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Editorial
January 27, 2020

New Insights Into the APOE ε4–Soccer Heading Interaction: Handle With Care

Author Affiliations
  • 1Department of Neurosciences, University of California, San Diego
  • 2Boston University Alzheimer’s Disease and Chronic Traumatic Encephalopathy Center, Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
JAMA Neurol. 2020;77(4):417-418. doi:10.1001/jamaneurol.2019.4451

Soccer is perhaps the most popular sport on the planet, with the Fédération Internationale de Football Association (FIFA) estimating that 4% of the world’s population plays the game.1 Although most ball contacts are made with the lower limbs, headers, when the ball is intentionally hit with the head instead of the foot, are frequent plays. When the head makes contact with another mobile object, there is, of course, a possibility for brain injury. Historical and recent research suggests that sports with exposure to repetitive head impacts (RHIs), such as US football and boxing, are associated with neurodegenerative diseases, including chronic traumatic encephalopathy.2-4 Professional soccer has recently been associated with higher mortality associated with neurodegenerative disease, but lower rates of cardiovascular disease.5

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