balance and vestibulo-ocular function in athletes with sport-related
    concussion. <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>. 2025;11(3). doi:<a
    href="https://doi.org/10.1136/bmjsem-2024-002447">10.1136/bmjsem-2024-002447</a>
  apa: Weike, L., Reeschke, R., &#38; Reinsberger, C. (2025). Clinical symptom clusters,
    neurocognitive function, balance and vestibulo-ocular function in athletes with
    sport-related concussion. <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>, <i>11</i>(3),
    Article e002447. <a href="https://doi.org/10.1136/bmjsem-2024-002447">https://doi.org/10.1136/bmjsem-2024-002447</a>
  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={<a href="https://doi.org/10.1136/bmjsem-2024-002447">10.1136/bmjsem-2024-002447</a>},
    number={3e002447}, journal={BMJ Open Sport &#38;amp; Exercise Medicine}, publisher={BMJ},
    author={Weike, Lea and Reeschke, Rebecca and Reinsberger, Claus}, year={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.” <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>
    11, no. 3 (2025). <a href="https://doi.org/10.1136/bmjsem-2024-002447">https://doi.org/10.1136/bmjsem-2024-002447</a>.
  ieee: 'L. Weike, R. Reeschke, and C. Reinsberger, “Clinical symptom clusters, neurocognitive
    function, balance and vestibulo-ocular function in athletes with sport-related
    concussion,” <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>, vol. 11, no. 3,
    Art. no. e002447, 2025, doi: <a href="https://doi.org/10.1136/bmjsem-2024-002447">10.1136/bmjsem-2024-002447</a>.'
  mla: Weike, Lea, et al. “Clinical Symptom Clusters, Neurocognitive Function, Balance
    and Vestibulo-Ocular Function in Athletes with Sport-Related Concussion.” <i>BMJ
    Open Sport &#38;amp; Exercise Medicine</i>, vol. 11, no. 3, e002447, BMJ, 2025,
    doi:<a href="https://doi.org/10.1136/bmjsem-2024-002447">10.1136/bmjsem-2024-002447</a>.
  short: L. Weike, R. Reeschke, C. Reinsberger, BMJ Open Sport &#38;amp; Exercise
    Medicine 11 (2025).
date_created: 2025-08-25T15:45:20Z
date_updated: 2025-08-27T08:41:19Z
department:
- _id: '35'
- _id: '176'
- _id: '17'
doi: 10.1136/bmjsem-2024-002447
intvolume: '        11'
issue: '3'
language:
- iso: eng
publication: BMJ Open Sport &amp; Exercise Medicine
publication_identifier:
  issn:
  - 2055-7647
publication_status: published
publisher: BMJ
status: public
title: Clinical symptom clusters, neurocognitive function, balance and vestibulo-ocular
  function in athletes with sport-related concussion
type: journal_article
user_id: '33213'
volume: 11
year: '2025'
...
---
_id: '32451'
abstract:
- lang: eng
  text: <jats:p>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.</jats:p>
article_number: e001091
author:
- first_name: Alli
  full_name: Gokeler, Alli
  last_name: Gokeler
- first_name: Anne
  full_name: Benjaminse, Anne
  last_name: Benjaminse
- first_name: Francesco
  full_name: Della Villa, Francesco
  last_name: Della Villa
- first_name: Fillippo
  full_name: Tosarelli, Fillippo
  last_name: Tosarelli
- first_name: Evert
  full_name: Verhagen, Evert
  last_name: Verhagen
- first_name: Jochen
  full_name: Baumeister, Jochen
  last_name: Baumeister
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. <i>BMJ Open Sport &#38;amp; Exercise Medicine</i>.
    2021;7(2). doi:<a href="https://doi.org/10.1136/bmjsem-2021-001091">10.1136/bmjsem-2021-001091</a>'
  apa: 'Gokeler, A., Benjaminse, A., Della Villa, F., Tosarelli, F., Verhagen, E.,
    &#38; Baumeister, J. (2021). Anterior cruciate ligament injury mechanisms through
    a neurocognition lens: implications for injury screening. <i>BMJ Open Sport &#38;amp;
    Exercise Medicine</i>, <i>7</i>(2), Article e001091. <a href="https://doi.org/10.1136/bmjsem-2021-001091">https://doi.org/10.1136/bmjsem-2021-001091</a>'
  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={<a href="https://doi.org/10.1136/bmjsem-2021-001091">10.1136/bmjsem-2021-001091</a>},
    number={2e001091}, journal={BMJ Open Sport &#38;amp; 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} }'
  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.” <i>BMJ Open
    Sport &#38;amp; Exercise Medicine</i> 7, no. 2 (2021). <a href="https://doi.org/10.1136/bmjsem-2021-001091">https://doi.org/10.1136/bmjsem-2021-001091</a>.'
  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,” <i>BMJ Open Sport &#38;amp; Exercise
    Medicine</i>, vol. 7, no. 2, Art. no. e001091, 2021, doi: <a href="https://doi.org/10.1136/bmjsem-2021-001091">10.1136/bmjsem-2021-001091</a>.'
  mla: 'Gokeler, Alli, et al. “Anterior Cruciate Ligament Injury Mechanisms through
    a Neurocognition Lens: Implications for Injury Screening.” <i>BMJ Open Sport &#38;amp;
    Exercise Medicine</i>, vol. 7, no. 2, e001091, BMJ, 2021, doi:<a href="https://doi.org/10.1136/bmjsem-2021-001091">10.1136/bmjsem-2021-001091</a>.'
  short: A. Gokeler, A. Benjaminse, F. Della Villa, F. Tosarelli, E. Verhagen, J.
    Baumeister, BMJ Open Sport &#38;amp; Exercise Medicine 7 (2021).
date_created: 2022-08-01T19:13:37Z
date_updated: 2022-12-16T15:46:56Z
department:
- _id: '17'
doi: 10.1136/bmjsem-2021-001091
intvolume: '         7'
issue: '2'
keyword:
- Physical Therapy
- Sports Therapy and Rehabilitation
- Orthopedics and Sports Medicine
language:
- iso: eng
publication: BMJ Open Sport &amp; Exercise Medicine
publication_identifier:
  issn:
  - 2055-7647
publication_status: published
publisher: BMJ
status: public
title: 'Anterior cruciate ligament injury mechanisms through a neurocognition lens:
  implications for injury screening'
type: journal_article
user_id: '46'
volume: 7
year: '2021'
...
