scholarly journals Brain–Immune Interactions as the Basis of Gulf War Illness: Clinical Assessment and Deployment Profile of 1990–1991 Gulf War Veterans in the Gulf War Illness Consortium (GWIC) Multisite Case-Control Study

2021 ◽  
Vol 11 (9) ◽  
pp. 1132
Author(s):  
Lea Steele ◽  
Nancy Klimas ◽  
Maxine Krengel ◽  
Emily Quinn ◽  
Rosemary Toomey ◽  
...  
Keyword(s):  
Military Service ◽  
Neuropsychological Testing ◽  
Case Control ◽  
Gulf War ◽  
Post Traumatic Stress ◽  
Gulf War Illness ◽  
War Veterans ◽  
Enlisted Personnel ◽  
Gulf War Veterans ◽  
War Experiences

The Boston University-based Gulf War Illness Consortium (GWIC) is a multidisciplinary initiative developed to provide detailed understanding of brain and immune alterations that underlie Gulf War illness (GWI), the persistent multisymptom disorder associated with military service in the 1990–1991 Gulf War. The core GWIC case-control clinical study conducted in-depth brain and immune evaluation of 269 Gulf War veterans (223 GWI cases, 46 controls) at three U.S. sites that included clinical assessments, brain imaging, neuropsychological testing, and analyses of a broad range of immune and immunogenetic parameters. GWI cases were similar to controls on most demographic, military, and deployment characteristics although on average were two years younger, with a higher proportion of enlisted personnel vs. officers. Results of physical evaluation and routine clinical lab tests were largely normal, with few differences between GWI cases and healthy controls. However, veterans with GWI scored significantly worse than controls on standardized assessments of general health, pain, fatigue, and sleep quality and had higher rates of diagnosed conditions that included hypertension, respiratory and sinus conditions, gastrointestinal conditions, and current or lifetime depression and post-traumatic stress disorder. Among multiple deployment experiences/exposures reported by veterans, multivariable logistic regression identified just two significant GWI risk factors: extended use of skin pesticides in theater (adjusted OR = 3.25, p = 0.005) and experiencing mild traumatic brain injury during deployment (OR = 7.39, p = 0.009). Gulf War experiences associated with intense stress or trauma (e.g., participation in ground combat) were not associated with GWI. Data and samples from the GWIC project are now stored in a repository for use by GWI researchers. Future reports will present detailed findings on brain structure and function, immune function, and association of neuroimmune measures with characteristics of GWI and Gulf War service.

scholarly journals Neurological disorders in Gulf War veterans

2006 ◽  
Vol 361 (1468) ◽  
pp. 605-618 ◽  
Author(s):  
Michael R Rose ◽  
Kelley Ann Brix
Keyword(s):  
Neurological Disorders ◽  
Military Service ◽  
Large Population ◽  
Great Majority ◽  
Epidemiological Studies ◽  
Gulf War ◽  
Neurological Function ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Increased Risk

We present a review of neurological function in Gulf War veterans (GWV). Twenty-two studies were reviewed, including large hospitalization and registry studies, large population-based epidemiological studies, investigations of a single military unit, small uncontrolled studies of ill veterans and small controlled studies of veterans. In nearly all studies, neurological function was normal in most GWVs, except for a small proportion who were diagnosed with compression neuropathies (carpal tunnel syndrome or ulnar neuropathy). In the great majority of controlled studies, there were no differences in the rates of neurological abnormalities in GWVs and controls. In a national US study, the incidence of amyotrophic lateral sclerosis (ALS) seems to be significantly increased in GWVs, compared to the rate in controls. However, it is possible that military service, in general, might be associated with an increased risk of ALS, rather than Gulf War service in particular. Taken together, the conclusion is that if a neurological examination in a GWV is within normal limits, then extensive neurological testing is unlikely to diagnose occult neurological disorders.

Gulf War illness: an overview of events, most prevalent health outcomes, exposures, and clues as to pathogenesis

2015 ◽  
Vol 30 (4) ◽  
Author(s):  
Kathleen J. Kerr
Keyword(s):  
Oxidant Stress ◽  
Gastrointestinal Symptoms ◽  
Epidemiologic Studies ◽  
Gulf War ◽  
Institute Of Medicine ◽  
Gulf War Illness ◽  
Gulf War Syndrome ◽  
War Veterans ◽  
Gulf War Veterans ◽  
The Usa

