May 18, 2026

expert reaction to study of heading the ball in amateur football and acute blood markers of neural damage

A study published in JAMA Neurology looks at football heading and elevations in blood biomarkers of neural damage. 

Dr Peter Theobald, Reader in Biomedical Engineering, Cardiff University, said:

“This study adds to the emerging evidence that even modest head impacts elicit a negative response from brain tissue.  Even a small number of headers were found to correlate with a change in blood markers immediately post-match and again with 48-hours post-match.  This would indicate that heading is causing some brain trauma.  This finding is consistent with a recent study – ironically published from my lab – that also shows a modest (in this case 10) headers to cause a change in brain structure, with a 24-hour post-match period (reference below).  These findings were still evident 6-months after this single intervention.

“The authors of the new study do not investigate whether these changes exist beyond 48 hours post-match, which is a limitation of the methodology and so limits their ability to infer any potential longer-term risks.  Equally, they do not use their presented data to infer what these changes may mean for longer-term brain health – and so the risk of brain disease, which is appropriate, as these correlations for such changes in blood markers are not fully understood. The study is limited but their inability to quantify the energy associated with the header – whilst they used a reasonable approximation, for such sensitive analyses this approach is an inherent limitation. 

“Overall, in my opinion this is an incremental addition to the literature and so does not warrant significant media attention.  It also does have the potential for causing undue concern in the wider population. Arguably, our study has greater significance, given that the methodology was more robust in quantifying the intervention (i.e. the headers), and more specific in being able to identify the precise brain regions that were influenced, and over an extended period of time.  Whilst we had a smaller sample size, the results were still statistically significant, predominantly as we were using field-leading magnetic resonance imaging, which enabled far more detailed investigation.”

Reference:

‘Quantified Head-Ball Impacts in Soccer: A Preliminary, Prospective Study’ by Hugh McClosky et al. Neurotrauma Reports DOI: 10.1177/2689288X251380145

‘Amateur Soccer Heading and Acute Elevations in Blood-Based p-Tau217 and S100B’ by Marloes I. Hoppen et al. was published in JAMA Neurology at 16:00 UK time on Monday 18^th May. 

DOI: 10.1001/jamaneurol.2026.1224

Declared interests

Dr Peter Theobald: Whilst appearing to over-lap, our study should not be considered to create a conflict of interest in reviewing their work – we have very different approaches to trying to quantify the same effect, and ultimately are aiming towards different funding bodies.