Soccer Heading is Associated with Loss of Gray Matter-White Matter Contrast in Females, but not Males

Motivation: Repetitive head impacts (RHI) from soccer heading are associated with excess adverse effects on cognitive performance among women. Preclinical and biomechanical studies point to the cerebral gray-white interface (GWI) as a region susceptible to shear force trauma. Goal(s): We characterize tissue differentiation near the GWI using T1-weighted imaging to study the effects of RHI, particularly in females. Approach: We calculated GM/WM contrast in a group of adult amateur soccer players, and performed sex stratified analyses. Results: This study identified attenuation of GM/WM contrast at the GWI in female, but not male amateur soccer players, indicating sex-specific susceptibility to adverse effects of RHI. Impact: Our results place focus on women as uniquely affected by adverse brain effects of heading, identify heading-associated pathology at an underappreciated brain location and can be readily applied to analysis of existing clinical images and datasets.