Overview

• A JAMA Network Open study using a new diffusion-MRI method found a fuzzier gray–white matter interface in the orbitofrontal cortex among the most frequent amateur headers, who also scored a few points lower on verbal learning and memory tests.
• A companion Neurology paper reported heading-related disruptions in juxtacortical white matter within brain folds, and mediation analysis indicated these changes partially explained poorer cognitive performance.
• Across studies, alterations concentrated in frontal and sulcal regions, with minimal effects detected in deep white matter.
• Participants’ heading exposure was estimated over one year by self-report and all data were cross-sectional, so causation, durability and clinical trajectory of the changes remain uncertain.
• Investigators are advancing longitudinal and biomarker studies, and the findings are informing discussions about training practices and youth heading guidelines.