The Multiple Hit Hypothesis for Gulf War Illness: Self-Reported Chemical/Biological Weapons Exposure and Mild Traumatic Brain Injury

The Gulf War Illness Consortium (GWIC) was designed to identify objective biomarkers of Gulf War Illness (GWI) in 1991 Gulf War veterans. The symptoms of GWI include fatigue, pain, cognitive problems, gastrointestinal, respiratory, and skin problems. Neurotoxicant exposures during deployment, such as pesticides, sarin, and pyridostigmine bromide pills have been identified as contributors to GWI. We have also found an association between mild traumatic brain injury (mTBI) and increased rates of GWI. However, the combined impact of these physical and chemical exposures has not yet been explored in GWI. The objective of this study was to examine both self-reported mTBI and exposure to chemical/biological weapons (CBW) as a multiple or two hit model for increased risk of GWI and other chronic health conditions. The study population included 125 Gulf War (GW) veterans from the Boston GWIC. Exposure to CBW was reported in 47.2% of the study population, and 35.2% reported sustaining a mTBI during the war. Results confirmed that those with both exposures (mTBI and CBW) had higher rates of comorbid chronic health conditions while rates of GWI were equivalent for mTBI and CBW or mTBI alone. The timing of exposure to mTBI was found to be strikingly different between those with GWI and those without it. Correspondingly, 42.3% of GWI cases reported experiencing a mTBI during military service while none of the controls did (p = 0.0002). Rates of mTBI before and after the war did not differ between the cases and controls. In addition, 54% of cases compared to 14.3% of controls (p = <0.001) reported being exposed to CBW during military service. The current study examined the relation of the separate and combined effects of exposure to mTBI and CBW in 1991 GW veterans. The findings from this study suggest that both exposure to mTBI and CBW are associated with the development of GWI and multiple chronic health conditions and that combined exposure appears to lead to higher risk of chronic health effects.

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A-124 Sleep Quality and Quantity in Individuals Aging with Traumatic Brain Injury: Associations with Psychosocial Outcomes and Health Conditions

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.142 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1174-1174

Author(s):

Rachael M Riccitello ◽

Amanda R Rabinowitz ◽

Umesh M Venkatesan ◽

Kristine C Dell ◽

Samantha M Vervoordts ◽

...

Keyword(s):

Psychological Distress ◽

Brain Injury ◽

Sleep Quality ◽

Sleep Duration ◽

Chronic Health Conditions ◽

Health Conditions ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Chronic Health

Abstract Objective To examine the association of sleep quality/duration with chronic health conditions, psychological distress, and quality of life (QOL) in older adults with chronic traumatic brain injury (TBI). Methods 120 older adults (x-age = 64.2 ± 8.3) 1 or more years (med = 9.8, range = 1.1–45.6) post moderate–severe TBI reported on history of chronic health conditions and current sleep duration and quality. Participants were categorized by sleep duration (< 6, 6–8, >8 hours) and whether or not they felt well-rested. Outcome measures were QOL (Quality of Life after Brain Injury questionnaire) and psychological distress (Brief Symptom Inventory-18). Results 65% of individuals reported receiving 6–8 hours of sleep; 78% reported feeling well-rested. 17.5% reported no health conditions, 47.5% one condition, and 35% reported two or more. High blood pressure, high cholesterol, and diabetes were the most common. Number of health conditions was not related to sleep quality χ2(2,N = 120) =0.83, p = 0.66, or quantity, χ2(4,N = 120) =7.4, p = 0.12. MANCOVA controlling for age, chronicity, and injury severity revealed a significant association between poor sleep quality and decreased QOL across multiple life domains, V = 0.30, F(6,105) = 4.6, p < 0.001, ηp2 = 0.21. Sleep duration was also associated with QOL, Λ = 0.80, F(12,208) = 2.1, p < 0.05, ηp2 = 0.108. In ANCOVAs, poor sleep quality was related to increased psychological distress, F(1,110) = 18.3, p < 0.001, ηp2 = 0.142, but sleep duration was not, F(2,109) = 2.2, p = 0.12, ηp2 = 0.038. Conclusion Although most participants received the recommended amount of sleep, poor sleep quality/quantity were associated with poorer QOL and sleep quality was additionally associated with psychological distress. Chronic health conditions were prevalent in the sample, but not related to self-reported sleep quality/duration.

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Alterations in high-order diffusion imaging in veterans with Gulf War Illness is associated with chemical weapons exposure and mild traumatic brain injury

Brain Behavior and Immunity ◽

10.1016/j.bbi.2020.07.006 ◽

2020 ◽

Vol 89 ◽

pp. 281-290 ◽

Cited By ~ 1

Author(s):

Chia-Hsin Cheng ◽

Bang-Bon Koo ◽

Samantha Calderazzo ◽

Emily Quinn ◽

Kristina Aenlle ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Diffusion Imaging ◽

Gulf War ◽

High Order ◽

Chemical Weapons ◽

Gulf War Illness

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Improvements in Gulf War Illness Symptoms After Near-Infrared Transcranial and Intranasal Photobiomodulation: Two Case Reports

Military Medicine ◽

10.1093/milmed/usz037 ◽

2019 ◽

Vol 184 (9-10) ◽

pp. e568-e574 ◽

Cited By ~ 2

Author(s):

Linda L Chao

Keyword(s):

Traumatic Brain Injury ◽

At Risk ◽

Brain Injury ◽

Cognitive Dysfunction ◽

Musculoskeletal Pain ◽

Near Infrared ◽

Case Reports ◽

Gulf War ◽

Gulf War Illness ◽

Us Veterans

Abstract At least one-fourth of US veterans who served in the 1990–1991 Gulf War (GW) are affected by the chronic symptomatic illness known as Gulf War illness (GWI). This condition typically includes some combination of fatigue, headaches, cognitive dysfunction, musculoskeletal pain, and respiratory, gastrointestinal and dermatologic complaints. To date, effective treatments for GWI have been elusive. Photobiomodulation (PBM) describes the non-pharmacological, non-thermal use of light to stimulate, heal, and protect tissue that has either been injured, is degenerating, or else is at risk of dying. Significant benefits have been reported following application of transcranial PBM to humans with acute stoke, traumatic brain injury (TBI), and dementia. This report describes the first documentation of improved GWI symptoms in two GW veterans following 12 weeks of PBM treatments.

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