AbstractIntroduction:During or very soon after the 1990–1991 Persian Gulf War, veterans of the conflict began to report symptoms of illness. Common complaints included combinations of cognitive difficulties, fatigue, myalgia, rashes, dyspnea, insomnia, gastrointestinal symptoms and sensitivity to odors. Gradually in the USA, and later in the UK, France, Canada, Denmark and Australia, governments implemented medical assessment programs and epidemiologic studies to determine the scope of what was popularly referred to as “the Gulf War syndrome”. Attention was drawn to numerous potentially toxic deployment-related exposures that appeared to vary by country of deployment, by location within the theater, by unit, and by personal job types. Identifying a single toxicant cause was considered unlikely and it was recognized that outcomes were influenced by genetic variability in xenobiotic metabolism.Methods:Derived from primary papers and key reports by the Research Advisory Committee on Gulf War Veterans’ Illnesses and the Institute of Medicine, a brief overview is presented of war related events, symptoms and diagnostic criteria for Gulf War illness (GWV), some international differences, the various war-related exposures and key epidemiologic studies. Possible exposure interactions and pathophysiologic mechanisms are discussed.Results:Exposures to pyridostigmine bromide, pesticides, sarin and mustard gas or combinations thereof were most associated with GWI, especially in some genotype subgroups. The resultant oxidant stress and background exposome must be assumed to have played a role.Conclusion:Gulf War (GW) exposures and their potential toxic effects should be considered in the context of the human genome, the human exposome and resultant oxidant stress to better characterize this unique environmentally-linked illness and, ultimately, provide a rationale for more effective interventions and future prevention efforts.

scholarly journals Lack of serological evidence for Mycoplasma fermentans infection in army Gulf War veterans: a large scale case-control study

2000 ◽  
Vol 125 (3) ◽  
pp. 609-616 ◽  
Author(s):  
S.-C. LO ◽  
L. LEVIN ◽  
J. RIBAS ◽  
R. CHUNG ◽  
R. Y.-H. WANG ◽  
...  
Keyword(s):  
Case Control Study ◽  
Gulf War ◽  
Serological Evidence ◽  
Gulf War Illness ◽  
War Veterans ◽  
Mycoplasma Fermentans ◽  
Desert Storm ◽  
Gulf War Veterans ◽  
Operation Desert Storm ◽  
Control Study

Mycoplasma fermentans is suspected in the development of ‘Gulf War illness’ in veterans of Operation Desert Storm. We conducted a matched case-control study for the prevalence of M. fermentans-specific antibodies before and after the operation, as well as seroconversion rates in veterans with and without complaints of ‘Gulf War illness’. Cases consisted of Gulf War veterans, who complained of various illnesses and were enrolled in the second phase of the health evaluation by the Army Comprehensive Clinical Examination Program (CCEP). Controls were selected from Gulf War veterans who did not participate in the registry and did not request a health evaluation by the CCEP. Before operation deployment, 34 out of 718 of the cases (4·8%) and 116 out of 2233 of the controls (5·2%) tested positive for M. fermentans-specific antibodies. There was no difference in rates of seroconversion between cases and controls (1·1 vs. 1·2%) to M. fermentans during Operation Desert Storm. Thus, there is no serological evidence that suggests infection by M. fermentans is associated with development of ‘Gulf War illness’.

scholarly journals Psychological health of Australian veterans of the 1991 Gulf War: an assessment using the SF-12, GHQ-12 and PCL-S

2004 ◽  
Vol 34 (8) ◽  
pp. 1419-1430 ◽  
Author(s):  
D. P. McKENZIE ◽  
J. F. IKIN ◽  
A. C. McFARLANE ◽  
M. CREAMER ◽  
A. B. FORBES ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Health ◽  
Military Service ◽  
Comparison Group ◽  
Short Form ◽  
Gulf War ◽  
Self Report ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Group Members

Background. Elevated rates of psychological morbidity and symptomatology have been widely reported in 1991 Gulf War veterans. The present study used brief self-report instruments to compare the psychological health of Australian Gulf War veterans with that of a randomly sampled military comparison group.Method. The 12-item Short Form Health Survey (SF-12), 12-item General Health Questionnaire (GHQ-12), Posttraumatic Stress Disorder Checklist – Specific (PCL-S) and Military Service Experience (MSE) questionnaire were administered to 1424 male Australian Gulf War veterans and 1548 male Australian Defence Force members who were operational at the time of the Gulf War conflict, but were not deployed there.Results. The Gulf War veterans exhibited poorer psychological health, as measured by the above three instruments, than the comparison group members. For Gulf War veterans, the number of stressful experiences, as measured by the MSE questionnaire, was correlated with scores on the three instruments. SF-12 mental health component summary scores and PCL-S caseness, but not GHQ-12 caseness, differed significantly between Gulf War veterans and comparison group members who had been on at least one active deployment.Conclusions. More than a decade after the 1991 Gulf War, Australian Gulf War veterans are exhibiting higher levels of current (past month) psychological ill-health, as measured using the GHQ-12 and PCL-S, as well as lower mental health status, as measured by the SF-12, than the comparison group. Although not a replacement for formal psychiatric diagnosis, instruments such as those above may aid in the assessment of veterans' psychological health.

