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@ARTICLE{Ntikas:908087,
      author       = {Ntikas, Michail and Binkofski, Ferdinand and Shah, N. Jon
                      and Ietswaart, Magdalena},
      title        = {{R}epeated {S}ub-{C}oncussive {I}mpacts and the {N}egative
                      {E}ffects of {C}ontact {S}ports on {C}ognition and {B}rain
                      {I}ntegrity},
      journal      = {International journal of environmental research and public
                      health},
      volume       = {19},
      number       = {12},
      issn         = {1660-4601},
      address      = {Basel},
      publisher    = {MDPI AG},
      reportid     = {FZJ-2022-02366},
      pages        = {7098 -},
      year         = {2022},
      abstract     = {Sports are yielding a wealth of benefits for cardiovascular
                      fitness, for psychological resilience, and for cognition.
                      The amount of practice, and the type of practiced sports,
                      are of importance to obtain these benefits and avoid any
                      side effects. This is especially important in the context of
                      contact sports. Contact sports are not only known to be a
                      major source of injuries of the musculoskeletal apparatus,
                      they are also significantly related to concussion and
                      sub-concussion. Sub-concussive head impacts accumulate
                      throughout the active sports career, and thus can cause
                      measurable deficits and changes to brain health. Emerging
                      research in the area of cumulative sub-concussions in
                      contact sports has revealed several associated markers of
                      brain injury. For example, recent studies discovered that
                      repeated headers in soccer not only cause measurable signs
                      of cognitive impairment but are also related to a prolonged
                      cortical silent period in transcranial magnetic stimulation
                      measurements. Other cognitive and neuroimaging biomarkers
                      are also pointing to adverse effects of heading. A range of
                      fluid biomarkers completes the picture of cumulating effects
                      of sub-concussive impacts. Those accumulating effects can
                      cause significant cognitive impairment later in life of
                      active contact sportswomen and men. The aim of this review
                      is to highlight the current scientific evidence on the
                      effects of repeated sub-concussive head impacts on contact
                      sports athletes’ brains, identify the areas in need of
                      further investigation, highlight the potential of advanced
                      neuroscientific methods, and comment on the steps governing
                      bodies have made to address this issue. We conclude that
                      there are indeed neural and biofluid markers that can help
                      better understand the effects of repeated sub-concussive
                      head impacts and that some aspects of contact sports should
                      be redefined, especially in situations where sub-concussive
                      impacts and concussions can be minimized},
      cin          = {INM-4 / INM-11 / JARA-BRAIN},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-4-20090406 / I:(DE-Juel1)INM-11-20170113 /
                      I:(DE-Juel1)VDB1046},
      pnm          = {5253 - Neuroimaging (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5253},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {35742344},
      UT           = {WOS:000816530800001},
      doi          = {10.3390/ijerph19127098},
      url          = {https://juser.fz-juelich.de/record/908087},
}