Objective Neurocognitive changes have been found in football players without documented concussion raising concerns regarding the long term consequences of subconcussive head impacts in sport. It remains unknown if similar neurocognitive changes are found in female soccer athletes without concussion. Females have been found to have higher concussion rates compared to males and soccer is the most popular sport internationally providing a compelling area of study.

Design Observational study.

Setting American collegiate women’s soccer team.

Participants 16 National Collegiate Athletic Association Division III women’s soccer athletes (19.88±1.1 years old, 163.7±4.9 cm, 61.2±4.9 kg) volunteered and provided consent for the study.

Assessment of risk factors We measured head impacts during practices and games throughout the 15 week season with the xPatch (X2 Biosystems, Seattle, WA, USA). All participants completed ImPACT and the Sport Concussion Assessment Tool – 3^rd Edition (SCAT3) prior to the season’s start and at the end of the season.

Outcome measures The xPatch stored location, frequency, and magnitude (linear and rotational accelerations) of head impacts. Event film was used to verify each head impact. Changes in neurocognitive function were determined by comparing the baseline ImPACT and SCAT3 scores with the post-season scores.

Main results A stepwise regression found a significant relationship between weekly head impact frequency during practices and the ImPACT measures of Visual Motor Speed (P=0.03) and Symptom Score (P=0.03).

Conclusions Soccer activity may lead to lower visual motor speed and higher symptom scores. Future studies should use additional screening tools to verify these preliminary findings.

Competing interests None.