This article caught my interest due to the amount of trauma I see in my practice as it relates to heading a soccer ball. Enjoy! Dr. Maj

Soccer players who use their head to work the ball may be at risk for white matter abnormalities similar to those seen in traumatic brain injury (TBI) — but only beyond a certain threshold, researchers said here.

In a small study of amateur soccer players, those who headed the ball more than 1,320 times per year had a greater likelihood of tiny changes in white matter as measured on diffusion tensor imaging, Michael Lipton, MD, PhD, of the Albert Einstein College of Medicine in Bronx, N.Y., reported at the Radiological Society of North America meeting here.

“These are changes in the brain that are similar to those we see with a concussion or TBI,” Lipton said during a press briefing. “I’m not advocating banning heading, but there may be a threshold level, which we defined, that indicates a safe range of heading.”

Lipton explained that after heading the ball, patients have reported symptoms such as headache and feeling dazed or confused, and some studies have shown that cognitive performance may also be affected.

Still, there have not been many imaging studies of its potential neurological consequences, he said.

So he and his colleagues used diffusion tensor MRI to look at tiny changes in white matter — the fibers that make up the brain’s network wiring, he said — in 38 amateur soccer players in the New York City area who’ve been playing the game their whole lives.

Over the preceding year, the number of times the patients headed the ball ranged from none to 5,600, and Lipton said the upper quartile was 1,320.

Compared with the other soccer players, those in the upper quartile of heading had lower fractional anisotropy — uniform diffusion of water across white matter — in six regions of the brain.

That included five regions in temporooccipital white matter and one in frontal white matter.

The researchers noted that the relationship between heading and fractional anisotropy followed a reverse “S” shape, indicating that white matter abnormalities rise as the frequency of heading rises.

Although further study is needed — particularly to assess whether these changes in white matter correspond with changes in cognitive performance — Lipton said the findings suggest there may be room for public health intervention, given that more than 250 million people worldwide play soccer regularly. In the U.S. alone, that estimate is 18 million people, he said.

Lipton noted that more soccer players need to be assessed over a longer period of time to see if their threshold stands up, but still, he said, players should try to minimize heading, especially during practice drills, when balls are repeatedly headed back and forth.

According to guidelines from the American Academy of Pediatrics, there are not enough data to recommend against heading altogether, but the organization similarly encourages children to minimize the number of times they do so.

Max Wintermark, MD, of the University of Virginia in Charlottesville, who was not involved in the study, cautioned that the results are preliminary and that given the small number of participants, “we have to be careful not to generalize findings that have been obtained in just a few patients.”

Still, he said it’s “worth more study,” particularly among children — although such a study would involve practical limitations, such as the need for sedation.

Primary source: Radiological Society of North America

Source reference:

Kim N, et al “Making soccer safer for the brain: DTI-defined exposure thresholds for white matter injury due to soccer heading” RSNA 2011; Abstract SSK12-04.

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net

A new study adds more reason to why our bodies employ fevers as a defense against sickness.

Researchers from Roswell Park Cancer Institute found that a higher body temperature can help our immune systems to work better and harder against infected cells. The finding was published in the Journal of Leukocyte Biology.

“Having a fever might be uncomfortable, … but this research report and several others are showing that having a fever is part of an effective immune response,” John Wherry, Ph.D., deputy editor of the Journal of Leukocyte Biology, said in a statement.

Before, researchers thought that fevers worked by hindering dangerous microbes from multiplying, Wherry said.

But “this new work also suggests that the immune system might be temporarily enhanced functionally when our temperatures rise with fever,” he said in the statement, though he noted that the finding should only prompt people to reconsider how they treat mild fevers, and not fevers that are dangerously high.

The secret is in a kind of immune cell, or lymphocyte, called a CD8+ cytotoxic T-cell. This kind of lymphocyte is able to destroy cells infected with viruses and even tumor cells, researchers said. Researchers found that a higher body temperature (like one achieved in a fever) raises the number of these CD8+ cytotoxic T-cells, which means a greater body response against infection.

To find this, researchers injected mice with an antigen and saw how the CD8+ cytotoxic T-cells activated to react to the antigen. Then, they raised the body temperatures of half the mice by 2 degrees centigrade, while leaving the temperatures of the other = mice alone. They found that the mice whose body temperatures were raised had more of the CD8+ cytotoxic T-cells than the mice without raised body temps.

The rise in mouse’s body temperature is “similar to that that happens in fever,” study researcher Elizabeth Repasky told the Toronto Star.

University of Pittsburgh Medical Center clinical associate professor Dr. Amesh A. Adalja, who wasn’t involved with the study, told MSNBC that the finding shouldn’t mean a fever should never be treated because too-high fevers can lead to brain cell damage. Parents should still take care to lower fevers in children, particularly if the fever is above 102 degrees Fahrenheit, since high fever can lead to seizures, Adalja told MSNBC.

Adalja also warns it”s also not worth the risk to your own health if you have heart disease, have suffered a stroke or endure other medical complications. “This is not a blanket recommendation,” he says. “Secondary consequences to the fever can cause other conditions in the patient to occur or worsen. If someone has a persistent fever of 104, it’s a sign of infection, and it”s not just some viral thing you are going to get over.”

This is certainly not the first research to suggest that fevers ramp up our body’s immune responses. Discover magazine reported in 2007 on another Roswell Park Cancer Institute mouse study, which showed that mice that were heated up produced more immune cells to fight disease than mice that weren’t heated.

http://www.huffingtonpost.com/2011/11/03/fever-immune-system-cells_n_1074445.html

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net

Your position when holding the telephone receiver can cause problems in the neck area which lead to headaches, neck tension, pain and stiffness. An estimated four million Americans suffer from chronic headaches, most of which are caused by neck problems. One major contributor to displaced vertebrae in the neck is the telephone.

Most people do not realize that awkward positioning, such as cradling the phone on the shoulder and bending the neck to fit the ear to the receiver, can throw the upper region of the spine (neck) out of balance. Pain can result as vertebrae become misaligned or locked, leading to abnormal muscle contraction and irritation of the nerves of the spine.

Headaches, another symptom of such a misalignment, are another way the body signals that something is wrong. Headache sufferers spend almost $2 billion a year on over-the-counter pain remedies that do not correct the problem. Painkillers only cover up symptoms that may become more serious. The cause of the headaches remains.

One proper posture, to avoid pain from vertebral misalignment when using a telephone, is to sit up straight, keep your head level and switch hands from time to time to equalize tension. Another is always hold the telephone with one of your hands and never cradle it between the neck and shoulder.

Chiropractic care can dramatically reduce headache pain because it corrects nerve system dysfunction that causes headaches. If your work requires repetitive actions that strain the neck and back, seek regular chiropractic adjustments to restore proper nerve system function. Feeling great can become an everyday occurrence with regular chiropractic care.

Dr. Stephanie Maj has a thriving family practice in the heart of Chicago. Her clinic is located at 1442 W. Belmont Ave., 1E, Chicago, IL 60657. 773.528.8485. www.communitychiropractic.net