SynthesisNeuroradiology2026
Brain MRI findings associated with soccer heading: a systematic review and meta-analysis.
Synthesis in Neuroradiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesRepetitive head impacts from soccer heading may cause subclinical brain alterations, but the magnitude and consistency of neuroimaging abnormalities remain uncertain.
methodsA systematic review and meta-analysis of brain MRI studies in soccer players was performed. Diffusion MRI was the primary outcome; magnetic resonance spectroscopy (MRS) and structural MRI morphometry were secondary outcomes.
resultsThirteen independent studies were included. Five diffusion MRI studies (n≈300 players) were synthesised using Fisher's z. Soccer heading exposure was associated with significant white-matter microstructural alteration (pooled Fisher's z - 0.73, 95% CI - 1.02 to - 0.44), corresponding to an equivalent correlation of r≈ - 0.62 and a standard mean difference of approximately - 1.5. Between-study heterogeneity was moderate (I
conclusionsSoccer heading is associated with moderate-to-large effect sizes in diffusion MRI metrics of white-matter microstructure, whereas metabolic and structural MRI findings are smaller, less consistent, and of uncertain clinical significance. ADVANCES IN KNOWLEDGE: This meta-analysis provides the first quantitative evidence that soccer heading is associated with a robust, moderate-to-large diffusion MRI signal of white-matter microstructural alteration. It further shows that diffusion MRI is more sensitive than spectroscopy or structural morphometry for detecting subclinical brain effects of repetitive head impacts.
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