Fig. 3: Cognitive deficit and biomarker level differences between female and male soccer players.
a Schematic illustration of the experimental setup. Psychological testing revealed significantly worse scores in (b) focused attention and (c) cognitive flexibility in male (M) soccer players compared to female (F) players after exercise (E), while heading training (H + E) showed greater negative effects on cognitive performance in females compared to males. Fold change for the male cohort was calculated using a pre-exercise baseline. d Analysis of tau fold change in plasma showed no difference between male and female players. e Significant difference in pTau181 was observed in males 1 hour after exercise and 1 to 24 hours after heading compared to females. f The ratio of pTau181:tau fold change was significantly higher 1 to 24 hour after exercise and 1 hour post-heading in male players compared to females. The dotted line in (b-f) represents the pre-training baseline and the horizontal black lines denote the mean with 95% CI. Number of headers correlated with (g) the change in plasma pTau181 and (h) plasma pTau181:tau fold change ratio in a combined group of soccer players at 1 hour post-heading. The dotted line (g, h) shows the 95% CI bands. i The ROC analysis showed high accuracy for plasma pTau181:tau fold change ratio and Tau fold change to distinguish exposure to repetitive head impacts (n = 58, F = 30, M = 28) from exercise in a group of male and female athletes (n = 68, F = 36, M = 32).