scholarly journals Human Leukocyte Antigen (HLA) and Gulf War Illness (GWI): HLA-DRB1*13:02 Spares Subcortical Atrophy in Gulf War Veterans

EBioMedicine ◽  
2017 ◽  
Vol 26 ◽  
pp. 126-131 ◽  
Author(s):  
Lisa M. James ◽  
Peka Christova ◽  
Brian E. Engdahl ◽  
Scott M. Lewis ◽  
Adam F. Carpenter ◽  
...  
Keyword(s):  
Human Leukocyte Antigen ◽  
Human Leukocyte ◽  
Gulf War ◽  
Gulf War Illness ◽  
War Veterans ◽  
Leukocyte Antigen ◽  
Gulf War Veterans

scholarly journals Reprogramming cells from Gulf War veterans into neurons to study Gulf War illness

Neurology ◽  
2017 ◽  
Vol 88 (20) ◽  
pp. 1968-1975 ◽  
Author(s):  
Liang Qiang ◽  
Anand N. Rao ◽  
Gustavo Mostoslavsky ◽  
Marianne F. James ◽  
Nicole Comfort ◽  
...  
Keyword(s):  
Cell Lines ◽  
Cell Types ◽  
Experimental Models ◽  
Gulf War ◽  
Gulf War Illness ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Chronic Headaches ◽  
The Persian Gulf ◽  
Impaired Sleep

Gulf War illness (GWI), which afflicts at least 25% of veterans who served in the 1990–1991 war in the Persian Gulf, is thought to be caused by deployment exposures to various neurotoxicants, including pesticides, anti–nerve gas pills, and low-level nerve agents including sarin/cyclosarin. GWI is a multisymptom disorder characterized by fatigue, joint pain, cognitive problems, and gastrointestinal complaints. The most prominent symptoms of GWI (memory problems, poor attention/concentration, chronic headaches, mood alterations, and impaired sleep) suggest that the disease primarily affects the CNS. Development of urgently needed treatments depends on experimental models appropriate for testing mechanistic hypotheses and for screening therapeutic compounds. Rodent models have been useful thus far, but are limited by their inability to assess the contribution of genetic or epigenetic background to the disease, and because disease-vulnerable proteins and pathways may be different in humans relative to rodents. As of yet, no postmortem tissue from the veterans has become available for research. We are moving forward with a paradigm shift in the study of GWI, which utilizes contemporary stem cell technology to convert somatic cells from Gulf War veterans into pluripotent cell lines that can be differentiated into various cell types, including neurons, glia, muscle, or other relevant cell types. Such cell lines are immortal and will be a resource for GWI researchers to pursue mechanistic hypotheses and therapeutics.

scholarly journals War-related psychological stressors and risk of psychological disorders in Australian veterans of the 1991 Gulf War

2004 ◽  
Vol 185 (2) ◽  
pp. 116-126 ◽  
Author(s):  
Jillian F. Ikin ◽  
Malcolm R. Sim ◽  
Mark C. Creamer ◽  
Andrew B. Forbes ◽  
Dean P. McKenzie ◽  
...  
Keyword(s):  
Comparison Group ◽  
Psychological Disorders ◽  
Composite International Diagnostic Interview ◽  
Diagnostic Interview ◽  
Gulf War ◽  
Post Traumatic Stress ◽  
War Veterans ◽  
Gulf War Veterans ◽  
Psychological Stressors ◽  
Increased Risk

BackgroundQuestions remain about the long-term health impacts of the 1991 Gulf War on its veterans.AimsTo measure psychological disorders in Australian Gulf War veterans and a military comparison group and to explore any association with exposure to Gulf War-related psychological stressors.MethodPrevalences of DSM–IV psychological disorders were measured using the Composite International Diagnostic Interview. Gulf War-related psychological stressors were measured using a service experience questionnaire.ResultsA total of 31% of male Gulf War veterans and 21% of the comparison group met criteria for a DSM–IVdisorder first present in the post-Gulf War period. The veterans were at greater risk of developing post-Gulf War anxiety disorders including post-traumatic stress disorder, affective disorders and substance use disorders. The prevalence of such disorders remained elevated a decade after deployment. The findings can be explained partly as a ‘war-deployment effect‘. There was a strong dose–response relationship between psychological disorders and number of reported Gulf War-related psychological stressors.ConclusionsService in the 1991 Gulf War is associated with increased risk of psychological disorders and these are related to stressful experiences.

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